STarT Back Trial

  • Hill J, D Whitehurst, Lewis M, Bryan S, Dunn K, Foster N, Konstantinou, Main C, Mason E, Somerville S, Sowden G, Vohora K, Hay E. A randomised controlled trial and economic evaluation of stratified primary care management for low back pain compared with current best practice: The STarT Back trial.The Lancet, Volume 378, Issue 9802, Pages 1560 – 1571, 29 October 2011 link
  • E Hay, K Dunn, J Hill, M Lewis, E Mason, K Konstantinou, G Sowden, S Somerville, K Vohora, D Whitehurst and C Main. A randomised clinical trial of subgrouping and targeted treatment for low back pain compared with best current care. The STarT Back Trial Study Protocol . BMC Musculoskeletal Disorders April 2008, 9:58 link
  • Whitehurst DG, Bryan S, Lewis M, Hill J, Hay EM. Exploring the cost-utility of stratified primary care management for low back pain compared with current best practice within risk-defined subgroups. Ann Rheum Dis 2012; 71(11): 1796-802. link
  • Main C, Hill J, Sowden G and Watson P. Integrating physical and psychosocial approaches to treatment in low back pain. The development and content of the Keele STarT Back trial’s “high risk” intervention (StarTBack; ISRCTN 37113406). Physiotherapy 2011 link

IMPaCT study

  • Foster N, Mullis R, Hill J, Lewis M, Whitehurst D, Doyle C, Konstantinou K, Main C, Somerville S, Sowden G, Wathall S, Young J, Hay E. Effect of Stratified Care for Low Back Pain in Family Practice (IMPaCT Back): A Prospective Population-Based Sequential Comparison. Ann Fam Med March/April 2014 vol. 12 no. 2 102-111 link
  • Sowden G, Hill JC, Konstantinou K, Khanna M, Main C, Salmon P, Somerville S, Wathall S, Foster N. Subgrouping for targeted treatment in primary care for low back pain: the treatment system and clinical training programmes used in the IMPaCT Back study (ISRCTN 55174281) Family Practice 2011 link
  • Foster NE, Mullis R, Young J, Doyle C, Lewis M, Whitehurst D, Hay EM; IMPaCT Back Study team. IMPaCT Back study protocol. Implementation of subgrouping for targeted treatment systems for low back pain patients in primary care: a prospective population-based sequential comparison. BMC Musculoskeletal Discord 2010; 20(11): 186. link

STarT Back Tool

  • Hill JC, Dunn KM, Lewis M, Mullis R, Main CJ, Foster NE, et al. A primary care back pain screening tool: identifying patient subgroups for initial treatment. Arthritis Rheum 2008;59(5):632–41 link
  • Jonathan C. Hill *, Kate M. Dunn, Chris J. Main, Elaine M. Hay. Subgrouping low back pain: A comparison of the STarT Back Tool with the Örebro Musculoskeletal Pain Screening Questionnaire. Eur J. Pain 2009; doi:10.1016/j.ejpain.2009.01.003 link
  • Gusi N, Del Pozo-Cruz B, Olivares PR, Hernandez-Mocholi M, Hill JC. The Spanish version of the “STarT Back Screening Tool” (SBST) in different subgroups. Aten Primaria 2010 link
  • Hill et al. Comparing the STarT Back Screening Tool’s Subgroup Allocation of Individual Patients With That of Independent Clinical Experts. Clinical Journal of Pain: 2010 – Volume 26 – Issue 9 – pp 783-787 link
  • Morsø L, Albert H, Kent P, Manniche C, Hill J. Translation and discriminative validation of the STarT Back Screening Tool into Danish. Eur Spine J. 2011 Dec;20(12):2166-73. Epub 2011 Jul 19. link
  • Olivier Bruyere, Maryline Demoulin, Clara Brereton, Fabienne Humblet, Daniel Flynn, Jonathan C Hill, Didier Maquet, Julien Van Beveren, Jean-Yves Reginster, Jean-Michel Crielaard and Christophe Demoulin. Translation validation of a new back pain screening questionnaire (the STarT Back Screening Tool) in FrenchArchives of Public Health, 70:12 (07 Jun 2012) link
  • Nadine E Foster, Johannes R Anema, Dan Cherkin, Roger Chou, Steven P Cohen, Douglas P Gorss, Paulo H Ferreria, Julie M Fritz, Bart W Koes, Wilco Peul, Judith A Turner, Chris G Maher. Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet. Link

