Socio-Demographic Inequalities in the Burden of Low Back Pain Across Development Strata: Sex-Specific, Age-Standardized Trends in Prevalence, Incidence and Disability from the Global Burden of Disease Study 2023, 2003-2023.
5 affiliations
- 1Department of Physical Therapy, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia.
- 2Department of Health Rehabilitation Sciences, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk, Saudi Arabia.
- 3Department of Physiotherapy, Composite Regional Centre for Skill Development, Rehabilitation, and Empowerment of Persons with Disabilities, Lucknow, Uttar Pradesh, India.
- 4Department of Physiotherapy, Faculty of Medical & Health Sciences, Integral University, Lucknow, Uttar Pradesh, India.
- 5Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
Abstract
Background
Low back pain (LBP) is a leading contributor to non-fatal disability and rehabilitation needs worldwide. Monitoring trends across sociodemographic strata is important for understanding whether the disability burden is changing equitably across health systems.Purpose
To examine temporal trends and socio-demographic inequalities in the burden of LBP across Socio-demographic Index (SDI) groups from 2003 to 2023 using Global Burden of Disease Study 2023 estimates.Methods
GBD 2023 estimates for LBP prevalence, incidence and years lived with disability (YLDs) were analysed across High, High-middle, Middle, Low-middle and Low SDI groups. Age-standardized rates, all-age numbers, percentage changes and estimated annual percentage changes were calculated. Sex-specific, age-specific and inequality analyses were conducted. The change in all-age YLDs was also partitioned approximately into demographic (population growth and ageing) and epidemiological (age-standardized rate) components.Results
Age-standardized prevalence, incidence, and YLD rates declined modestly across all SDI groups between 2003 and 2023. The greatest decline in age-standardized YLD rates occurred in High SDI countries (-6.2%), whereas Low-middle SDI countries showed the smallest reduction (-2.5%). Despite declining rates, all-age YLD numbers increased in every SDI group, with the largest increase in Low SDI group (+65.2%). In 2023, High SDI had the highest age-standardized YLD rate, followed by Low SDI. Female YLD rates exceeded male rates in all SDI groups, and age-specific YLD rates rose steadily with age. Demographic change alone would have increased YLDs by 28.4% in High SDI and by 51.6-73.9% in the other groups; falling age-standardized rates offset 28.1% of this demographic increase in High SDI but only 7.1-14.1% elsewhere.Conclusion
The age-standardized rates of LBP declined modestly, but the absolute disability burden increased substantially, particularly in lower-SDI settings. Persistent SDI, sex, and age inequalities indicate the need for scalable, gender-sensitive, and context-responsive rehabilitation services. Outside High SDI settings, improvements in age-standardized rates offset only a small share of demographically driven growth in disability.
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BibTeX
@article{alshehri2026sociodemographic,
title = {{Socio-Demographic Inequalities in the Burden of Low Back Pain Across Development Strata: Sex-Specific, Age-Standardized Trends in Prevalence, Incidence and Disability from the Global Burden of Disease Study 2023, 2003-2023.}},
author = {Mohammed M Alshehri and Mohammad Abu Shaphe and Rashid Ali Beg and Aafreen Aafreen and Shahul Hameed Pakkir Mohamed and G Shankar Ganesh and Abdur Raheem Khan and Monira I Aldhahi},
journal = {Journal of pain research},
year = {2026},
month = oct,
doi = {10.2147/jpr.s651675},
url = {https://europepmc.org/article/MED/42898646},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Socio-Demographic Inequalities in the Burden of Low Back Pain Across Development Strata: Sex-Specific, Age-Standardized Trends in Prevalence, Incidence and Disability from the Global Burden of Disease Study 2023, 2003-2023.
AU - Mohammed M Alshehri
AU - Mohammad Abu Shaphe
AU - Rashid Ali Beg
AU - Aafreen Aafreen
AU - Shahul Hameed Pakkir Mohamed
AU - G Shankar Ganesh
AU - Abdur Raheem Khan
AU - Monira I Aldhahi
PY - 2026
DA - 2026/10/14
JO - Journal of pain research
DO - 10.2147/jpr.s651675
UR - https://europepmc.org/article/MED/42898646
AB - Background Low back pain (LBP) is a leading contributor to non-fatal disability and rehabilitation needs worldwide. Monitoring trends across sociodemographic strata is important for understanding whether the disability burden is changing equitably across health systems.Purpose To examine temporal trends and socio-demographic inequalities in the burden of LBP across Socio-demographic Index (SDI) groups from 2003 to 2023 using Global Burden of Disease Study 2023 estimates.Methods GBD 2023 estimates for LBP prevalence, incidence and years lived with disability (YLDs) were analysed across High, High-middle, Middle, Low-middle and Low SDI groups. Age-standardized rates, all-age numbers, percentage changes and estimated annual percentage changes were calculated. Sex-specific, age-specific and inequality analyses were conducted. The change in all-age YLDs was also partitioned approximately into demographic (population growth and ageing) and epidemiological (age-standardized rate) components.Results Age-standardized prevalence, incidence, and YLD rates declined modestly across all SDI groups between 2003 and 2023. The greatest decline in age-standardized YLD rates occurred in High SDI countries (-6.2%), whereas Low-middle SDI countries showed the smallest reduction (-2.5%). Despite declining rates, all-age YLD numbers increased in every SDI group, with the largest increase in Low SDI group (+65.2%). In 2023, High SDI had the highest age-standardized YLD rate, followed by Low SDI. Female YLD rates exceeded male rates in all SDI groups, and age-specific YLD rates rose steadily with age. Demographic change alone would have increased YLDs by 28.4% in High SDI and by 51.6-73.9% in the other groups; falling age-standardized rates offset 28.1% of this demographic increase in High SDI but only 7.1-14.1% elsewhere.Conclusion The age-standardized rates of LBP declined modestly, but the absolute disability burden increased substantially, particularly in lower-SDI settings. Persistent SDI, sex, and age inequalities indicate the need for scalable, gender-sensitive, and context-responsive rehabilitation services. Outside High SDI settings, improvements in age-standardized rates offset only a small share of demographically driven growth in disability.
SN - 1178-7090
ER -