Burden of Neck Pain, with Sex-Stratified Trends, Sociodemographic Disparities, and Age-Period-Cohort Drivers: A Systematic Analysis of the Global Burden of Disease Study 2021

Abstract

Importance: Neck pain is a widespread and disabling condition affecting global health and quality of life, with significant economic and social implications. Studying it through the Global Burden of Disease (GBD) database is crucial for understanding its prevalence, risk factors, and disparities, enabling the development of targeted interventions and intelligent diagnostic tools to improve patient outcomes and reduce healthcare burdens. This research is essential for advancing public health strategies and addressing the multifaceted impact of neck pain on individuals and societies.

Objectives: To estimate neck pain burden of disease in the all word. Understanding the long-term trends and underlying factors is crucial for effective intervention and policy formulation.

Methods: Data were utilized from the GBD Study 2021 to analyze the incidence, prevalence, and disability-adjusted life years (DALYs) due to neck pain in global from 1990 to 2021. Joinpoint regression analysis identified key changes in trends, while age-period-cohort analysis and decomposition analysis quantified the contributions of aging, epidemiological changes, and population growth to these trends.

Results: From 1990 to 2021, global neck pain incidence, prevalence, and DALYs surged by 73.8%, 79.8%, and 78.4%, respectively, with age-standardized rates (ASRs) remaining stable (incidence: 513.21 to 519.28; prevalence: 2,436.71 to 2,443.02; DALYs: 241.96 to 242.3). Striking gender disparities emerged: female ASRs rose significantly (incidence: +2.7%; prevalence: +1.8%; DALYs: +1.6%), while male ASRs declined (incidence: −0.9%; prevalence: −2.0%; DALYs: −2.0%). Middle sociodemographic index (SDI) regions bore the highest absolute burden, whereas high-middle SDI quintiles exhibited the steepest ASR increases. Southeast Asia, East Asia, and Oceania faced the most rapid ASR growth (incidence EAPC=0.06; DALYs EAPC=0.1), contrasting with declining trends in most regions. Age-specific analysis revealed peak incidence at 40–44 years and DALYs at 45–49 years, with females disproportionately affected across all age strata. Joinpoint regression identified critical inflection points: ASRs declined sharply during 1996–2005 (annual percent change [APC]: −0.96% to −1.03%, P<0.05), followed by sustained increases post-2005, particularly among females (APC=0.09%, P<0.05). Age-period-cohort modeling demonstrated U-shaped period effects (nadir: 2002–2007) and birth cohort-linked risk escalation, lowest in the 1990–1994 cohort. Frontier analysis highlighted efficiency gaps: high-SDI nations (e.g., Austria, Sweden) diverged furthest from optimal benchmarks, while low-SDI countries (Somalia, Bhutan) achieved near-ideal outcomes relative to SDI. Projections to 2035 forecast stable male ASRs but rising female burdens, underscoring urgent needs for gender-specific interventions. Decomposition attributed 68% of incidence growth to demographic shifts, with aging driving 42% of female DALYs increases.

Conclusion: This multilevel analysis reveals neck pain as a persistently escalating public health priority, shaped by sociodemographic transitions, aging populations, and entrenched gender inequities.

Keywords: Neck pain, Global, Incidence, Prevalence, Disease Burden, Global burden of disease