Comprehensive Analysis of Modifiable Global Risk Factors for Low Back Pain
Xiangji Man1, Xue Yun1, Lei Zhang2
1Department of Orthopaedics II, Xi'an Central Hospital Affiliated to Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.
Journal of Pain Research
|August 5, 2026
Summary
High body mass index (BMI) and environmental factors significantly contribute to global low back pain (LBP). Public health strategies must target these risks, especially in low-income regions, to combat rising LBP burdens.
Area of Science:
- Epidemiology
- Public Health
- Musculoskeletal Disorders
Background:
- Low back pain (LBP) is a significant global public health issue.
- Understanding modifiable risk factors is key to effective LBP interventions.
- Epidemiological trends require continuous assessment for public health strategies.
Purpose of the Study:
- To analyze the global burden of LBP attributable to modifiable risk factors from 1990-2021.
- To project future LBP trends to 2041.
- To identify key risk factors and demographic patterns associated with LBP.
Main Methods:
- Utilized data from the Global Burden of Disease (GBD) study, the Chinese Health and Retirement Longitudinal Study (CHARLS), and Genome-Wide Association Studies (GWAS).
- Employed age-sex analyses, cohort-based non-linear relationship analyses, and two-sample Mendelian randomization.
- Applied the GBD analytical framework for comprehensive burden assessment.
Main Results:
- Environmental/occupational risks, smoking, and high body mass index (BMI) are primary contributors to LBP burden.
- A rising global LBP burden attributable to high BMI is projected, particularly in low and middle Sociodemographic Index (SDI) regions.
- Smoking-related LBP burden is declining, while high BMI shows a non-linear relationship with LBP risk, supported by Mendelian randomization.
Conclusions:
- Urgent, targeted public health strategies are needed to address modifiable risks for LBP.
- Interventions should consider regional, age, and sex disparities.
- Mitigating high BMI is crucial for reducing the future global burden of LBP.
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