Stratified Care

  • Hill JC. The early identification of patients with complex back pain problems. The Back Care Journal. Spring 2010. link
  • Hill JC, Fritz JM. Psychosocial influences on low back pain, disability, and response to treatment. Phys Ther. 2011;91:712–721 link
  • Fritz JM, Beneciuk JM, George SZ. Relationship between categorization with the STarT Back Screening Tool and prognosis for people receiving physical therapy for low back pain. Phys Ther. 2011;91:722–732 link
  • Alice Kongsted, Else Johannesen and Charlotte Leboeuf-Yde. Feasibility of the STarT back screening tool in chiropractic clinics: a cross-sectional study of patients with low back pain. Chiropractic & Manual Therapies 2011, 19:10 doi:10.1186/2045-709X-19-10 link
  • Fritz JM, Beneciuk JM, George SZ. Relationship between categorization with the STarT Back Screening Tool and prognosis for people receiving physical therapy for low back pain. Phys Ther 2011;91:722–732. link
  • del Pozo-Cruz B, Parraca JA, del Pozo-Cruz J, Adsuar JC, Hill JC, Gusi N. 2012. An occupational, internet-based intervention to prevent chronicity in sub-acute lower back pain: A randomized controlled trial. Journal of Rehabilitation Medicine. vol. 44(7), 581-587. link
  • Hill JC, Foster NE, Hay EM. 2010. Cognitive behavioural therapy shown to be an effective and low cost treatment for subacute and chronic low-back pain, improving pain and disability scores in a pragmatic RCT. Evid Based Med, vol. 15(4), 118-119. link
  • Field J, Newell D. Relationship between STarT Back Screening Tool and prognosis for low back pain patients receiving spinal manipulative therapy. Chiropr Man Therap. 2012 Jun 12;20(1):17. link
  • Beneciuk JM, Bishop MD, Fritz JM, Robinson ME, Asal NR, Nisenzon AN, George SZ. The STarT Back Screening Tool and Individual Psychological Measures: Evaluation of Prognostic Capabilities for Low Back Pain Clinical Outcomes in Outpatient Physical Therapy Settings. Phys Ther. 2012 Nov 2. link
  • Wideman TH, Hill JC, Main CJ, Lewis M, Sullivan MJ, Hay EM. Comparing the responsiveness of a brief, multidimensional risk screening tool for back pain to its unidimensional reference standards: The whole is greater than the sum of its parts. Pain. 2012 Nov;153(11):2182-91. link
  • N Foster & A Delitto. Embedding Psychosocial Perspectives Within Clinical Management of Low Back Pain: Integration of Psychosocial Informed Management Principles into Physical Therapist Practice – Challenges and Opportunities. Physical Therapy 2011. link
  • Kongsted A, Johannesen E, Leboeuf-Yde C. Feasibility of the STarT Back Screening Tool in chiropractic clinics: A cross-sectional study of patients with low back pain. Chiropr Man Therap. 2011;19(1):10. link
  • C Main & S George. Psychologically informed practice for management of low back pain: future directions in practice and research. Physical Therapy 2011. link

