Identify "Yellow flags" (Psychosocial risk factors)

Yellow flags represent psychosocial and occupational risk factors that may increase the risk of developing or perpetuating long-term disability, distress and work loss¹⁴.

Yellow Flags, which may predict disability, include¹⁴:

• Belief that pain is harmful
• ‘Sickness behaviours’ (like extended rest)
• Tendency to low mood and withdrawal from social interaction
• Treatment that does not fit best practice
• Problems with compensation and claims
• Problems at work, poor job satisfaction
• Heavy work, unsociable hours
• Overprotective family or lack of support

The Örebro Musculoskeletal Pain Screening Questionnaire (OMPQ) may be used for early identification of Yellow Flags (psychosocial factors) prior to intervention. Questionnaire scores greater than 105 indicate that the patient is at risk of long-term (chronic) problems or disability¹⁴.

This score produces ¹⁴:

75% correct identification of those not needing modification to ongoing management.
86% correct identification of those who will have between 1 and 30 days off work.
83% correct identification of those who will have more than 30 days off work.

Scoring Instructions

• For question 1, count the number of pain sites and multiply by two - this is the score (maximum score allowable is 10).
• For questions 2 and 3 the score is the number bracketed after the ticked box.
• For questions 4,5,6,7,9,10,11,14,15 and 16 the score is the number that has been ticked or circled.
• For questions 8,12,13,17,18,19,20 and 21 the score is 10 minus the number that has been circled.
• Write the score in the shaded area beside each item.
• Add up the scores for questions 1 to 21 - this is the total ÖMPQ score.

Appendix 7: Örebro Musculoskeletal Pain Screening Questionnaire (OMPQ) ²⁰