Back Pain Risk Score Calculator
Estimates the risk of chronic or disabling low back pain using a validated psychosocial and physical screening approach based on the STarT Back Screening Tool (SBST). Stratifies patients into low, medium, or high risk to guide treatment decisions.
Physical & Functional Symptoms
Psychosocial Factors (Distress Subscale)
Overall Bothersomeness
Formula & Scoring
Based on the STarT Back Screening Tool (SBST) (Hill et al., 2008):
- Total Score = Sum of all 9 items (each scored 0 = Disagree, 1 = Agree; item 9 scored 0 = Not at all/Slightly, 1 = Moderately or worse). Range: 0–9.
- Distress Subscale Score = Sum of items 5–9 (psychosocial items). Range: 0–5.
Risk Stratification:
- Low Risk: Total score ≤ 3
- Medium Risk: Total score ≥ 4 AND Distress subscale ≤ 3
- High Risk: Total score ≥ 4 AND Distress subscale ≥ 4
Assumptions & References
- Designed for adults (≥18 years) presenting with non-specific low back pain in primary care settings.
- Not validated for back pain due to specific pathology (e.g., fracture, malignancy, infection, inflammatory arthritis).
- The tool stratifies patients to match treatment intensity to risk level, improving outcomes and resource allocation.
- Validated sensitivity ~91%, specificity ~39% for identifying high-risk patients (Hill et al., 2008).
- Reference: Hill JC, Whitehurst DG, Lewis M, et al. Comparison of stratified primary care management for low back pain with current best practice (STarT Back): a randomised controlled trial. Lancet. 2011;378(9802):1560–1571.
- Original validation: 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.
- This calculator is for educational and screening purposes only and does not replace clinical evaluation.