Epidemiological Trends and Dietary Risk Factors of Neck Pain in Asia: A 1990-2021 Analysis with Projections to 2035

Abstract

Background: Neck pain is a leading global cause of disability, ranking fourth in terms of disability-adjusted life years (DALYs) and significantly affecting quality of life. In Asia, where rapid urbanization, demographic shifts, and occupational changes are taking place, neck pain poses a major public health challenge. However, detailed analyses of neck pain trends in the region, particularly from 2019 to 2021, remain limited. This study aims to address this gap by examining the burden of neck pain across 49 Asian countries from 1990 to 2021 and projecting future trends up to 2035. In addition, we investigate the causal relationship between dietary factors and neck pain through Mendelian Randomization (MR) analysis to identify potential modifiable risk factors.

Methods: Using data from the Global Burden of Disease (GBD) 2021 database, we analyzed incidence and DALYs trends across different age groups, genders, and sociodemographic indices (SDIs) in Asia. Estimated Annual Percentage Change (EAPC) was calculated to assess temporal trends. Dietary contributions to neck pain were evaluated using MR analysis based on 243 dietary categories, with data drawn from the UK Biobank.

Findings: From 1990 to 2021, DALYs due to neck pain in Asia increased by 93.81%, while incidence cases rose by 83.71%. The burden was most pronounced in older age groups, particularly those aged 50 and above, with females consistently experiencing higher DALYs and age-standardized incidence rates (ASIR) compared to males. China and India exhibited the highest neck pain burden, while countries with moderate SDI, such as China and India, showed the steepest rise. The MR analysis identified 29 dietary categories significantly associated with neck pain. Protective factors included thin butter/margarine spread, turnip/swede intake, and glucosamine/chondroitin supplements. Risk factors included melon intake, cheesy biscuits, and powdered soups, highlighting the potential for dietary interventions in neck pain management.

Interpretation: The burden of neck pain in Asia has escalated significantly, particularly among aging populations and women. The projected rise in neck pain incidence through 2035 underscores the urgent need for targeted public health strategies. Additionally, our findings suggest that dietary interventions could play a role in managing neck pain, opening new pathways for prevention and treatment. Public health initiatives should focus on these dietary risk factors alongside ergonomic and lifestyle interventions to reduce the growing burden of neck pain in Asia.

Funding: XC would like to acknowledge the support from, CUHKSZ-Dalian Practical Biotechnology Joint Laboratory Fund, the University Development Fund (UDF01002532) of The Chinese University of Hong Kong, Shenzhen, The Chinese University of Hong Kong, Shenzhen start-up funding (K10120220254), Shenzhen Natural Science Foundation, Shenzhen-Hong Kong Cooperation Zone for Technology and Innovation (HZQB-KCZYB-2020056), Shenzhen Peacock Talent Programme, Key project at central government level: The ability establishment of sustainable use for valuable Chinese medicine resources (2060302) and Ministry of Science and Technology of China International Young Scholar Grant (QN2023032004L).

Declaration of Interest: The authors declared that there was no potential conflict of interest.

Keywords: Neck Pain, Global Burden of Disease, Disability-Adjusted Life Years, Incidence Rate, Musculoskeletal Disorder