Objective  To analyze the burden and trend of musculoskeletal diseases (including gout, low back pain, neck pain, osteoarthritis, and rheumatoid arthritis) in China from 1990 to 2021, and to provide reference for formulating and adjusting prevention strategies for musculoskeletal diseases.

Methods  The Global Burden of Disease (GBD) in 2021 database was used to analyze the status and trend of the incidence and disability-adjusted life years (DALYs) rate of musculoskeletal diseases in China. Annual percentage change (EAPC) was used to comprehensively evaluate the trend of the burden of musculoskeletal diseases from 1990 to 2021. Gender and age-specific incidence and DALYs rate of musculoskeletal diseases were analyzed.

Results  In 2021, the number of cases of gout, low back pain, neck pain, osteoarthritis, and rheumatoid arthritis in China was 3,079,836, 43,374,995, 10,292,099, 11,652,721, and 247,307, respectively. Among the 5 major musculoskeletal conditions, low back pain had the greatest incidence and DALYs rate. From 1990 to 2021, the age-standardized incidence of gout, osteoarthritis, and rheumatoid arthritis showed an upward trend, that of neck pain remained relatively stable, and that of low back pain showed a downward trend. The age-standardized DALYs rates of gout and osteoarthritis showed an increasing trend, that of neck pain and rheumatoid arthritis remained relatively stable, and that of low back pain showed a decreasing trend. The results of the stratified analysis by gender and age indicated that, the age-standardized incidence rate and age-standardized DALYs rate of gout were higher in men than in women, while the age-standardized incidence rate and age-standardized DALYs rate of low back pain, neck pain, osteoarthritis, and rheumatoid arthritis were higher in women than in men. The age groups with the burden of the five major musculoskeletal diseases were relatively consistent, mainly in the 40-75 years old.

Conclusion  From 1990 to 2021, the disease burden of gout, osteoarthritis, and rheumatoid arthritis increased significantly in China, while the disease burden of neck pain remained relatively stable, while the disease burden of low back pain showed a certain improvement. In addition, the burden of musculoskeletal diseases in China varies greatly by gender and age. Targeted intervention measures should be implemented as soon as possible based on the stratification results by gender and age, and health education and basic healthcare should be improved to effectively reduce the burden of musculoskeletal diseases.

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