the Short form of the Örebro Musculoskeletal pain Screening Questionnaire (ÖMpSQ-short) and the Start Back tool (SBt) have been developed to screen for risk factors for future low back pain (LBp)related disability and work loss respectively. The aim of this study was to investigate the accordance of the two questionnaires and to evaluate the accumulation of risk factors in the risk groups of both screening tools in a large population-based sample. The study population consisted of 3079 participants of the Northern Finland Birth Cohort 1966 who had reported LBP over the previous 12 months and had SBT and ÖMPSQ-short data. We evaluated the association of depressive and anxiety symptoms (Hopkins symptom check list-25, Generalized anxiety disorder 7 questionnaire, and Beck's Depression Inventory 21), psychological features (Fear-Avoidance Beliefs Questionnaire), lifestyle characteristics (BMI, smoking, alcohol abuse, physical inactivity) and social factors (education level) with the SBT and ÖMPSQ-short risk groups. The high-risk groups of both questionnaires were associated (p < 0.001) with depressive and anxiety symptoms and fear-avoidance beliefs. In addition, adverse lifestyle factors accumulated in the higher risk groups, especially from the ÖMPSQ-short. Agreement between the two questionnaires was moderate for men and fair for women. Low back pain (LBP) is the most disabling health condition worldwide 1. No cost-effective or widely available preventive LBP interventions have yet been developed 2. Predictors of persistent LBP-related disability include symptom-related factors such as previous LBP episodes, pain intensity and the presence of leg pain; lifestyle factors such as overweight/obesity, smoking and physical inactivity; psychological factors such as depression, catastrophizing and fear-avoidance beliefs; and social factors such as education, physical workload and work satisfaction 3. To improve the effectiveness of healthcare, care processes need to take these factors into account individually and systematically 2. Early identification of patients who are at the highest risk of developing a prolonged or persistent pain problem is important 2. The short form of the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ-short) and the STarT Back Tool (SBT) have been developed for the easy and systematic identification of predictive psychosocial and symptom-related factors 4-6. The SBT was developed to identify subgroups of patients with non-specific LBP in order to determine which kind of treatment would benefit each patient. Cutoff scores divide patients into low-, medium-and high-risk

AbstractIntroductionChronic pain causes suffering for affected individuals and incurs costs to society through work disability. Interventions based on early screening of psychological risk factors for chronic pain using screening tools such as the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) have been found to reduce work absenteeism and health care visits and increase perceived health. The aim of the current study was to translate the ÖMPSQ into Finnish and test its validity and reliability in a patient sample.MethodsThe ÖMPSQ was forward–backward translated and cross-culturally adapted, and applied to our study population (n = 69), the members of which had been referred to the Department of Physical and Rehabilitation Medicine of Oulu University Hospital from primary health care centres in Northern Finland due to chronic low back pain. The patients answered the ÖMPSQ two weeks before the hospital visit, and the follow-up questionnaire either during the hospital visit, or after by mail. The reliability of the ÖMPSQ was evaluated using intraclass correlation coefficients (ICC). Factor analysis was used to group items of the ÖMPSQ, and internal consistency between the items was determined by calculating Cronbach’s alphas.ResultsThe cross-cultural adaptation revealed only minor semantic and cultural differences. Measurements showed reliability as moderate to nearly perfect for all of the ÖMPSQ items (ICC values ranged from 0.59 to 0.96). Items loaded into five different factors: disability, psychological symptoms, pain, fear avoidance, and work. All except one (work) showed acceptable internal consistency. The ÖMPSQ score was positively associated with both intensity of pain and the Oswestry Disability Index.Conclusions and implicationsThe reliability and construct validity of the Finnish version of the ÖMPSQ were good. The predictive ability of the ÖMPSQ in the Finnish population should be evaluated in further studies.

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