Objective  To analyze the changing trends of musculoskeletal disease burden in China from 1990 to 2021, predict the development trend of musculoskeletal disease burden from 2022 to 2036, and provide a basis for formulating the prevention and treatment strategies of musculoskeletal disease.

Methods  Data on the burden of musculoskeletal disease in China from 1990 to 2021, including prevalence, incidence, mortality and disability-adjusted life years (DALYs), were collected from the Global Burden of Disease Study (GBD) 2021 database. These indicators were used to describe the changing trend of musculoskeletal disease burden in China over the past 30 years. Joinpoint regression model was used to calculate the average annual percent change (AAPC) of age-standardized incidence rate and age-standardized DALYs rate of musculoskeletal disease. Age-period-cohort (APC) model was used to estimate the age, period, and cohort effects of the incidence and prevalence risks of musculoskeletal disease. The autoregressive integrated moving average model (ARIMA) was used to predict the age-standardized incidence rate and age-standardized DALYs rate of musculoskeletal disease from 2022 to 2036.

Results  From 1990 to 2021, the number of patients with musculoskeletal disease in China increased from 170.594 4 million [95% uncertain interval (UI): 159.481 1 million-182.116 3 million] to 342.123 8 million (95%UI: 322.5419 million-361.025 9 million), incident cases rose from 42.000 8 million (95%UI: 37.804  1 million-46.495 4 million) to 68.647 0 million (95%UI: 61.976 5 million-74.990 2 million), and DALYs grew from 16.629 5 million person-years (95%UI: 12.164 7 million person-years-22.138 1 million person-years) to 30.419 4 million person-years (95%UI: 21.752 7 million person-years-41.618 8 million person-years). The disease burden of musculoskeletal disease increased with age, and the disease burden indicators for women were higher than those for men in the same period. The Joinpoint regression model results showed that the age-standardized incidence rate of musculoskeletal disease decreased from 4 039.14/100 000 (3 648.56/100 000-4  437.89/100 000) to 3 629.61/100 000 (3 307.36/100 000-3 954.47/100 000) from 1990 to 2021, with an AAPC of -0.34%; the age-standardized DALYs rate decreased from 1 615.73/100 000 (1 169.69/100 000-2 151.25/100 000) to 1 578.37/100  000 (1 140.06/100 000-2 129.43/100 000), with an AAPC of -0.06%. The APC model results showed that the longitudinal age curves of the incidence and prevalence rates of musculoskeletal disease both showed significant upward trends; with the passage of time, the incidence and prevalence risks both showed downward trends. The cohort results showed that the incidence and prevalence risks of later-born cohorts were lower than those of earlier-born cohorts. The ARIMA model prediction results showed that by 2036, the age-standardized incidence rate of musculoskeletal disease will increase to 3 158.08/100 000 for men and 4 180.89/100 000 for women. The age-standardized DALYs rate among men will increase to 1 439.41/100 000, and among women, it can reach 1 822.06/100 000.

Conclusion  The aggravation of population aging will continue to increase the disease burden of musculoskeletal disease in China, which will bring increasing pressure to the public health system of China. It is necessary to formulate personalized prevention and treatment strategies for musculoskeletal disease for different genders and age groups.

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