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Incidence trend of five common musculoskeletal disorders from 1990 to 2017 at the global, regional and national level: results from the global burden of disease study 2017
  1. Ziyi Jin1,
  2. Dandan Wang1,
  3. Huayong Zhang1,
  4. Jun Liang1,
  5. Xuebing Feng1,
  6. Jinkou Zhao2,
  7. Lingyun Sun1
  1. 1 Department of Rheumatology and Immunology, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, Jiangsu, China
  2. 2 Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
  1. Correspondence to Professor Lingyun Sun, Department of Rheumatology and Immunology, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing 210008, China; lingyunsun{at}


Objective To assess cause-specific incidence and its trend of musculoskeletal (MSK) disorders at global, regional and national levels.

Methods Data on MSK disorders were downloaded from the Global Burden of Disease 2017 study website. Estimated annual percentage change (EAPC) was calculated to quantify the temporal trend in age-standardised incidence rate (ASR) of MSK disorders, by age, sex, region and cause.

Results Between 1990 and 2017 incident cases of MSK disorders increased globally by 58% from 211.80 million to 334.74 million, with a decreasing ASR of 0.18% annually (95% CI −0.21% to −0.15%). The ASR decreased for low back pain (LBP), remained stable for neck pain (NP), and increased for rheumatoid arthritis (RA), osteoarthritis (OA) and gout, with EAPCs (95% CI) of −0.24 (−0.29 to –0.20), −0.09 (−0.13 to −0.05), 0.36 (0.28 to 0.43), 0.32 (0.28 to 0.36) and 0.22 (0.21 to 0.23), respectively. It appears women have higher increase in EAPC than men for RA (1.3 times) and gout (1.6 times). The absolute EAPC was strikingly high in high or high-middle sociodemographic index (SDI) regions for overall, LBP and gout, and in low SDI regions for NP. EAPC was significantly associated with baseline ASR for LBP (nonlinear), RA (ρ=−0.41) and gout (ρ=−0.42), also with 2017 human development index for LBP (ρ=−0.53) and gout (ρ=0.15).

Conclusions Globally, MSK disorders remain a public health burden. The ASR is decreasing for MSK disorders overall, mainly in high-middle SDI regions, but increasing for RA, OA and gout.

  • epidemiology
  • gout
  • low back pain
  • osteoarthritis
  • rheumatoid arthritis

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  • JZ and LS are joint senior authors.

  • Handling editor Josef S Smolen

  • JZ and LS contributed equally.

  • Contributors ZJ, JZ and LS helped in the study conception and design. Acquisition of data and analysis and drafting of the article was performed by ZJ. DW, HZ, JL, XF, JZ and LS helped in revising the article. All authors have finally approved the submitted version to be published.

  • Funding Bill and Melinda Gates Foundation funded the GBD study, but did not fund this study. This study was supported by the Major International (Regional) Joint Research Project (No. 81720108020), the Jiangsu Province Major Research and Development Programme (No. BE2015602), Jiangsu Province 333 Talent Grant (No. BRA2016001) and the National Key Research and Development Programme of China (No. 2017YFC0909003).

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  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository. We downloaded data from the Global Health Data Exchange (GHDx) query tool (