Interregional Trends in Lower Back Pain in the United States: 2000-2019

Introduction: Lower back pain (LBP) continues to be a significant cause of disability, lost wages, and medical costs in the United States. This number is expected to continue rising due to the population aging and expanding. Several reports highlight the burden of chronic lower back pain to around 250 billion. This study aims to interrogate interregional trends for lower back pain in the United States for the years 2000-2019 and better inform resource allocation.

Methods: Data were collected from the Global Burden of Disease (GBD) database from 2000 to 2019. The United States was divided into four regions per the US government census regions. Age-standardized measures were used for all metrics (reported per 100,000 people). All statistical analyses were done using R Studio (4.2.1) with p< 0.05 indicating statistical significance.

Results: For 2019, the Midwest region had the highest disease burden (1,474) followed by the West region (1,433). The Midwest region and West region also had the first and second highest prevalence and incidence, respectively (Midwest incidence: 3,622; West incidence: 3,547; Midwest prevalence: 13,325; West prevalence: 12,967). From 2000-2019, the mean DALYs and prevalence were significantly higher in the Midwest than the Northeast, South and West regions (p < 0.001). There was no significant difference between the South and West mean DALYs or prevalence during this period. The Midwest had a significantly higher mean incidence than the Northeast, South and West regions (p < 0.001). The Northeast had a significantly lower incidence than the South and West regions (p < 0.01 and p< 0.001, respectively).

Conclusion : LBP remains a major contributor to morbidity and economic costs within the United States, with the results of this study indicating potential regional disparities. This data may be used to guide targeted prevention strategies and improved health care.