Oswestry Low Back Disability Index
This questionnaire is designed to enable us to understand how much your back condition has affected your ability to manage everyday activities. Please answer each section by selecting the one (1) choice that most applies to you, right now, today.
Patient Name (required)
*
First Name
Last Name
Pain Intensity
0- The pain comes and goes and is very mild.
1- The pain is mild and does not vary much.
2- The pain comes and goes and is moderate.
3- The pain is moderate and does not vary much.
4- The pain is severe but comes and goes.
5- The pain is severe and does not vary much.
Personal Care
0- I would not have to change my way of washing or dressing in order to avoid pain.
1- I do not normally change my way of washing or dressing even though it causes some pain.
2- Washing and dressing increases the pain, but I manage not to change my way of doing it.
3- Washing and dressing increases the pain and I change the way I do it.
4- Because of the pain, I am unable to do any washing and dressing without help.
5- Because of the pain, I do not get dressed, wash with difficulty, and stay in bed.
Lifting
0- I can lift heavy weights without extra pain.
1- I can lift heavy weights, but it causes extra pain.
2- Pain prevents me from lifting heavy weights off the floor.
3- Pain prevents me from lifting heavy weights off the floor, but I can manage if they are conveniently positioned, e.g. on the table.
4- Pain prevents me from lifting heavy weights, but I can manage light to medium weights if they are conveniently positioned.
5- I can only lift very light weights, at the most.
Walking
0- Pain does not prevent me from walking any distance.
1- Pain prevents me from walking more than one mile.
2- Pain prevents me from walking more than 1/2 mile.
3- Pain prevents me from walking more than 1/4 mile.
4- I can only walk while using a cane or on crutches.
5- I am in bed most of the time and have to crawl to the toilet.
Sitting
0- I can sit in any chair for as long as I like without pain.
1- I can only sit in my favorite chair for as long as I like.
2- Pain prevents me from sitting more than one hour.
3- Pain prevents me from sitting more than 1/2 hour.
4- Pain prevents me from sitting more than ten minutes.
5- Pain prevents me from sitting at all.
Submit Form
Should be Empty: