The spatio-temporal distribution of musculoskeletal disorders: results of the Global Burden of Disease in 204 countries and 21 subregions between 1990 and 2019

Objectives This study aimed to globally assess the prevalence and distribution of primary-origin musculoskeletal disorders (MSDs) from 1990 to 2019 to better understand their temporal trends. Methods Using data from the 2019 Global Burden of Diseases, prevalence rates of 6 primary-origin MSDs were analysed across sub-regions, age groups, and genders. Raw and age-standardized data were mapped for over 204 countries. Cochran-Armitage trend tests evaluated temporal prevalence trends. The correlation between MSDs prevalence, national income levels, and medical density was explored. Results In 2019, global MSDs prevalence varied significantly among countries. Hip osteoarthritis had a prevalence of 0.56% [95% CI: 0.43-0.70], while low back pain was 8.62% [95% CI: 7.62-9.74]. Most MSDs exhibited an increasing prevalence with age, except for neck pain, which stabilized or decreased after age 45-50. Women generally had higher prevalence rates across all age groups. High-income countries consistently showed higher prevalence rates compared to middle and low-income countries. Over time, most sub-regions experienced a significant increase in MSD prevalence. However, after adjusting for age, the temporal trends for back and neck pain became non-significant, except for hip osteoarthritis, where half of the sub-regions remained significant. Multivariate linear regressions revealed positive associations between MSD prevalence and both national income level and medical density. Conclusion The global burden of MSDs is increasing due to population ageing, but other factors should be considered. Longitudinal studies with a wider range of MSDs and additional risk factors are needed for improved prevention strategies. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The French National Institute for Science, Technology, and Management (Cnam) grant and the Health and Enterprises Chair (Cnam, Malakoff Humanis). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced are available online at the global burden of disease site