OSWESTRY LOW BACK PAIN SCALE

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.

Name

First NameLast Name

Date

1. PAIN INTENSITY

I can tolerate the pain I have without having to use pain killersThe pain is bad but I manage without taking pain killersPain killers give complete relief from painPain killers give moderate relief from painPain killers give very little relief from painPain 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 painI can look after myself normally but it causes extra painIt is painful to look after myself and I am slow and carefulI need some help but manage most of my personal careI need help every day in most aspects of self careI don't get dressed, I was with difficulty and stay in bed

3. LIFTING

I can lift heavy weights without extra painI can lift heavy weights but it gives extra painPain prevents me from lifting heavy weights off the floor, but I can manage if they are conveniently positioned, i.e. on a tablePain prevents me from lifting heavy weights, but I can manage light to medium weights if they are conveniently positionedI can lift very light weightsI cannot lift or carry anything at all

4. WALKING

Pain does not prevent me walking any distancePain prevents me walking more than one milePain prevents me walking more than 1/2 milePain prevents me walking more than 1/4 mileI can only walk using a stick or crutchesI 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 likeI can only sit in my favourite chair as long as I likePain prevents me from sitting more than one hourPain prevents me from sitting more than 1/2 hourPain prevents me from sitting more than 10 minutesPain prevents me from sitting at all

6. STANDING

I can stand as long as I want without extra painI can stand as long as I want but it gives me extra painPain prevents me from standing for more than one hourPain prevents me from standing for more than 30 minutesPain prevents me from standing for more than 10 minutesPain prevents me from standing at all

7. SLEEPING

Pain does not prevent me from sleeping wellI can sleep well only by using medicationEven when I take medication, I have less than 6 hrs sleepEven when I take medication, I have less than 4 hrs sleepEven when I take medication, I have less than 2 hrs sleepPain prevents me from sleeping at all

8. SOCIAL LIFE

My social life is normal and gives me no extra painMy social life is normal but increases the degree of painPain 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 oftenPain has restricted my social life to my homeI have no social life because of pain

9. TRAVELLING

I can travel anywhere without extra painI can travel anywhere but it gives me extra painPain is bad, but I manage journeys over 2 hoursPain restricts me to journeys of less than 1 hourPain restricts me to short necessary journeys under 30 minutesPain prevents me from travelling except to the doctor or hospital

10. EMPLOYMENT/ HOMEMAKING

My normal homemaking/ job activities do not cause painMy normal homemaking/ job activities increase my pain, but I can still perform all that is required of meI 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.

The Oswestry Disability Index (aka the Oswestry Low Back Pain Disability Questionnaire) is an ex- tremely 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.

INSTRUCTIONS:

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.

SCORE	DISABILITY LEVEL
0-4	No disability
5-14	Mild disability
15-24	Moderate disability
25-34	Severe disability
35-50	Completely disabled

No disability

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

Mild disability

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.

Moderate disability

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

Severe disability

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

Completely disabled

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

WHY BOTHER WITH AN OUTCOMES MEASURE?

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.

REFERENCES:

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

OSWESTRY LOW BACK PAIN SCALE

Scoring the Oswestry Disability Index