The global macroeconomic burden of musculoskeletal disorders

BACKGROUND: Previous literature lacks comprehensive reporting on the economic burden of musculoskeletal disorders (MSDs). Our objective was to report the macroeconomic burden of MSDs, and their subcategories, including rheumatoid arthritis (RA), osteoarthritis (OA), low back pain, neck pain, gout, and other MSDs, across 183 countries and regions in 2021. METHODS: Data on overall MSDs and their subcategories in disability-adjusted life years (DALYs) were collected from the Global Burden of Disease (GBD) 2019 and 2021 database. Purchasing power parity (PPP)-adjusted gross domestic product (GDP) data were obtained from the World Bank. GDP and DALY data were combined, and the value of lost welfare (VLW) method was used to estimate macroeconomic losses. All results are presented in 2021 international dollars (PPP-adjusted). RESULTS: In 2021, MSDs were responsible for a global VLW of $2099.84 billion, representing 1.41% of global GDP. Among MSD subcategories, low back pain had the highest VLW/GDP ratio (43%), followed by other MSDs (27%) and OA (14%). The highest economic burden was observed in high-income regions (1.74% of GDP), while the lowest was in sub-Saharan Africa (0.65% of GDP). At the national level, Cyprus and Japan experienced losses exceeding 2% of GDP. Age- and sex-specific analyses further showed that the highest burden occurred among people aged 55-59 years, with females generally bearing greater costs than males, except in gout. CONCLUSION: MSDs impose a substantial economic burden on the global economy, especially in high-income regions. Moreover, it is anticipated that lower- and middle-income regions will also face significant economic impacts from MSDs in the future. Among the subcategories, low back pain and other MSDs contribute the most to the overall disease burden. High-income regions should prioritize cost-effective care pathways, early intervention, and access to quality rehabilitation services, while lower- and middle-income regions need to strengthen MSDs' prevention and invest in healthcare infrastructure to better manage the growing burden.