Temporal and spatial distribution of musculoskeletal disorders from 1990 to 2019: a systematic analysis of the global burden of disease.

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 six primary-origin MSDs were analysed across subregions, age groups and genders. Raw and age-standardised prevalence 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% to 0.70%), while low back pain was 8.62% (95% CI: 7.62% to 9.74%). Most MSDs exhibited an increasing prevalence with age, except for neck pain, which stabilised 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 with middle and low-income countries. Over time, most subregions 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 subregions remained significant. Multiple linear regressions revealed positive correlation 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.