The Keele STarT Back Screening Tool 
 
Patient name: _______________________________    Date: _____________ 
 
Thinking about the last 2 weeks tick your response to the following questions: 
 	 	Disagree 	Agree 

9.  Overall, how bothersome has your back pain been in the last 2 weeks? 

	Not at all 	Slightly 	Moderately 	Very much 	Extremely 
	 	 	 	 	 
	0 	0 	0 	1 	1 

	Total score (all 9): __________________   	Sub Score (Q5-9):______________