Yellow flags START Back tool
A more formal tool used to assess psychosocial issues is the STarT back screening tool. This enables the identification of those LBP patients at risk of developing chronicity thus allowing the implementation of appropriate treatment.
In Sheffield primary care clinicans are encouraged to use this tool to determine need and speed of referral
Low risk - suggests patient will probably settle with appropriate advice and analgesia - return to primary care if they feel needed
Medium risk - suggests higher level of vigilance, plan review in primary care in 1-2 weeks, consider referral to Back pain specialist team if not improving
High risk - suggests significant risk of developing chronicity - consider early referral to Back pain specialist teams (may be appropriate to trail analgesia, advice and review first)
The early treatment of patients at risk of developing chronic pain has been found to be effective at preventing long-term disability and chronicity.
This Word document contains a copy of the STarT screening tool.
