Question numbers may not run in sequence — this is normal. The assessment skips questions that are not relevant to your situation based on your previous answers.
⚠ Severe acute injury? If you have just had a significant injury and are in severe pain, cannot stand or walk, or your back pain came on after a fall, collision, or accident — go to A&E or call 999 rather than completing this assessment. This tool is for assessment of back pain, not for acute emergencies. If your pain is manageable, please continue.
⚠ Numbness between your legs, or loss of bladder/bowel control? If you have any new or worsening numbness around your saddle area (between your legs, inner thighs, or groin), difficulty passing urine, or loss of bladder or bowel control, alongside back pain — go to A&E or call 999 now, rather than completing this assessment. This combination can indicate a rare but serious condition called cauda equina syndrome, which needs emergency treatment. If you don’t have these symptoms, please continue.
Symptom Assessment & Safety Screening
Answer honestly — there are no right or wrong answers. Conditional questions appear based on your previous answers so you will typically see around 30–35 questions. Allow around 8 minutes.
Safety screening included
Results in minutes
Shareable with your clinician
- Identification of the most likely pattern or cause of your back pain, based on your answers
- A plain-language explanation of what that pattern means and why it emerged from your answers
- A confidence indicator — likely, worth considering, or possible — so you know how to weight the findings
- Safety screening: flags for conditions that need urgent or prompt medical attention
- A context-specific report about your back pain, that you can share with your GP/doctor or other clinician
- Links to relevant fact sheets and the myBackPain knowledge library
- A "what to watch for" guide — symptoms that would change the picture or require earlier review
The report guides rather than diagnoses. All findings are described as patterns based on your answers, subject to your clinician’s review. The assessment is not a substitute for clinical examination.
Before we begin — About you
Question numbers may not run in sequence — this is normal for a conditional assessment
About you — Step 1 of 2
What is your age range?
About you — Step 2 of 2
Which of the following applies to you?
We ask because some causes of back pain are more common in men or women, and some follow-up questions are only relevant to one group. Your answer helps us give you the most relevant report.
Section 1 of 7 — About your pain
Where is your pain?
Step 1 — Select the outline closest to your build
Zones are approximate — tap the area closest to where you feel your pain. Select all that apply.
Figure A — Front view
Tap a dashed region to select it
Selected areas
Nothing selected yet
Section 1 of 7 — About your pain
Do you also have significant pain or stiffness in your neck or upper/mid back?
This assessment is specifically for lower back pain, so we won\u2019t ask about your neck or upper back in detail \u2014 but knowing whether it\u2019s part of the same pattern is genuinely useful context.
Section 1 of 7 — About your pain
How long have you had this back pain?
Section 1 of 7 — About your pain
How did it start?
Section 1 of 7 — About your pain
How bad is your pain on average?
0 = no pain | 10 = worst imaginable
Section 1 of 7 — About your pain
When you stand, how would you describe your posture?
This helps us understand how your pain is affecting your body position — some presentations cause the body to adopt a protective posture automatically, which is clinically significant.
Section 1 of 7 — About your pain
What makes your pain worse?
Select all that apply
Section 1 of 7 — About your pain
What position, if any, relieves your pain?
Select all that apply
Section 1 of 7 — About your pain
When sitting, how would you describe your usual posture?
This helps us understand habitual loading patterns that may be contributing to your pain — many people don’t make the connection themselves.
Section 1 of 7 — About your pain
Does the pain travel into your leg or buttock?
Pain that travels into the leg — particularly below the knee — suggests a nerve may be involved. Pain that stays in the buttock or upper thigh is often referred from the lower back without nerve involvement. The distinction significantly affects diagnosis and treatment.
Section 1 of 7 — About your pain
Compared to your back pain, how would you describe your leg pain?
Whether your leg pain or your back pain is more severe helps identify what is driving your symptoms. Leg-dominant pain often points to a disc or nerve root as the primary problem, particularly if it’s on one side. Back-dominant pain with some leg involvement suggests the spine itself is the main source. If your leg pain is dominant on both sides equally, that pattern is more suggestive of spinal stenosis than a single nerve root.
Section 1 of 7 — About your pain
How would you describe the leg pain or sensation?
Shooting/electric and burning suggest nerve root involvement (sciatica). Aching/heaviness is more typical of referred pain. Numbness or weakness are important neurological signs — tell your practitioner specifically about these.
Section 1 of 7 — About your pain
You mentioned some numbness or weakness — has this been getting worse over time?
