Modified Oswestry Low Back Pain Questionnaire
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Modified Oswestry Low Back Pain Questionnaire
This questionnaire is designed to enable us to understand how much you low back pain has affected
your ability to manage your everyday activities. Please answer each section by marking in each
section one circle that most applies to you. We realize that you may feel that more than one
statement may relate to you, but please just mark the circle that most closely describes your
problem. HIGHER NUMBER = MORE DISABLED
Section 1 - Pain Intensity
O The pain comes and goes and is very mild.
O The pain is mild and does not vary much.
O The pain comes and goes and is moderate.
O The pain is moderate and does not vary much.
O The pain comes and goes and is severe.
O The pain is severe and does not vary much.
Section 2 - Personal Care
O I do not have to change my way of washing or dressing to avoid pain.
O I do not normally change my way of washing or dressing even though it causes me pain.
O Washing and dressing increase the pain, but I manage not to change my way of doing it.
O Washing and dressing increases the pain and I find it necessary to change my way of doing it.
O Because of the pain I am unable to do some washing and dressing without help.
O Because of the pain I am unable to do any washing and dressing without help.
Section 3 - Lifting (skip if you have not attempted lifting since the onset of your low back pain)
O I can lift heavy weights without extra low back pain.
O I can lift heavy weights but it causes extra pain.
O Pain prevents me lifting heavy weights off the floor.
O Pain prevents me lifting heavy weights off the floor, but I can manage if they are conveniently
positioned, e.g. on a table.
O Pain prevents me lifting heavy weights but I can manage light to medium weights if they are
conveniently positioned.
O I can only lift light weights at the most.
Section 4 - Walking
O I have no pain walking.
O I have some pain on walking, but I can still walk my required to normal distances.
O Pain prevents me from walking long distances.
O Pain prevents me from walking intermediate distances.
O Pain prevents me from walking even short distances.
O Pain prevents me from walking at all.
Section 5 - Sitting
O Sitting does not cause me any pain.
O I can sit as long as I need provided I have my choice of sitting surfaces.
O Pain prevents me from sitting more than 1 hour.
O Pain prevents me from sitting more than 1/2 hour.
O Pain prevents me from sitting more than 10 minutes.
O Pain prevents me from sitting at all.
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