Oswestry Disability Index

"*" indicates required fields

MM slash DD slash YYYY
MM slash DD slash YYYY

Oswestry Disability Index - 2.1a

This questionnaire has been designed to give us information as to how your back (or leg) trouble affects your ability lo manage in everyday life. Please answer every section. Mark one box only in each section that most closely describes you today.
Section 1 - Pain Intensity*
Section 2 - Personal Care (washing, dressing, etc.)*
Section 3 - Lifting*
Section 4 - Walking*
Section 5 - Sitting*
Section 6 - Standing*
Section 7 - Sleeping*
Section 8 - Sex Life (If applicable)*
Section 9 - Social Life*
Section 10 -Traveling*
This field is for validation purposes and should be left unchanged.