Prospective Back Pain Trajectories or Retrospective Recall-Which Tells Us Most About the Patient?

Area of Science:

• Pain research
• Clinical outcomes assessment
• Patient-reported outcomes

Background:

• Prospective repeated measures of low back pain (LBP) trajectories often differ from patients' retrospective recall.
• Understanding the clinical relevance of these differing trajectory types is crucial for effective LBP management.

Purpose of the Study:

• To compare the association of retrospective versus prospective pain trajectory assessments with clinical outcomes in LBP patients.
• To determine which pain trajectory assessment method provides more clinically relevant information.

Main Methods:

• 724 adults with LBP completed weekly prospective pain intensity and frequency measures for 52 weeks, forming trajectory classes.
• After 52 weeks, participants retrospectively selected their pain trajectory from the same classes.
• Clinical outcomes included disability, pain intensity, back beliefs, and work ability.

Main Results:

• Retrospective pain trajectory classes showed a stronger association with clinical outcomes (disability, pain, beliefs, work ability) than prospective trajectory classes.
• This association was consistent at baseline, follow-up (week 52), and for changes between baseline and follow-up.
• The strongest associations were observed at week 52, indicating retrospective recall's high clinical relevance over time.

Conclusions:

• Patients' retrospective assessment of their LBP trajectory is more strongly linked to their clinical status than prospective measures.
• Retrospective pain trajectory assessments may offer valuable clinical insights not captured by prospective data collection.
• Retrospective assessments provide a more clinically relevant understanding of LBP's perceived impact than repeated prospective measures.