Validation of the STarT Back Screening Tool in the Military

Subjects with low back pain presenting to primary care will be enrolled in a study that aims
to evaluate the utility of the SBST for providing risk-stratified care. The concept of this
approach revolves around matching treatment to patients based on their risk for developing
chronic disability from back pain. Those at low risk receive less treatment, and those at
high risk need more specialized treatment, that includes psychosocially-focused and cognitive
considerations. This approach will be compared to usual care, where general practitioners
carry out the course of action they think best for each patient, without any other guidance.
Patients will be followed for 1 year.

Inclusion Criteria:

1. Males and females who are between the ages of 18-50 years old

2. Primary complaint of LBP for any duration, with or without associated radiculopathy

3. Can speak and understand English

4. Be willing and able to give full, informed written consent

Exclusion Criteria:

1. Red Flags: Any potentially serious or systemic disorders (e.g., cauda equina
compression, inflammatory arthritis, compression fracture, malignancy, infection,
severe neurological progression), serious illness or comorbidity

2. Spinal surgery in the past 24 months

3. Current pregnancy (or within the last 6 months)

4. Already receiving treatment (other than primary care) for this episode of LBP

5. Inability to attend regular treatment sessions

6. Pending litigation or a medical evaluation board