A more formal tool used to assess psycho-social issues is the 'Keele STarT' musculoskeletal screening tool. This is very closely based on the Keele STarT Back screening tool which has been validatedfor use in the screening and targeted treatment of patients with back pain
This enables the identification of those spinal pain patients at risk of developing chronicity thus allowing the implementation of appropriate treatment.
The Keele STarT back tool was developed by the Primary Care Centre at Keele University, with funding from Arthritis Research UK. It is well validated for low back pain, but is also being used widely for other spinal pains.
In Sheffield a local consensus decision has been taken to use a generic musculoskeletal screening tool for all spinal pains.
In Sheffield, primary care clinicans are strongly encouraged to use the STarT MSK tool to help inform the need for, and speed of referral.
- Low risk - suggests patient will probably settle with appropriate advice and analgesia - but should be advised to reconsult in primary care if they feel needed.
- Medium risk - suggests higher level of vigilance is appropriate, 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 trial analgesia, advice and review first)
Click on the right to download a copy of the Keele STart back musculoskeletal screening tool. There's also an online version of the STarT MSK screening tool.