Section 1 of 7 — About your pain
Have you noticed any change in how you walk or your balance, or found yourself tripping or stumbling more than you used to?
Section 2 of 7 — Your symptoms
How does your pain affect your sleep at night?
Night pain that wakes you in the second half of the night — roughly 2am to 5am — and eases once you get up and move is a specific pattern associated with inflammatory spinal conditions. It is different from pain caused by lying awkwardly. If yours wakes you in the early hours, please tell us precisely when.
Section 2 of 7 — Your symptoms
Which sleeping positions provoke or disturb your pain?
Sleeping position can be a useful clue about what is driving your pain, and knowing which positions help or aggravate can guide practical advice for a more comfortable night.
Select all that apply
Section 2 of 7 — Your symptoms
Is there a position that relieves your pain at night?
Section 2 of 7 — Your symptoms
How do you feel when you first wake up?
The character of morning symptoms helps distinguish inflammatory from age-related or disc-related causes. Pain lasting more than 30 minutes that improves with movement is a key inflammatory signal.
Section 2 of 7 — Your symptoms
What happens to your morning symptoms as the day progresses?
Section 2 of 7 — Your symptoms
Does gentle exercise or movement improve your symptoms?
Section 2 of 7 — Safety
Any changes to your bladder or bowel?
We ask this because certain changes to bladder or bowel function alongside back pain can indicate a rare but serious spinal emergency (cauda equina syndrome) requiring same-day assessment. Most people answer "no" to this question.
Important safety question — think about any new or worsening changes since your back pain began
Section 2 of 7 — Safety
Any numbness or altered sensation between your legs or in the groin area?
The saddle area refers to the region that would contact a saddle on a horse — inner thighs, perineum, and genitals. Numbness or altered sensation here alongside back pain can indicate pressure on nerves at the base of the spine. This is a safety question — please answer it carefully and honestly.
Section 2 of 7 — Safety
Any unexplained weight loss alongside the back pain?
Section 2 of 7 — Safety
Have you noticed any of the following alongside your back pain?
Back pain accompanied by fever, chills, night sweats, nausea, or a general feeling of being unwell can occasionally indicate an infection or other condition needing medical assessment. If your back pain feels like part of a broader illness rather than a mechanical problem, please flag it here.
Section 2 of 7 — Your symptoms
Does your back or pelvic pain follow a cyclical pattern related to your menstrual cycle?
Women only — this can be an important clinical indicator
Section 3 of 7 — Your history
Have you had back pain before?
Section 3 of 7 — Your history
Did previous episodes resolve fully?
Section 3 of 7 — Your history
At what age did your back problems first begin?
Not necessarily this episode — when you first remember any back trouble starting
Section 3 of 7 — Your history
Do you recall suffering from persistent aches and pains from a young age, perhaps even before you were a teenager?
Section 3 of 7 — Your history
Would you say that your back pain is progressively worsening over time?
Section 3 of 7 — Your history
Have you had any injury, fall, or accident involving your back — even a minor one?
High-energy trauma means any significant impact — a road accident, fall from height, or forceful collision during sport. Even if you felt unharmed at the time, significant forces can cause injuries that are not immediately obvious. Please include any event that preceded your pain, even if it seemed minor.
Section 3 of 7 — Your history
Can you identify a specific incident or probable cause for this episode of back pain?
For example: a specific movement, starting new exercise, or an unusual physical demand
Section 3 of 7 — Your history
Did you have a gut, urinary, or throat infection in the 2–6 weeks before this started?
This is a specific but useful question given your age and how your symptoms came on
Section 3 of 7 — Your history
Did your back pain start or significantly worsen during a period of high stress or a difficult life event?
This is not suggesting your pain is psychological. Significant life stress can lower the threshold at which the nervous system generates pain — meaning a physical problem becomes much harder to bear. Understanding this context helps us give you a more complete picture of what may be driving your pain.
Psychological stress has a direct physiological effect on back pain and is a recognised contributor
Section 3 of 7 — Your history
Have you had an MRI scan for your back pain?
Section 3 of 7 — Your history
Have you been told what's wrong with your back, or been given an explanation for your back pain?
Section 3 of 7 — Your history
What were you told?
Optional — type freely or skip
Section 3 of 7 — Your history
Have you had any procedures for your back pain?
Procedures include spinal injections, nerve root blocks, facet joint injections, radiofrequency ablation (a treatment using heat to reduce nerve signals), and any surgical procedure on your back. If you have had any of these, please include them — they help us understand what has already been tried and how your spine has responded.
