Low Back Pain Recovery Factors Checklist

Clinical context

Complete all 12 items using information from the patient and clinical assessment.

Patient name or reference

Assessment date

Episode context

Assessment setting

Clinical screening confirmed Appropriate assessment for serious pathology, urgent neurological compromise and other reasons for medical referral has been completed where clinically indicated.

0 of 12 questions answered

Select an assessment date, confirm clinical screening and answer all 12 questions before generating the result.

0 clear factors identified

Recovery factors reviewed

No result has been generated.

Clear factors 0

Needs clarification 0

Primary review domain None

Factors identified

Factors requiring clarification

Suggested clinical focus

Documentation-ready result

Evidence basis: The checklist domains were independently written using themes described in low-back-pain guidance and prognostic research, including function, activity avoidance, recovery beliefs, self-efficacy, distress and occupational or social barriers. WHO guideline , NICE NG59 , psychosocial prognostic review .

Clinical note: This checklist has not been validated as a prognostic instrument. The number of factors identified must not be interpreted as a probability of chronic pain, treatment intensity category or diagnosis. Use the result to guide further discussion and clinical reasoning alongside the complete assessment.