STarT Back Screening Tool

Learn more about the STarT Back Screening Tool and get access to a free printable PDF with an example of how to use it.

By Ericka Pingol on Aug 2, 2025.

Fact Checked by Ericka Pingol.

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What is the Keele STarT Back Screening Tool?

Low back pain is a common yet often debilitating condition that affects individuals of all ages. It can present as an acute or chronic condition, and symptoms can range from mild to severe. Common causes of low back pain include muscle strain, degenerative disc disease, herniated discs, and osteoarthritis. Other causes may include poor posture, obesity, trauma, and various medical conditions.

The is designed to help healthcare providers identify the risk of persistent pain and disability in individuals with low back pain. The assessment is designed to evaluate a patient’s risk factors and help predict how likely they are to have persistent pain and disability. Providers can then use this information to develop an appropriate treatment plan for each individual’s condition and help them manage their pain and disability effectively.

STarT Back Screening Tool Template

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How does this STarT Back Tool work?

The STarT Back Tool is a 9-item questionnaire that assesses a patient’s risk factors for persistent pain and disability related to low back pain. Here's how to use the template:

Step One: Access the assessment tool

Get a copy of the free STarT Back Tool using the link provided on this page. You can also download it from the Carepatron app or our extensive resources library.

Step Two: Explain the test to your patient

Explain the purpose of the assessment to your patient. Ensure they understand that it is a short questionnaire and that their answers are confidential.

Step Three: Administer the tool

Administer the assessment tool to your patient. Have them answer each question as accurately and honestly as possible. Then, tally their test score before analyzing the results.

Step Four: Evaluate the patient’s results

Evaluate your patient's results and determine the severity of their condition. A score of less than 3 indicates low risk. Meanwhile, a score of 4 or more indicates a high risk for low back pain.

STarT Back Tool Scoring

The STarT Back Tool is used to determine risk in patients with low back pain. It helps practitioners identify the appropriate treatment for their patients based on their risk levels. A score of 0-3 indicates low risk, and 4 or higher is high risk.

High risk is also determined using the distress scale or the last five items of the questionnaire (Q5-9). The distress scale ranges from 0 to 5, with 5 being the highest.

It is important to note that the STarT Back Tool is not intended to replace a diagnosis or assessment but can be used as an additional tool in determining a patient’s risk level.

When to use this STarT Back assessment?

The STarT Back Tool is most effective when used at the beginning of treatment. You may also administer this treatment to:

Identify patients at risk of back pain

You can use this exam to identify potential risk factors and prevention strategies for back pain. You can also use it to assess if your patient will likely experience long-term or chronic back pain.

Track treatment progress

The STarT Back Tool is a great way to track the progress of a patient’s treatment over time. It provides valuable information that can be used to adjust treatments and evaluate their effectiveness.

Monitor patient outcomes

The STarT Back Tool can help you monitor your patient’s progress and ensure they receive the best care possible. You can use it to identify any changes in their condition and potential areas needing improvement.

Who are these STarT Back Screening Tool PDF for?

The STarT Back Screening Tool PDF is beneficial for:

Physical therapists
Occupational therapists
Chiropractors
Care providers
Primary care doctors
Nurses
Rehabilitation specialists

This tool can be used in hospitals, outpatient clinics, long-term care facilities, and home health services. Similarly, the tool can be used for educational purposes to help inform patients and families about various musculoskeletal issues they may be experiencing.

Benefits of free STarT Back Screening Tool

This free STarT Back Screening Tool can help assess patients with back-related issues. Here are some of its benefits:

Quick assessment

This exam is a quick and easy way to assess patients for low back pain. You can score patients in just a few minutes, and the results can be used to further inform treatment plans.

Accuracy

The STarT Back Tool has been tested and validated to ensure its accuracy. You can trust the results it provides for your patients.

Easy to use

This assessment is designed with simplicity in mind and can be used by anyone with minimal training. You don't need to read complicated instructions before using the tool.

Fully digital

You can access this template from your computer or mobile device anytime. This makes it easy to use in various settings and ensures the results are immediately available.

Commonly asked questions

Keele University developed the STarT Back Screening Tool to assess the risk of developing chronic back pain. The tool is based on evidence-based research and has been tested in clinical trials to ensure accuracy and reliability.

The STarT Back Screening Tool is used to evaluate an individual’s risk of developing chronic back pain. It helps identify individuals at greatest risk so they can receive more targeted care, allowing for quicker recovery. It also helps develop individual treatment plans tailored to each patient’s needs.

The STarT Back Screening Tool is scored from 0 to 9, with higher scores indicating an increased risk of developing chronic back pain. Each of the nine items is scored from 0 to 1, depending on the individual’s responses to questions.