Section 4 of 7 — Previous treatment
Which treatments have you tried for your back pain?
Select all that apply
Section 4 of 7 — Previous treatment
How did the treatments or procedures you tried go?
Section 4 of 7 — Previous treatment
Which one made things worse?
Select all that apply
Section 4 of 7 — Previous treatment
Were you given home exercises or a self-management plan? Did you follow it?
Section 4 of 7 — Previous treatment
Is there anything you feel previous practitioners missed or did not address?
Optional — type freely or skip
Section 5 of 7 — Your life and context
How would you describe your general day-to-day activity level?
Section 5 of 7 — Your life and context
Do you regularly participate in any of the following activities?
Some activities place significant compressive or rotational load on the lumbar spine. Yoga (particularly forward-bending styles) can stress lumbar discs. Cycling in an aggressive position loads the spine in sustained flexion. This information helps us understand your pain pattern.
These can be relevant to back pain, particularly when leg symptoms are present
Section 5 of 7 — Your life and context
As a child or teenager, did you do gymnastics, diving, cheerleading, dance, or another sport involving repeated back-bending or arching?
Section 5 of 7 — Your life and context
Has anyone — including you — noticed your body leaning or curving to one side over time? Not just during a pain flare, but as a more lasting change.
For example: one shoulder or hip sitting higher than the other, clothes fitting differently on each side, or one arm swinging further from your body than the other when you walk.
Section 5 of 7 — Your life and context
Which areas of your life is the pain most affecting?
Select all that apply
Section 5 of 7 — Your life and context
How is your mood being affected by the pain?
Section 5 of 7 — Your life and context
Are there movements or activities you avoid because you worry they might harm your back?
Avoiding movements you fear will cause damage is a natural response to pain — but in most back pain presentations, careful movement does not cause harm and avoidance often makes things worse. This question helps us understand whether fear of movement is contributing to your pain, which responds well to the right guidance.
Section 5 of 7 — Your life and context
Are you currently taking any medication for your back pain?
Some medications are directly relevant to back pain assessment. Long-term steroid use affects bone density and is important context for any spinal problem. Anti-inflammatory medications being particularly effective is itself a clinical clue. Nerve pain medications tell us something about how your pain has been understood and managed previously.
Section 6 of 7 — About you
Are you currently pregnant or in the postpartum period (within 12 months of delivery)?
Section 6 of 7 — About you
Have you had your ovaries removed (oophorectomy), either on their own or as part of a hysterectomy?
Section 6 of 7 — About you
Do you have any of the following conditions?
These conditions can influence back pain or its management in important ways. Uveitis, sausage fingers/toes, heel pain and nail changes are associated with inflammatory spinal conditions that are often missed for years.
Select all that apply — these can influence back pain and how it is best managed
Section 6 of 7 — About you
You mentioned heel or Achilles pain — where is it mainly?
Where this pain is located actually matters clinically. Pain right at the heel bone has a different set of likely causes to pain higher up in the tendon itself.
Section 6 of 7 — About you
Have you ever had a fracture in your spine (a vertebral fracture) — whether from a significant injury or without much force?
Section 6 of 7 — About you
A few questions about joint flexibility
Answer based on now, or any point in your life — these help us understand whether joint hypermobility could be a relevant factor.
Can you (or could you ever) place your palms flat on the floor without bending your knees?
Can you (or could you ever) bend your thumb backwards to touch your forearm?
As a child, could you bend your body into unusual positions, or do the splits?
Have any of your joints (shoulder, kneecap, or others) come out of place / dislocated more than once?
Do you consider yourself “double-jointed”?
Section 6 of 7 — About you
Do you experience sudden waves of extreme tiredness or “energy crashes”, beyond normal day-to-day fatigue?
Section 6 of 7 — About you
Does anyone in your immediate family (parent, sibling, child) have any of the following?
Inflammatory spinal conditions such as ankylosing spondylitis run in families — a parent or sibling with a diagnosis meaningfully increases your own likelihood. A family history of osteoporosis is also relevant to how your spine ages. You don't need exact diagnoses — anything your family has mentioned about their joints, spine, or bones is worth including.
Family history is clinically relevant for inflammatory spinal conditions and for bone health conditions which have a significant hereditary component
Section 6 of 7 — About you
Has your activity level changed since the back pain started?
