Musculoskeletal & Rheumatology
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[comment memo="The British Pain Society guidelines recommend the early use of the Keele STarT Back Tool at two weeks post Low Back Pain episode if there is little improvement in pain and function.
This approach identifies patients at low, medium and high risk of developing chronic Low Back Pain and adjusts treatment recommendations to reduce risk.

Low risk patients benefit from education, self management and reassurance.

Medium risk patients require targeted 1:1 goal centered physiotherapy.

High-risk patients are recommended to initiate cognitive behavioural therapy in conjunction to individual physiotherapy.

(Lee J. et al., 2013)."]

The Keele STarT Back Screening Tool.

[select name="Q1" value="Disagree (0 points)=0|Agree (1 points)=1"] < – Q1. My back pain has spread down my leg(s) at some time in the last 2 weeks (over the last two weeks)?
[select name="Q2" value="Disagree (0 points)=0|Agree (1 points)=1"] < – Q2. I have had pain in the shoulder or neck at some time in the last 2 weeks (over the last two weeks)?
[select name="Q3" value="Disagree (0 points)=0|Agree (1 points)=1"] < – Q3. I have only walked short distances because of my back pain (over the last two weeks)?
[select name="Q4" value="Disagree (0 points)=0|Agree (1 points)=1"] < – Q4. In the last 2 weeks, I have dressed more slowly than usual because of back pain (over the last two weeks)?
[select name="Q5" value="Disagree (0 points)=0|Agree (1 points)=1"] < – Q5. It’s not really safe for a person with a condition like mine to be physically active (over the last two weeks)?
[select name="Q6" value="Disagree (0 points)=0|Agree (1 points)=1"] < – Q6. Worrying thoughts have been going through my mind a lot of the time (over the last two weeks)?
[select name="Q7" value="Disagree (0 points)=0|Agree (1 points)=1"] < – Q7. I feel that my back pain is terrible and it’s never going to get any better (over the last two weeks)?
[select name="Q8" value="Disagree (0 points)=0|Agree (1 points)=1"] < – Q8. In general I have not enjoyed all the things I used to enjoy (over the last two weeks)?
[select name="Q9" value="Not at all (0 points)=0|Slightly (0 points)=0|Moderately (0 points)=0|Very much (1 points)=1|Extremely (1 points)=1"] < - Q9. Overall, how bothersome has your back pain been in the last 2 weeks?

Total -> [calc value="score=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9)" memo="calculation"] out of 9 points

Interpretation –> [calc value=”score=(Q1)+(Q2)+(Q3)+(Q4)+((Q5)*100)+((Q6)*100)+((Q7)*100)+((Q8)*100)+((Q9)*100);score>404?’subscore 5, High Risk’:score>304?’subscore 4, High Risk’:score>300?’subscore 3, Medium Risk’:score>204?’subscore 3, Low Risk (total score less than 4)’:score>201?’subscore 2, Medium Risk’:score>104?’subscore 2, Low Risk’:score>102?’subscore 1, Medium Risk’:score>4?’subscore 1, Low Risk’:score>3?’subscore 0, Medium Risk’:’subscore 0, Low Risk'” memo=”categorized by total points and subscore of questions 5 through 9″]
The British Pain Society guidelines recommend the early use of the Keele STarT Back Tool at two weeks post Low Back Pain episode if there is little improvement in pain and function.
This approach identifies patients at low, medium and high risk of developing chronic Low Back Pain and adjusts treatment recommendations to reduce risk.

Low risk patients benefit from education, self management and reassurance.

Medium risk patients require targeted 1:1 goal centered physiotherapy.

High-risk patients are recommended to initiate cognitive behavioural therapy in conjunction to individual physiotherapy.

(Lee J. et al., 2013).


The Keele STarT Back Screening Tool.

< – Q1. My back pain has spread down my leg(s) at some time in the last 2 weeks (over the last two weeks)?
< – Q2. I have had pain in the shoulder or neck at some time in the last 2 weeks (over the last two weeks)?
< – Q3. I have only walked short distances because of my back pain (over the last two weeks)?
< – Q4. In the last 2 weeks, I have dressed more slowly than usual because of back pain (over the last two weeks)?
< – Q5. It’s not really safe for a person with a condition like mine to be physically active (over the last two weeks)?
< – Q6. Worrying thoughts have been going through my mind a lot of the time (over the last two weeks)?
< – Q7. I feel that my back pain is terrible and it’s never going to get any better (over the last two weeks)?
< – Q8. In general I have not enjoyed all the things I used to enjoy (over the last two weeks)?
< - Q9. Overall, how bothersome has your back pain been in the last 2 weeks?

Total -> calculationscore=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9) out of 9 points

Interpretation –> ”categorized”score=(Q1)+(Q2)+(Q3)+(Q4)+((Q5)*100)+((Q6)*100)+((Q7)*100)+((Q8)*100)+((Q9)*100);score>404?’subscore

Result - Copy and paste this output: