STarT Back Screening Tool (low back pain risk)
STarT Back Screening Tool (Hill 2008, Keele): stratifies low back pain in primary care into low, medium and high risk of persisting disability.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Pain spread down the leg
- Yes
- Pain in the shoulder or neck
- Yes
- Walked only short distances
- Yes
- Dressed more slowly than usual
- Yes
- Activity feels unsafe
- Yes
- Worrying thoughts
- Yes
- Bothersomeness
- Extremely (1)
Result: STarT Back total 7 of 9, psychosocial subscore 3 of 5 - medium risk.
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Low
- Total 3 or less.
- Medium
- Total 4 or more with a subscore of 3 or less.
- High
- Total 4 or more with a subscore of 4 or 5.
- Caution
- The GROUP, not the total, drives stratified care: the same total falls in either group depending on which items scored. Red flags are assessed separately.
What you enter
- Pain spread down the leg
- Pain in the shoulder or neck
- Walked only short distances
- Dressed more slowly than usual
- Activity feels unsafe (subscore)
- Worrying thoughts (subscore)
- Pain will never improve (subscore)
- Loss of enjoyment (subscore)
- Bothersomeness (subscore)
How this is calculated
- Scoring
- Items 1-8 score 1 for agree. Item 9 (bothersomeness) scores 1 only for very much or extremely. Total 0-9; subscore over items 5-9 is 0-5.
Hill JC, Dunn KM, Lewis M, et al. A primary care back pain screening tool: identifying patient subgroups for initial treatment. Arthritis Rheum. 2008;59(5):632-641. Keele University form, free for clinical use. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.