Lower back pain is a major health problem in the UK, affecting four out of five people at some point in their lifetime. Back pain is estimated to make up 20% of total health spend in the UK and was responsible for almost 10 million lost work days in 2014.

There are many treatments available for back pain, but previously it was unclear which patients would benefit most from which treatment. To address this problem Arthritis Research UK funded a team of researchers to develop the STarT Back Screening Tool (a short questionnaire) to screen primary care patients with low back pain for indicators that are relevant to treatment choice.  The information gathered by the tool helps primary care clinicians to group patients into group of low, medium or high-risk of pain. By being able to categorise patients into these three groups, clinicians are then able to target interventions to each sub-group of patients to help improve outcome.

Research revealed significant improvements in symptoms, a 50% reduction in days off work, and cost savings to the NHS of £34 per patient when using the targeted approach compared to usual care.

The tool is now recommended by the Royal College of General Practitioners and the British Pain Society, and has been adopted by more than 20 healthcare organisations in the UK. Further afield, over 85 clinical services worldwide are using the tool to categorise patients and inform them of the probable progression of their pain.

Feedback from this activity shows that adopting the STarT Back approach is having a substantial beneficial impact where it is being implemented, making a big difference to patients, with reduced access times to clinical services, high patient satisfaction and reduced clinical variation. Researcher perspective