Welcome to the Supply Center


Oswestry Low Back Pain Questionnaire -- DIRECTIONS FOR THE PRACTITIONER

Monitoring the patient's subjectives, objectives, laboratory, and diagnostic imaging changes is an important part of determining the effectiveness of a treatment plan. Another method to monitor treatment progress is by Functional Outcome Measures.

These questionnaires measure the patient's function both subjectively and in activities of daily life (eg. reading, sitting, walking, driving in a car, etc.).  These pertain only to the neck and low back. Many others are available.

1. Give the patient the questionnaire corresponding to the area of pain.

2. Instruct the patient to read each description in the boxes. Circle the letter of the line which best describes their condition relative to the boxes' areas of function.

3. Out of view of the patient, grade the questionnaire by assigning numeric values to each letter circled. A = Zero; B = One; C = Two; D = Three; E = Four; and F = Five. There are 10 selections, which gives a maximum value of 50 for the questionnaire. Multiply the numeric value by 2 to obtain a score out of 100.

4. After 30 days, give a blank questionnaire to the patient. Do not allow the patient to see what was answered previously. Score the new questionnaire as described above. Compare the results, both numerically and by individual sections to all previous questionnaires. This will provide an indication of the progress with care.

download questionnaire

©The Supply Center / KM Enterprises