Template:Oswestry

Oswestry Low Back Disability Questionnaire

1. PAIN INTENSITY
I can tolerate the pain I have without having to use pain killers
The pain is bad but I manage without taking pain killers
Pain killers give complete relief from pain
Pain killers give moderate relief from pain
Pain killers give very little relief from pain
Pain killers have no effect on the pain and I do not use them

2. PERSONAL CARE (e.g. Washing, Dressing)
I can look after myself normally without causing extra pain
I can look after myself normally but it causes extra pain
It is painful to look after myself and I am slow and careful
I need some help but manage most of my personal care
I need help every day in most aspects of self care
I don’t get dressed, I wash with difficulty and stay in bed

3. LIFTING
I can lift heavy weights without extra pain
I can lift heavy weights but it gives extra pain
Pain prevents me from lifting heavy weights off the floor, but I can manage if they are conveniently positioned, i.e. on a table
Pain prevents me from lifting heavy weights, but I can manage light to medium weights if they are conveniently positioned
I can lift very light weights
I cannot lift or carry anything at all

4. WALKING
Pain does not prevent me walking any distance
Pain prevents me walking more than one mile
Pain prevents me walking more than ½ mile
Pain prevents me walking more than ¼ mile
I can only walk using a stick or crutches
I am in bed most of the time and have to crawl to the toilet

5. SITTING
I can sit in any chair as long as I like
I can only sit in my favourite chair as long as I like
Pain prevents me from sitting more than one hour
Pain prevents me from sitting more than ½ hour
Pain prevents me from sitting more than 10 minutes
Pain prevents me from sitting at all

6. STANDING
I can stand as long as I want without extra pain
I can stand as long as I want but it gives me extra pain
Pain prevents me from standing for more than one hour
Pain prevents me from standing for more than 30 minutes
Pain prevents me from standing for more than 10 minutes
Pain prevents me from standing at all

7. SLEEPING
Pain does not prevent me from sleeping well
I can sleep well only by using medication
Even when I take medication, I have less than 6 hrs sleep
Even when I take medication, I have less than 4 hrs sleep
Even when I take medication, I have less than 2 hrs sleep
Pain prevents me from sleeping at all

8. SOCIAL LIFE
My social life is normal and gives me no extra pain
My social life is normal but increases the degree of pain
Pain has no significant effect on my social life apart from limiting my more energetic interests, i.e. dancing, etc.
Pain has restricted my social life and I do not go out as often
Pain has restricted my social life to my home
I have no social life because of pain

9. TRAVELLING
I can travel anywhere without extra pain
I can travel anywhere but it gives me extra pain
Pain is bad, but I manage journeys over 2 hours
Pain restricts me to journeys of less than 1 hour
Pain restricts me to short necessary journeys under 30 minutes
Pain prevents me from traveling except to the doctor or hospital

10. EMPLOYMENT/HOMEMAKING
My normal homemaking/ job activities do not cause pain
My normal homemaking/ job activities increase my pain, but I can still perform all that is required of me
I can perform most of my homemaking/ job duties, but pain prevents me from performing more physically stressful activities (e.g. lifting, vacuuming)
Pain prevents me from doing anything but light duties.
Pain prevents me from doing even light duties.
Pain prevents me from performing any job or homemaking chores