Section 7 of 7 — Your goals and expectations
What would meaningful, lasting improvement look like for you?
Select all that apply — this becomes part of your patient brief
Section 7 of 7 — Your goals and expectations
What activities do you most want to be able to do that your back pain currently prevents?
Optional — very useful for a practitioner to know
Section 7 of 7 — Your goals and expectations
What is your preferred approach to managing your pain?
Section 7 of 7 — Your goals and expectations
Would you like to understand more about what is causing your back pain and why it persists?
Research shows that patients who understand their pain have measurably better outcomes than those who don’t
Section 7 of 7 — Your goals and expectations
Is there anything else you would most want a practitioner to understand about your situation?
Optional — goes directly into your patient brief
A few more questions
A few more questions before your results
Some of your answers suggest an inflammatory pattern worth exploring further. These questions cover a different set of symptoms that are sometimes overlooked when back pain is being assessed — please answer honestly even if they seem unrelated to your back.
Have you noticed any new changes in sexual function or sensation?
Have you ever had episodes of blurred vision, pain when moving your eyes, or temporary loss of vision — even if it resolved and seemed unrelated to your back?
Do you ever get an electric-shock-like sensation running down your spine or into your arms or legs when you bend your neck forward?
Have you noticed any numbness, tingling, or weakness in your arms or hands?
Does numbness or tingling ever shift or move to different parts of your body over time — for example, from one side to the other, or from your legs to your arms?
Do you get numbness or tingling in patches that don’t seem to follow a clear line or strip down one leg or arm — more scattered or patchy instead?
Have you experienced sudden waves of extreme tiredness or “energy crashes” that feel out of proportion to your activity levels?
Section 2 of 7 — Your symptoms
Does your pain ever shift from one side to the other — for example, left hip one week and right hip the next, or buttock pain that moves from side to side?
Pain that alternates between sides rather than staying fixed on one side is one of the most clinically significant patterns for distinguishing different causes of back, hip and pelvic pain.
Section 5 of 7 — Your life and context
Have you tried ibuprofen or naproxen (anti-inflammatory painkillers) for this back pain?
How well anti-inflammatory medications work compared to other painkillers is a clinically validated clue for identifying inflammatory back pain.
Refers to anti-inflammatories (ibuprofen, naproxen, diclofenac) — not paracetamol
Section 2 of 7 — Safety
Does movement provoke your pain (i.e. does it hurt when you move)?
Most spinal pain varies at least somewhat with movement or position. Pain that is genuinely unaffected by movement is a different kind of signal worth exploring separately.
Section 2 of 7 — Safety
Which best describes the pattern, since movement doesn’t seem to provoke it?
Severe pain that comes in waves — building, peaking, then easing, often over minutes — is the classic pattern of a kidney stone moving through the urinary tract (renal colic). Pain that is genuinely constant, unaffected by anything you do, is a different signal worth exploring separately. This is different from most spinal pain, which tends to vary at least somewhat with movement or position.
Section 2 of 7 — Safety
Have you had a urine infection (UTI) recently, or do you get them often?
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Your Results
Based on your answers — for guidance only, not a diagnosis
Your assessment summary
⚠ Contraindications to Manual Therapy
▲ Inflammatory / Non-MSK Features
⸮ Bone Health Considerations
⚡ Nerve / Sciatic Involvement
💬 Ask Your Clinician to Consider
How to read your results
Most consistent with — several specific features in your answers point clearly toward this.
Also consistent with — a genuine, secondary pattern alongside your main finding.
Worth considering — a real possibility raised by your answers, but with less certainty.
Note — not a finding in itself, but something worth mentioning to your GP.
This report doesn’t diagnose you — only a clinician examining you can do that. What it does is organise what you’ve told us, so you and your practitioner start your conversation from a clearer, more focused place instead of from scratch.
What your answers suggest
A note about symptoms beyond your back: This assessment is designed to identify musculoskeletal and spinal causes of back pain. It does not assess symptoms affecting other body systems. If you have any of the following alongside your back pain — unexplained fatigue, changes to your urine, unexplained weight loss, persistent fever, or symptoms that feel generally unwell rather than specifically related to your back — please discuss the full picture with your GP rather than focusing on the back pain alone. These features may be unrelated to your spine and warrant separate assessment.
Always seek urgent help if you develop:
Sudden difficulty controlling your bladder or bowel • Numbness between your legs • Rapidly worsening leg weakness • Go to A&E or call 999 immediately.
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