Abstract
<title>Abstract</title> <p>Background Musculoskeletal disorders (MSK) are the leading cause of disability worldwide. With the increasing aging of the global population, the prevalence pattern of MSK is undergoing profound changes. This study aimed to systematically evaluate the spatiotemporal trends, population characteristics and underlying drivers of global burden of MSK from 1990 to 2023. Method Data on the prevalence, disability-adjusted life years (DALYs) and deaths of low back pain, osteoarthritis, neck pain, gout, rheumatoid arthritis and other MSK diseases were extracted from 21 regions in 204 countries and regions. Average annual percent change (AAPC) was used to estimate the growth rate. Four-quadrant analysis was used to identify the priority of policy intervention. Attributable decomposition method was used to quantify the contribution of population growth, ageing and epidemiological risk changes to the growth of burden. Result There was significant geographical heterogeneity in the global burden of MSK in 2023, with North America having the highest standardized DALY rate and East Asia showing an explosive increase. The burden of rheumatoid arthritis (RA) was higher in women than in women except for gout (male to female ratio was 0.4). Osteoarthritis and gout are the subtypes with the fastest growing burden between 1990 and 2023, with Aapcs exceeding 2% in East Asia and North America in general. The four-quadrant analysis showed that gout and osteoarthritis (OA) in East Asia were in the "high burden-high growth" urgent intervention quadrant. Mortality pattern analysis showed that MSK-related mortality increased sharply after age 75 years old, which was highly coupled with the aging process. Attributable decomposition shows that the surge in global cases is mainly driven by population growth (about 60%) and ageing, but in high-income regions, the rise in epidemiological risks (such as the obesity epidemic) has become a real driver that cannot be ignored. Conclusion The global burden of musculoskeletal conditions continues to increase and is shifting from high-income countries to lower-middle-income countries. The growth in burden is driven by demographic transitions combined with rising lifestyle risks. Health policy makers should integrate MSK prevention and control into the whole life cycle health management according to the principle of "driver differentiation", especially adopt gender-sensitive early intervention measures in high-growth regions to cope with the increasing challenge of aging.</p>