Global, Regional, and National Burden of Neck Pain, 1990 to 2020 and Projections to 2050: A Systematic Analysis of the Global Burden of Disease Study 2021

Background: Neck pain is a highly prevalent condition that leads to considerable pain, disability, and economic cost. This study presents the most current estimates of neck pain prevalence and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2021 Study by age, sex and GBD super-region. Prevalence of neck pain is forecast to 2050 at the regional level.Methods: Systematic reviews identified population-representative surveys used to estimate the prevalence of and YLDs from neck pain, spanning from 1990 to 2017, with additional data from opportunistic review. Medical claims data from the USA and Taiwan were also included. Input data were pooled using DisMod-MR 2.1, a Bayesian meta-regression tool. Prevalence was forecast to 2050 using a mixed-effects model using Socio-demographic Index as a predictor and multiplying by projected population estimates.Findings: Globally, in 2020, neck pain affected 203 million (95% uncertainty interval [UI] 163–253) people. The global age-standardised prevalence of neck pain and YLDs were estimated to be 2450 per 100,000 (1960–3040) and 244 per 100,000 (165–346), respectively. Age-standardised prevalence remained stable between 1990 and 2020 (per centage change: 0·2% [-1·3 to 1·7]). Globally, females had a higher age-standardised prevalence (2890 per 100,000; 2330–3620) than males (2000; 1600–2480), with the prevalence peaking between 45 and 74 years in both sexes. By 2050, the estimated global number of neck pain cases is forecasted to be 269 million (219–322), with an increase of 32·5% from 2020. Decomposition analysis showed population growth was the primary contributing factor, followed by population ageing.Interpretation: Although age-standardised rates have remained stable over the past three decades, by 2050 the projected case numbers are expected to rise. With the highest prevalence in older adults (women > men), a higher impact expected in low- and middle-income countries, and a rapidly ageing global population, neck pain continues to pose a challenge in terms of disability burden worldwide. For future planning, it is essential we improve our mechanistic understanding of the different causes and risk factors for neck pain and prioritise the consistent collection of global neck pain data and increase the number of countries with data on neck pain.Funding: GBD 2021 is funded by Bill and Melinda Gates Foundation; A Wu is funded by the National Natural Science Foundation of China (82272555), Zhejiang Provincial Natural Science Foundation of China (LGF21H060010). M Cross is partly funded by the Bone and Joint Foundation for the Global Alliance for Musculoskeletal Health (GMUSC).Declaration of Interest: None.