What Is the Oswestry Disability Index?

Also known as the Oswestry Low Back Pain Disability Questionnaire, the Oswestry Disability Index helps to measure a patient’s lower back pain. It evaluates the extent to which the patient’s level of function is restricted by the pain, concentrating on the effects rather than the nature of the pain. Considered by many clinicians and researchers as the gold standard for determining the degree of disability and estimating the quality of life for those experiencing back pain, the 10-question survey contains topics relating to pain intensity, daily activities, and sleep quality.

 man with low back pain red spot

History of the Oswestry Disability Index

In 1976, John O’Brien developed the Oswestry Disability Index after he interviewed patients suffering from back pain. He compiled a range of questions based on his research, and the final version of the questionnaire was published in 1980 in “Physiotherapy” by Dr. Jeremy Fairback, who was a professor of spinal surgery at the Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences in Oxford, England. Over time, the questionnaire has been revised, with the latest version published in 2000.

Oswestry Disability Index Questionnaire

If you’re a patient dealing with back or leg pain that affects you daily, you should fill out the questionnaire so your doctor can assess you better. Within the 10 sections, you select one of the six statements that best describes your situation. Although there might be two or more statements that you believe apply to you, select the one that best describes your issue. These 10 sections cover:

  1. Pain intensity. This measures the degree to which the patient tolerates pain before resorting to medication.
  2. Personal care. This deciphers how well the patients can care for themselves, such as dressing and washing without aid, and to what extent.
  3. This tells the patient’s ability to lift different sized weights with or without pain.
  4. This categorizes the distance the patient can walk with or without assistance.
  5. This states the patient’s ability to sit or if it’s not possible due to pain.
  6. This evaluates the patient’s ability to stand unassisted and for how long.
  7. This determines whether the patient experiences sleep deprivation or insomnia, and if so, the need for sleeping medication.
  8. Sex life, if applicable. This measures the prevention or impairment of intercourse because of pain.
  9. Social life. This examines any dysfunctionalities that affect the way a patient interacts with others socially.
  10. This looks at the patient’s ability to travel for either short or long trips, with or without pain.

For each of these sections, you choose from the following statements:

  • Right now, there is no pain. (Score = 0)
  • Right now, the pain is mild. (Score = 1)
  • Right now, the pain is moderate. (Score = 2)
  • Right now, the pain is fairly severe. (Score = 3)
  • Right now, the pain is very severe. (Score = 4)
  • Right now, the pain is the worst. (Score = 5)

If you answer these questions in a clinical setting, the answers you give at the first session might be used as a baseline. You may be asked to answer the questions again at two-week intervals during treatment to determine how well you’re recovering. Most offices agree that a 10% change is meaningful, and it’s understood that few patients will receive a score of zero during treatment, whether it involves spinal surgery or implementing spinal orthotics. These patients usually attain a score between five and 15, which represents 10% to 30%.

How To Score the Oswestry Disability Index

Each section in the questionnaire has a total possible score of five. If the first statement is marked, the score is zero. If the last statement is marked, the score is five. Add up your score from all 10 questions and divide that number by the total possible score.

For instance, if you scored 17 points in all 10 sections, the equation would be: 17 (total score) / 50 (total possible score) x 100 (to make it a percentage) = 34%.

However, if you answered questions in only nine sections, the equation would be: 17 (total score ) / 45 (total possible score ) x 100 (to make it a percentage) = 38%.

If you score 0%, you have no disability, while a score of 100% indicates a maximum disability. Remember that it’s best to round the percentage to a whole number to better understand where you fall within the results.

How To Interpret the Results

Once you have a score on the Oswestry Disability Index, you might wonder what comes next. Here are some common interpretations of the results:

  • Minimal disability: 0% to 20%. In this sector, the patient can usually deal with most activities. Typically, there is no treatment needed, except for advice on lifting, physical fitness, diet, and posture.
  • Moderate disability: 21% to 40%. Within this division, the patient experiences additional pain while sitting, standing, and lifting. Travel and social life might be affected as they can be more difficult to do. Treatment is usually managed by conservative means.
  • Severe disability: 41% to 60%. In this range, the patient deals with an intense amount of pain. Many other areas of life, including social life, travel, personal care, and sexual activity are affected.
  • Crippling back pain: 61% to 80%. Within this section, the patient has back pain that impairs all aspects of life. To deal with the pain, positive intervention is necessary.
  • Bed-bound or exaggerating symptoms: 81% to 100%. For this one, the patient is either in extreme pain and can only stay in bed or is exaggerating the symptoms. To determine which applies, the patient is evaluated during a medical exam.

If you’re experiencing back or leg pain, contact Scheck & Siress so we can issue the Oswestry Disability Index and determine your next course of action. We’ve been in business for more than 60 years, and we have more than 50 American Board-certified practitioners working at our 18-plus locations scattered throughout Illinois, Indiana, and Wisconsin. We strive to improve and restore mobility to our patients and offer in-house fabrication of orthotics, prosthetics, and pedorthics for both adult and pediatric patients. Let us help you get back on your feet again.


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