Instructions: this questionnaire has been designed to give us information as to how your back pain has affected your ability to manage everyday life. Please answer every section and mark in each section only the ONE box which applies to you at this time. We realize you may consider 2 of the statements in any section may relate to you, but please mark the box which most closely describes your current condition.

The Oswestry Disability Index (aka the Oswestry Low Back Pain Disability Questionnaire) is an extremely important tool that researchers and disability evaluators use to measure a patient’s permanent functional disability. The test has been around since 1980 and is considered the ‘gold standard’ of low back pain functional outcome tools.

For each question, there is a possible 5 points; 0 for the first answer, 1 for the second answer, etc. Add up the total for the 10 questions and rate them on the scale at right.

35 - 50 -------------- Completely disabled

The patient can cope with most living activities. Usually no treatment is indicated apart from advice on lifting, sitting and exercise.

The patient experiences more pain and difficulty with sitting, lifting and standing. Travel and social life are more difficult and they may be disabled from work. Personal care, sexual activity and sleeping are not grossly affected and the patient can usually be managed by conservative means.

Pain remains the main problem in this group but activities of daily living are affected. These patients require a detailed investigation.

Back pain impinges on all aspects of the patient’s life. Positive intervention is required.

These patients are either bed-bound or are exaggerating their symptoms.

As physical therapy works towards autonomous practice and incorporating evidence-based medicine into it’s practice, it is imperative that therapists utilize measuring tools which have been validated through research.

Insurance companies and physicians are very familiar with these instruments and are asking for scores such as Oswestry.

• Fairbank JC, Pynsent PB. “The Oswestry Disability Index.” Spine 2000: 25(22):2940-2952

• Fairbank JCT, Couper J, Davies JB. “The Oswestry Low Back Pain Questionnaire.” Physiotherapy 1980; 66:271-273

 

Patient Signature:

---