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Global, regional, and national burden of neck pain in the general population, 1990-2017: systematic analysis of the Global Burden of Disease Study 2017

BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m791 (Published 26 March 2020) Cite this as: BMJ 2020;368:m791
  1. Saeid Safiri, assistant professor1 2 3,
  2. Ali-Asghar Kolahi, associate professor4,
  3. Damian Hoy, research associate5 6,
  4. Rachelle Buchbinder, professor7 8,
  5. Mohammad Ali Mansournia, associate professor9,
  6. Deepti Bettampadi, research fellow10,
  7. Ahad Ashrafi-Asgarabad, doctoral student11,
  8. Amir Almasi-Hashiani, assistant professor12,
  9. Emma Smith, research fellow6 13,
  10. Mahdi Sepidarkish, assistant professor14,
  11. Marita Cross, research fellow6,
  12. Mostafa Qorbani, associate professor15,
  13. Maziar Moradi-Lakeh, professor16,
  14. Anthony D Woolf, professor17,
  15. Lyn March, professor5 6,
  16. Gary Collins, professor18,
  17. Manuela L Ferreira, professor6
  1. 1Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
  2. 2Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  3. 3Social Determinants of Health Research Center, Department of Community Medicine, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
  4. 4Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  5. 5Global Alliance for Musculoskeletal Health
  6. 6Institute of Bone and Joint Research, The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  7. 7Monash Department of Clinical Epidemiology, Cabrini Institute, Melbourne, Australia
  8. 8Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
  9. 9Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  10. 10Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
  11. 11Department of Epidemiology, School of Health, Bam University of Medical Sciences, Bam, Iran
  12. 12Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
  13. 13Pain Management Research Institute, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
  14. 14Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
  15. 15Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
  16. 16Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
  17. 17Royal Cornwall Hospital and University of Exeter Medical School, Truro, UK
  18. 18Centre for Statistics in Medicine, NDORMS, Botnar Research Centre, University of Oxford, Oxford, UK
  1. Correspondence to: M L Ferreira, Level 10, The Kolling Building, Royal North Shore Hospital, St Leonards, 2065, NSW, Australia manuela.ferreira{at}sydney.edu.au
  • Accepted 25 February 2020

Abstract

Objective To use data from the Global Burden of Disease Study between 1990 and 2017 to report the rates and trends of point prevalence, annual incidence, and years lived with disability for neck pain in the general population of 195 countries.

Design Systematic analysis.

Data source Global Burden of Diseases, Injuries, and Risk Factors Study 2017.

Main outcome measures Numbers and age standardised rates per 100 000 population of neck pain point prevalence, annual incidence, and years lived with disability were compared across regions and countries by age, sex, and sociodemographic index. Estimates were reported with uncertainty intervals.

Results Globally in 2017 the age standardised rates for point prevalence of neck pain per 100 000 population was 3551.1 (95% uncertainty interval 3139.5 to 3977.9), for incidence of neck pain per 100 000 population was 806.6 (713.7 to 912.5), and for years lived with disability from neck pain per 100 000 population was 352.0 (245.6 to 493.3). These estimates did not change significantly between 1990 and 2017. The global point prevalence of neck pain in 2017 was higher in females compared with males, although this was not significant at the 0.05 level. Prevalence increased with age up to 70-74 years and then decreased. Norway (6151.2 (95% uncertainty interval 5382.3 to 6959.8)), Finland (5750.3 (5058.4 to 6518.3)), and Denmark (5316 (4674 to 6030.1)) had the three highest age standardised point prevalence estimates in 2017. The largest increases in age standardised point prevalence estimates from 1990 to 2017 were in the United Kingdom (14.6% (10.6% to 18.8%)), Sweden (10.4% (6.0% to 15.4%)), and Kuwait (2.6% (2.0% to 3.2%)). In general, positive associations, but with fluctuations, were found between age standardised years lived with disability for neck pain and sociodemographic index at the global level and for all Global Burden of Disease regions, suggesting the burden is higher at higher sociodemographic indices.

Conclusions Neck pain is a serious public health problem in the general population, with the highest burden in Norway, Finland, and Denmark. Increasing population awareness about risk factors and preventive strategies for neck pain is warranted to reduce the future burden of this condition.

Footnotes

  • Contributors: SS, AAK, LM, and MLF designed the study. SS, AAK, MAM, AA-H, and AA-A analysed the data and performed the statistical analyses. SS, AAK, DB, ES, MS, MC, and MLF drafted the initial manuscript. All authors reviewed the drafted manuscript for critical content and approved the final version. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. SS and MLF are the guarantors.

  • Funding: The Global Burden of Disease Study is funded by the Bill and Melinda Gates Foundation. The funder was not involved in the preparation of this manuscript. The present report was also supported by Shahid Beheshti University of Medical Sciences, Tehran, Iran (grant No 20732-4-7). MLF holds a National Health and Medical Research Council of Australia research fellowship.

  • Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: Global Burden of Disease Study is funded by the Bill and Melinda Gates Foundation, and this study was supported by Shahid Beheshti University of Medical Sciences, Tehran, Iran (grant No 20732-4-7); no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

  • Ethical approval: This study was approved by ethics committee of Shahid Beheshti University of Medical Sciences, Tehran, Iran (IR.SBMU.RETECH.REC.1398.446).

  • Data sharing: The data used for the analyses are publicly available from the Institute of Health Metrics and Evaluation website (www.ihme.org).

  • The lead authors (SS and MLF are manuscript’s guarantors) affirms that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and any discrepancies have been explained.

  • Dissemination to participants and related patient and public communities: Our results will be disseminated through media outlets and presentations at scientific conferences and academic events. Given that no patients were recruited for the study, there are no plans to disseminate the results to study participants.

  • Publisher’s note: Published maps are provided without any warranty of any kind, either express or implied. BMJ remains neutral with regard to jurisdictional claims in published maps.

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