References to High Risk Matched Treatment STarTBack Online course

  1. Nicholas MK, George SZ. Psychologically Informed Interventions for Low Back Pain: An Update for Physical Therapists. Phys Ther. 2011;
  2. Hay EM, Mullis R, Lewis M, Vohora K, Main CJ, Watson P, et al. Comparison of physical treatments versus a brief pain-management programme for back pain in primary care: A randomised clinical trial in physiotherapy practice. Lancet. 2005;
  3. Hill JC, Whitehurst DGT, Lewis M, Bryan S, Dunn KM, Foster NE, et al. Comparison of stratified primary care management for low back pain with current best practice (STarT Back): A randomised controlled trial. Lancet. 2011;
  4. Williams DA, Thorn BE. An empirical assessment of pain beliefs. Pain. 1989;
  5. G W. The back pain Revolution. 2nd ed. Edinburg: Churchill Livingstone; 2004.
  6. Foster NE, Thomas E, Bishop A, Dunn KM, Main CJ. Distinctiveness of psychological obstacles to recovery in low back pain patients in primary care. Pain. 2010;
  7. Vlaeyen JWS, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art. Pain. 2000.
  8. Young Casey C, Greenberg MA, Nicassio PM, Harpin RE, Hubbard D. Transition from acute to chronic pain and disability: A model including cognitive, affective, and trauma factors. Pain. 2008;
  9. de Raaij EJ, Ostelo RW, Maissan F, Mollema J, Wittink H. The Association of Illness Perception and Prognosis for Pain and Physical Function in Patients With Noncancer Musculoskeletal Pain: A Systematic Literature Review. J Orthop Sport Phys Ther. 2018;
  10. Newman MG; Borkovec MT. Cognitive behavioural therapy for worry and generalised anxiety disorder. In: Simos G, editor. Cognitive behaviour therapy: A guide for the practising clinician. Taylor & Francis; 2002.
  11. Sullivan MJL, Thorn B, Haythornthwaite JA, Keefe F, Martin M, Bradley LA, et al. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain. 2001;
  12. Quartana PJ, Campbell CM, Edwards RR. Pain catastrophizing a critical review. Expert Review of Neurotherapeutics. 2009.
  13. Vlaeyen JWS, Linton SJ. Fear-avoidance model of chronic musculoskeletal pain: 12 years on. Pain. 2012.
  14. Vlaeyen JWS, Crombez G, Linton SJ. The fear-avoidance model of pain. Pain. 2016;
  15. Crombez G, Eccleston C, Van Damme S, Vlaeyen JWS, Karoly P. Fear-Avoidance Model of Chronic Pain. Clin J Pain. 2012;
  16. Pincus T, Smeets RJEM, Simmonds MJ, Sullivan MJL. The fear avoidance model disentangled: Improving the clinical utility of the fear avoidance model. Clinical Journal of Pain. 2010.
  17. Leeuw M, Elle M, Goossens EJB, Linton SJ, Crombez G, Boersma K, et al. The Fear-Avoidance Model of Musculoskeletal Pain: Current State of Scientific Evidence. J Behav Med. 2007;
  18. Moseley GL, Butler DS. Fifteen Years of Explaining Pain: The Past, Present, and Future. J Pain. 2015;
  19. Louw A, Diener I, Butler DS, Puentedura EJ. The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain. Archives of Physical Medicine and Rehabilitation. 2011.
  20. Bandura A. Self-efficacy: Toward a unifying theory of behavioral change. Adv Behav Res Ther. 1978;
  21. Bandura A. Cambridge handbook of psychology, health and medicine. In: A. Baum, S. Newman, J. Wienman, R. West & CM, editor. Cambridge: Cambridge University Press.; 1997. p. 160–2.
  22. Barlow JH. Understanding exercise in the context of chronic disease: an exploratory investigation of self-efficacy. Percept Mot Skills. 1998;
  23. McAuley E, Jerome GJ, Marquez DX, Elavsky S, Blissmer B. Exercise self-efficacy in older adults: Social, affective, and behavioral influences. Ann Behav Med. 2003;
  24. Ruben, Mollie A. Jodoin, Adriana N. Hall, Judith A. Blanch-Hartigan D. The impact of acute pain self-efficacy on pain intensity and the accurate recall of pain. JoHealth Psychol Rep. 2018;6(2):136–45.
  25. Nicholas MK. The pain self-efficacy questionnaire: Taking pain into account. Eur J Pain. 2007;
  26. Daykin AR, Richardson B. Physiotherapists’ Pain Beliefs and Their Influence on the Management of Patients with Chronic Low Back Pain. Spine (Phila Pa 1976). 2004;
  27. Adams LM, Turk DC. Central sensitization and the biopsychosocial approach to understanding pain. J Appl Biobehav Res. 2018;
  28. Eccleston C, Crombez G. Worry and chronic pain: A misdirected problem solving model. Pain. 2007.
  29. Harris R. ACT made simple an easy-to-read primer on acceptance and commitment therapy. Act made simple. 2009.
  30. Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. The Lancet. 2018.
  31. Linton SJ, Shaw WS. Impact of Psychological Factors in the Experience of Pain. Phys Ther. 2011;
  32. Fishbain DA, Cutler R, Rosomoff HL, Rosomoff RS. Chronic pain-associated depression: Antecedent or consequence of chronic pain? A review. In: Clinical Journal of Pain. 1997.
  33. Flor H, Kerns RD, Turk DC. The role of spouse reinforcement, perceived pain, and activity levels of chronic pain patients. J Psychosom Res. 1987;
  34. Romano JM, Turner JA, Jensen MP, Friedman LS, Bulcroft RA, Hops H, et al. Chronic pain patient-spouse behavioral interactions predict patient disability. Pain. 1995;
  35. Newton-John TRO. Solicitousness and chronic pain: A critical review. Pain Reviews. 2002.
  36. McCracken LM, Samuel VM. The role of avoidance, pacing, and other activity patterns in chronic pain. Pain. 2007;
  37. Sowden G, Hill JC, Konstantinou K, Khanna M, Main CJ, Salmon P, et al. Targeted treatment in primary care for low back pain: The treatment system and clinical training programmes used in the impact back study (ISRCTN 55174281). Fam Pract. 2012;
  38. Main CJ, Sowden G, Hill JC, Watson PJ, Hay EM. Integrating physical and psychological approaches to treatment in low back pain: The development and content of the STarT Back trial’s “high-risk” intervention (StarT Back; ISRCTN 37113406). Physiotherapy. 2012;