Neck Disability Index Questionnaire, Revised Oswestry Back Pain Disability Index Page 2
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2Revised Oswestry Back Pain Disability Index
SECTION 1 - Pain Intensity
SECTION 6- Standing
q
q
A I have no pain at the moment.
A I can stand as long as I want without extra pain.
q
q
B The pain is mild at the moment.
B I have some pain on standing, but it does not increase with time.
q
q
C The pain comes and goes and is moderate.
C I cannot stand for longer than 1 hour without increasing pain.
q
q
D The pain is moderate and does not vary much.
D I cannot stand for longer than 1/2 hour without increasing pain.
q
q
E The pain is severe but comes and goes.
E I cannot stand for longer than 10 minutes without increasing pain.
q
q
F The pain is severe and does not vary much.
F I avoid standing, because it increases the pain immediately.
q
q
q
q
q
q
q
q
q
q
q
q
Before my current symptoms started, I was an
A
B
C
D
E
F
Before my current symptoms started, I was an
A
B
C
D
E
F
SECTION 2 -Personal Care (Washing, Dressing, etc)
SECTION 7- Sleeping
q
q
A I can look after myself normally without causing extra pain.
A I get no pain in bed.
q
q
B I can look after myself normally, but it causes extra pain.
B I get pain in bed, but it does not prevent me from sleeping well.
q
q
C It is painful to look after myself and lam slow and careful
C Because of pain, my normal night’s sleep is reduced by less than 1/4
q
q
D I need some help, but manage most of my personal care.
D Because of pain, my normal night’s sleep is reduced by less than ½.
q
q
E I need help every day in most aspects of self care.
E Because of pain, my normal night’s sleep is reduced by less than 3/4.
q
q
F I do not get dressed, I wash with difficulty and stay in bed.
F Pain prevents me from sleeping at all.
q
q
q
q
q
q
q
q
q
q
q
q
Before my current symptoms started, I was an
A
B
C
D
E
F
Before my current symptoms started, I was an
A
B
C
D
E
F
SECTION 3- Lifting
SECTION 8- Social Life
q
q
A I can lift heavy weights without extra pain.
A . My social life is normal and gives me no extra pain.
q
q
B I can lift heavy weights, but it causes extra pain.
B My social life is normal, but increases the degree of my pain.
q
q
C Pain prevents me from lifting heavy weights off the floor, but I can
C Pain has no significant effect on my social life apart from limiting my
manage if they are conveniently positioned, for example on a table.
more energetic interests, e.g., dancing, etc.
q
q
D Pain prevents me from lifting heavy weights but I can manage light to
D Pain has restricted my social life and I do not go out very often.
q
medium weights if they are conveniently positioned.
E Pain has restricted my social life to my home.
q
E can only lift very light weights.
q
F I have no social life because of the pain.
q
F I cannot lift or carry anything at all.
q
q
q
q
q
q
q
q
q
q
q
q
Before my current symptoms started, I was an
A
B
C
D
E
F
Before my current symptoms started, I was an
A
B
C
D
E
F
SECTION 4- Walking
SECTION 9 - Traveling
q
q
A I have no pain walking
A I get no pain while traveling.
q
q
B I have some pain walking but it does not increase with distance.
B I get some pain while traveling but none of my usual sorts of travel
q
make it any worse.
C I cannot walk more than 1 mile without increasing pain.
q
q
C I get extra pain while traveling but it does not compel me to seek
D I cannot walk more than ½ mile without increasing pain,
alternative forms of travel.
q
E I cannot walk more than 1% mile without increasing pain
q
D I get extra pain while traveling which compels me to seek alternative
q
F I cannot walk at all without increasing pam.
forms of travel.
q
E Pain restricts all forms of travel.
q
F Pain prevents all forms of travel except that done lying down.
q
q
q
q
q
q
q
q
q
q
q
q
Before my current symptoms started, I was an
A
B
C
D
E
F
Before my current symptoms started, I was an
A
B
C
D
E
F
SECTION 5 - Sitting
SECTION 10- Changing Degree of Pain
q
q
A I can sit in any chair as long as I like.
A . My pain is rapidly getting better.
q
q
B I can sit only in my favorite chair as long as I like.
B My pain fluctuates but overall is definitely getting better.
q
q
C Pain prevents me from sitting more than one hour.
C My pain seems to be getting better but improvement is slow at
q
present.
D Pain prevents me from sitting more than 1/2 hour.
q
q
D My pain is neither getting better nor worse.
E Pain prevents me from sitting more than 10 minutes.
q
q
E My pain is gradually worsening.
F Pain prevents me from sitting at all.
q
F My pain is rapidly worsening.
q
q
q
q
q
q
q
q
q
q
q
q
Before my current symptoms started, I was an
A
B
C
D
E
F
Before my current symptoms started, I was an
A
B
C
D
E
F
Total score: ______ x 2 = __________%
Patient Signature: _____________________________________________________
Date:________________________
Doctor Signature: _____________________________________________________
Date:________________________
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