Oswestry Disability Index

The Oswestry Disability Index has emerged as the most commonly recommended condition-specific outcome measures for spinal disorders.

The development of the Oswestry Disability Index was initiated by John O’Brien in 1976

The index is based on a patient-completed questionnaire which gives a subjective percentage score of the level of function (disability) in activities of daily living in those rehabilitating from low back pain.

Here is the questionnaire that the patient receives

I have “Chronic Pain” or pain that has bothered me for 3 months or more:

Yes/ No

Check one of the following:

•  Prior to Surgery
• After Surgery 6 weeks
• After Surgery 3 Months
• After Surgery 1 year
• After Surgery 6 Months
• After Surgery 2 years

Please answer each section below by checking the One Choice that applies the most to you

At this time. (You may feel that more than one of the statement relates to you at this time, but it is very important that you Please check only one choice that best describes your problem at this time.

Section 1: Pain Intensity

• I can tolerate the pain I have without having to use painkillers. [0 points]
• The pain is bad but I manage without taking painkillers. [1 point]
• Painkillers give complete relief from pain. [2 points]
• Painkillers give moderate relief from pain. [3 points ]
• Painkillers give very little relief from pain. [4 points]
• Painkillers have no effect on the pain and I do not use them. [5 points]

Section 2: Personal Care

• I can look after myself normally without causing extra pain. [0 points]
• I can look after myself normally but it causes extra pain. [1 point]
• It is painful to look after myself and I am slow and careful. [2 points]
• I need some help but manage most of my personal care. [3 points]
• I need help every day in most aspects of self-care. [4 points]
• I do not get dressed wash with difficulty and stay in bed. [5 points]

 Section 3: Lifting

• I can lift heavy weights without extra pain. [0 points]
• I can lift heavy weights but it gives extra pain. [1 point]
• Pain prevents me from lifting heavy weights off the floor but I can manage if they are conveniently positioned for example on a table. [2 points]
• Pain prevents me from lifting heavy weights but I can manage light to medium weights if they are conveniently positioned. [3 points]
• I can lift only very light weights. [4 points]
• I cannot lift or carry anything at all. [5 points]

 Section 4: Walking

• Pain does not prevent me from walking any distance. [0 points]
• Pain prevents me from walking more than 1 mile. [1 point]
• Pain prevents me from walking more than 0.5 miles. [2 points]
• Pain prevents me from walking more than 0.25 miles. [3 points]
• I can only walk using a stick or crutches. [4 points]
• I am in bed most of the time and have to crawl to the toilet. [5 points]

 Section 5: Sitting

• I can sit in any chair as long as I like. [0 points]
• I can only sit in my favorite chair as long as I like. [1 point]
• Pain prevents me from sitting for more than 1 hour. [2 points]
• Pain prevents me from sitting more than 0.5 hours. [3 points]
• Pain prevents me from sitting for more than 10 minutes. [4 points]
• Pain prevents me from sitting at all. [5 points]

 Section 6: Standing

• I can stand as long as I want without extra pain. [0 points]
• I can stand as long as I want but it gives me extra pain. [1 point]
• Pain prevents me from standing for more than 1 hour. [2 points]
• Pain prevents me from standing for more than 30 minutes. [3 points]
• Pain prevents me from standing for more than 10 minutes. [4 points]
• Pain prevents me from standing at all. [5 points]
• Pain does not prevent me from sleeping well. [0 points]
• I can sleep well only by using tablets. [1 point]
• Even when I take tablets I have less than 6 hours sleep. [2 points]
• Even when I take tablets I have less than 4 hours sleep. [3 points]
• Even when I take tablets I have less than 2 hours of sleep. [4 points]
• Pain prevents me from sleeping at all. [5 points]

 Section 8: Sex Life

• My sex life is normal and causes no extra pain. [0 points]
• My sex life is normal but causes some extra pain. [1 point]
• My sex life is nearly normal but is very painful. [2 points]
• My sex life is severely restricted by pain. [3 points]
• My sex life is nearly absent because of pain. [4 points]
• Pain prevents any sex life at all. [5 points]

Section 9: Social Life

• My social life is normal and gives me no extra pain. [0 points]
• My social life is normal but increases the degree of pain. [1 point]
• Pain has no significant effect on my social life apart from limiting energetic interests such as dancing. [2 points]
• Pain has restricted my social life and I do not go out as often. [3 points]
• Pain has restricted my social life to my home. [4 points]
• I have no social life because of pain. [5 points]

Section 10: Traveling

• I can travel anywhere without extra pain. [0 points]
• I can travel anywhere but it gives me extra pain. [1 point]
• Pain is bad but I manage journeys over 2 hours. [2 points]
• Pain restricts me to journeys of less than 1 hour. [3 points]
• Pain restricts me to short necessary journeys under 30 minutes. [4 points]
• Pain prevents me from traveling except to the doctor or hospital. [5 points]

Interpretation

Simply add up your points for each section and plug it into the following formula in order to

calculate your level of disability: point total / 50 X 100 = % disability (aka: ‘point total’

divided by ’50’ multiply by ‘ 100 = percent disability)

For example, if the score is 18, then disability would come out to be  18/50 x 100 = 36 %.

 Gauging Disability

 0% to 20% (Minimal Disability)

Patients can cope with most activities of daily living. No treatment may be indicated except for suggestions on lifting, posture, physical fitness and diet. Patients with sedentary occupations (ex. secretaries) may experience more problems than others.

21%-40% (Moderate Disability)

Patients may experience more pain and problems with sitting, lifting and standing. Travel and social life are more difficult. Patients may be off work. Personal care, sleeping and sexual activity may not be grossly affected.

Conservative treatment may be sufficient.

41%-60% (Severe Disability)

Pain is a primary problem for these patients, but they may also be experiencing significant problems with travel, personal care, social life, sexual activity, and sleep. A detailed evaluation is appropriate.

61%-80% (Crippled)

Back pain has an impact on all aspects of daily living and work. Active treatment is required.

81%-100%

These patients may be bed bound or exaggerating their symptoms. Careful evaluation is recommended.