Keele STarT Back screening tool
Stratifies low back pain into low, medium or high risk of poor prognosis (9 items).
What it is for
Low back pain with or without sciatica at the first point of contact. NICE NG59 (2016, updated 2020): consider a risk stratification tool such as STarT Back to inform shared decision-making about stratified management.
Use the working calculator
The working Keele STarT Back screening tool calculator is on our calculators page. It is free and needs no account. Enter the values and it shows the result with the reading that goes with it.
The calculators are free. The trial opens the protocols and pathways they link to.What you enter
The calculator asks for 9 items.
Thinking about the last 2 weeks — tick if the patient agrees
- 1. My back pain has spread down my leg(s) at some time (1 point)
- 2. I have had pain in the shoulder or neck at some time (1 point)
- 3. I have only walked short distances because of my back pain (1 point)
- 4. I have dressed more slowly than usual because of back pain (1 point)
- 5. It’s not really safe for a person with a condition like mine to be physically active (1 point)Psychosocial subscale item.
- 6. Worrying thoughts have been going through my mind a lot of the time (1 point)Psychosocial subscale item.
- 7. I feel that my back pain is terrible and it’s never going to get any better (1 point)Psychosocial subscale item.
- 8. In general I have not enjoyed all the things I used to enjoy (1 point)Psychosocial subscale item.
- 9. Overall, how bothersome has your back pain been? (psychosocial subscale item)Options: Not at all / slightly / moderately; Very much / extremely
How the result is read
The result is shown as STarT Back total, out of a maximum of 9.
The calculator reads each total as follows. Where a single answer changes the reading (for example sex, age or one extreme value), the working calculator says so.
| Total | Band | What the calculator says |
|---|---|---|
| 0 to 3 | Low risk | |
| 4 to 9 | Medium or high risk (see subscale) |
Sources
These are the sources the calculator cites. Check the current version before relying on a threshold.
Related
For qualified clinicians. A score supports a clinical decision and does not make it: check the inputs, read the cited source, and use the tools in your clinical system for patient care where one is provided.