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Original article

The burden of neck pain across US states, 1990–2021: a systematic analysis of Global Burden of Disease Study 2021 data

Somin Park1orcid , Dong Woo Shin2orcid , Jung-Hyun Park1orcid , Yoonkyung Chang2orcid , Moo-Seok Park3orcid , Hyun Kyung Kim3orcid , Tae-Jin Song3orcid
DOI: https://doi.org/10.12771/emj.2026.01270 [Epub ahead of print]
Published online: October 2, 2026
1Department of Medicine, Ewha Womans University College of Medicine, Seoul, Korea
2Department of Neurology, Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea
3Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea
Corresponding author:  Tae-Jin Song
Email: knstar@ewha.ac.kr
Received: 27 March 2026   • Revised: 11 September 2026   • Accepted: 16 September 2026
Somin Park, Dong Woo Shin and Jung-Hyun Park contributed equally to this study as co-first authors.
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Purpose
Neck pain is a leading musculoskeletal cause of disability in the United States. This study aimed to assess temporal, geographic, and demographic disparities in its burden across US states from 1990 to 2021.
Methods
Global Burden of Disease 2021 data for all 50 US states and the District of Columbia were analyzed for 1990–2021. Counts and age-standardized rates per 100,000 population for prevalence, incidence, and years lived with disability (YLD) were compared by region, state, sex, age group, and sociodemographic index (SDI) level.
Results
In 2021, neck pain accounted for 9,430,000 (95% uncertainty interval [UI], 7,400,000–11,590,000) prevalent cases, 1,900,000 (95% UI, 1,490,000–2,320,000) incident cases, and 920,000 (95% UI, 620,000–1,300,000) YLD, increases of 41.17%, 37.44%, and 38.72%, respectively, from 1990. Although age-standardized incidence increased globally by 1.18% (0.07%–2.39%) over 1990–2021, the United States had small declines in age-standardized incidence (−0.11%; 95% UI, −0.18% to −0.06%), prevalence (−0.20%; 95% UI, −0.32% to −0.10%), and YLD (−1.12%; 95% UI, −2.02% to −0.22%). Neck pain rates were highest in the District of Columbia, Georgia, and Delaware and lowest in North Carolina, Alaska, and Wyoming. The burden peaked at ages 40–49 years and was higher in females. Age-standardized YLD rates for neck pain were significantly positively correlated with the SDI (Spearman’s ρ=0.601, P<0.001).
Conclusion
The geographic and demographic disparities in neck pain burden across US states indicate a need for targeted interventions.

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