• Oswestry Low Back Pain Disability Questionnaire

  • Instructions

  • This questionnaire has been designed to give us information as to how your back or leg pain is affecting your ability to manage in everyday life. Please answer by checking ONE box in each section for the statement which best applies to you. We realise you may consider that two or more statements in any one section apply but please just shade out the spot that indicates the statement which most clearly describes your problem.
  • Section 1-Pain intensity

  • Pain intensity options
  • Section 3-Lifting

  • Lifting options
  • Section 2 - Personal care (washing, dressing etc)

  • Personal care options
  • Section 4-Walking*

  • Walking options
  • Page 2
  • Oswestry Low Back Disability Questionnaire
  • Section 5–Sitting
  • Section 8– Sex life (if applicable)
  • Section 9–Social life
  • Section 6–Standing
  • Section 10–Traveling
  • Section 7–Sleeping
  • Date
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  • Should be Empty: