Analysis and prediction of disease burden of neck pain in China and globally from 1990 to 2023_Chinese Journal of Evidence-Based Medicine

Authors：

YAN Jiabao ¹ , ZHOU Ruijun ² , LENG Chuan ² , ZHOU Xin ² ,  FAN Xiaohong ²

1. Guangzhou Zengcheng District Hospital of Traditional Chinese Medicine, Guangzhou 511300, P. R. China;
2. Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, P. R. China;

Corresponding?author：

FAN Xiaohong, Email: fanxiaohong@cdutcm.edu.cn

Keywords：

Neck pain; Global burden of disease; Age-standardized rates; Joinpoint regression; Bayesian age-period-cohort model

DOI：

10.7507/1672-2531.202511092

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To analyze trends in the burden of neck pain (NP) in China and worldwide from 1990 to 2023 and to forecast future incidence. Methods Data for China and the globe were obtained from the Global Burden of Disease (GBD) database (1990-2023), including incident cases, prevalent cases, disability-adjusted life years (DALY), and age-standardized incidence, prevalence, and DALY rates (ASIR, ASPR, ASDR). Trends were visualized and assessed using R 4.3.1 and Joinpoint 5.1. A Bayesian age-period-cohort (BAPC) model was used to forecast sex-specific ASIRs for 2024-2036. Results Incident cases, prevalent cases, and DALY increased markedly in both China and globally. Globally, ASIR, ASPR, and ASDR declined slightly. In China, ASIR decreased slightly, whereas ASPR and ASDR increased slightly. In 2023, the burden in China peaked at ages 55-59, and women bore a higher burden than men. Joinpoint analysis showed slow declines in ASIR, ASPR, and ASDR during 1990-2005, a rapid rise in 2005-2010, and a slow decline in 2010-2023. Based on BAPC model projections up to 2036, the ASIR, ASPR, and ASDR for males are expected to rise to 512.59, 2 224.55, and 221.60 per 100 000, respectively; whereas for females, these rates are projected to decrease to 629.27, 2 867.17, and 286.67 per 100 000, respectively. Conclusion Although absolute NP burden increased substantially in China and globally, age-standardized rates changed only modestly—slightly down or up depending on indicator and setting. NP burden shows clear sex and age differences, with women and those aged 55-59 being priority groups for prevention and control. Forecasts suggest that sex disparities in incidence will persist.

Citation： YAN Jiabao, ZHOU Ruijun, LENG Chuan, ZHOU Xin, FAN Xiaohong. Analysis and prediction of disease burden of neck pain in China and globally from 1990 to 2023. Chinese Journal of Evidence-Based Medicine, 2026, 26(8): 903-908. doi: 10.7507/1672-2531.202511092 Copy

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1. World Health Organization. International classification of diseases 11th revision (ICD-11)[Z]. 2025.
2. Wu H, Li Y, Zou C, et al. Global burden of neck pain and its gender and regional inequalities from 1990 - 2021: a comprehensive analysis from the Global Burden of Disease Study 2021[J]. BMC Musculoskelet Disord, 2025, 26(1): 94.
3. Wei J, Yang K, Xue J, et al. Disease burden of neck pain in China from 1990 to 2021 and its prediction for 2042: the global burden of disease study 2021[J]. J Pain Res, 2025, 18: 1975-1990.
4. GBD 2023 Disease and Injury and Risk Factor Collaborators. Burden of 375 diseases and injuries, risk-attributable burden of 88 risk factors, and healthy life expectancy in 204 countries and territories, including 660 subnational locations, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023[J]. Lancet, 2025, 406(10513): 1873-1922.
5. Clegg LX, Hankey BF, Tiwari R, et al. Estimating average annual percent change in trend analysis[J]. Stat Med, 2009, 28(29): 3670-3682.
6. GBD 2021 Neck Pain Collaborators. Global, regional, and national burden of neck pain, 1990-2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021[J]. Lancet Rheumatol, 2024, 6(3): e142-e155.
7. Kong T, Zhou X, Mao X. Reassessing the nonlinear trends in the burden of atrial fibrillation and atrial flutter from 1990 to 2021[J]. Europace, 2025, 27(7): euaf131.
8. 馬麗萍. 數讀2023年度國家老齡事業發展公報[J]. 中國社會工作, 2024, (29): 24-25, 27.
9. Meng Y, Xue Y, Yang S, et al. The associations between sedentary behavior and neck pain: a systematic review and meta-analysis[J]. BMC Public Health, 2025, 25(1): 453.
10. 中國互聯網絡信息中心. 第56次《中國互聯網絡發展狀況統計報告》[Z]. 2025.
11. Kazeminasab S, Nejadghaderi SA, Amiri P, et al. Neck pain: global epidemiology, trends and risk factors[J]. BMC Musculoskelet Disord, 2022, 23(1): 26.
12. Carmo GP, Grigioni J, Fernandes FAO, et al. Biomechanics of traumatic head and neck injuries on women: a state-of-the-art review and future directions[J]. Biology (Basel), 2023, 12(1): 83.
13. Chen Q, Zhang W, Sadana N, et al. Estrogen receptors in pain modulation: cellular signaling[J]. Biol Sex Differ, 2021, 12(1): 22.
14. Wright VJ, Schwartzman JD, Itinoche R, et al. The musculoskeletal syndrome of menopause[J]. Climacteric, 2024, 27(5): 466-472.
15. Zhu J, Li X, Wang X, et al. Positive association of neck pain and depression in American young adults: a cross-sectional study[J]. J Clin Neurosci, 2025, 137: 111315.
16. Salk RH, Hyde JS, Abramson LY. Gender differences in depression in representative national samples: meta-analyses of diagnoses and symptoms[J]. Psychol Bull, 2017, 143(8): 783-822.
17. 方磊. 廣東兩地老年人就醫情況及影響因素研究[D]. 廣州: 廣東藥科大學, 2018.
18. Chen, M, Liu, W, Tao, X. Evolution and assessment on China's urbanization 1960–2010: under-urbanization or over-urbanization[J]? Habitat Int, 2013, 38: 25-33.
19. Zhang, M, Rantanen, J. Improving the law on the prevention and control of occupational diseases in China: an employer-supporting management perspective[J]. Glob Health J, 2020, 4(2): 33-41.

Chinese Journal of Evidence-Based Medicine

Analysis and prediction of disease burden of neck pain in China and globally from 1990 to 2023

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