Longitudinal quantitative measures of the natural course of low back pain recovery

Study Design. A prospective study was developed to quantify acute low back pain recovery. Objective. To compare traditional self-report measures of low back pain recovery with a quantitative measure of recovery. Summary of Background Data. The magnitude of low back disorders in society continues to be a problem. To prevent secondary injuries, an understanding of recovery must be gained by comparing the natural course of recovery using several outcome measures. Methods. For this study, 16 occupational and 16 nonoccupational patients with low back pain were recruited. Recovery was monitored prospectively every 2 weeks for 3 to 6 months, using subjective work status, pain symptoms, activities of daily living, and objective functional performance probability (trunk kinematics). Results. Return to work underestimated the percentage of subjects impaired, as compared with all other outcome measures. Symptoms, activities of daily living, and functional performance probability all showed similar patterns of recovery for 0 to 12 weeks. At 14 weeks, there was a lag in functional performance recovery. Both symptoms and activities of daily living indicated that 80% of the population was recovered, whereas functional performance indicated the figure to be 68%. Conclusion. This prospective study demonstrates the natural course of recovery using several outcome measures. The objective kinematic functional performance measure of recovery quantifies a different aspect of impairment not evaluated by traditional subjective measures. Use of several outcome measures may lead to a better understanding of low back pain recovery or residual impairment, which may minimize the risk of recurrent injury.