Temporal Trends in the Epidemiology of Lower Back Pain in the United States

Study Design. This was an observational study. Objective. This study aims to explore sociodemographic and regional geographic variations in Lower back pain (LBP) incidence, prevalence, and burden in the United States (US from 2000-2019. Summary of Background Data. LBP is a major contributor to lost wages and disability in the US. As LBP is associated with increasing age and sedentary lifestyle, the incidence of LBP is expected to rise. Due to LBP’s multifactorial causes, US epidemiological trends lack sufficient data. Methods. Descriptive epidemiological data including disability-adjusted life years (DALYs), incidence, and prevalence per 100,000 population from 2000-2019 were collected from the Global Burden of Disease database. State-level data regarding poverty, insurance and employment status were obtained from the US Government Census Bureau and US Department of Labor. Statistical significance was indicated by P <0.05. Results. From 2000-2019, the US demonstrated reductions in LBP incidence, prevalence, and DALYs. Regional analysis demonstrated the Midwest to have the greatest mean incidence, prevalence, and DALYs; with Midwestern females significantly more affected than females in other regions. Those aged 25-49 in the Midwest were impacted significantly more across all measures compared to age-matched populations in other regions. Nationally, there were no significant associations between unemployment and LBP. Poverty was inversely correlated with LBP incidence. Uninsured status was positively correlated with prevalence and DALYs. Conclusion. Although there has been progress in reducing the impact of LBP in the US, the Midwest region has greater rates for all measures compared to other US regions. Further, females and those aged 25-49 in the Midwest were more likely to be affected by LBP compared to counterparts in other regions. Future studies should identify specific factors contributing to elevated LBP rates in the Midwest in order to guide targeted interventions to reduce the incidence and burden of LBP there.