II. Indications

  1. Low Back Injury and Return to Work
    1. Assesses risk for progression from Acute Low Back Pain to chronic Low Back Pain

III. Criteria: Yes/No Questions (assign one point for each yes or agree answer)

  1. My back pain has spread down my leg(s) at the same time
  2. I have had pain in the neck or Shoulder at the same time
  3. I have only walked short distances because of my back pain
  4. I have dressed more slowly than usual because of back pain
  5. It is not really safe for a person with a condition like mine to be physically active
  6. Worrying thoughts have been going through my mind a lot of the time
  7. I feel that my back pain is terrible and that it is never going to get any better
  8. In general, I have not enjoyed all the things I used to enjoy

IV. Criteria: Severity

  1. Overall how bothersome has your back pain been in the last 2 weeks?
    1. Score 0: Not at all, Slightly or Moderately
    2. Score 1: Very much or Extremely

V. Interpretation

  1. Add the criteria (0-9 points total)
    1. One point for each YES or AGREE answer from the top 8 criteria questions
    2. One point if the severity in the last 2 weeks has been very or extremely severe
  2. Interpretation
    1. Score <=3: Low risk of progression to chronic Low Back Pain
    2. Score >3: Higher risk of chronic Low Back Pain

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