What is the Oswestry Disability Index?

This Oswest The Disability Index, also known as the Oswestry Low Back Pain Disability Questionnaire, is used to assess how a patient’s low back pain affects their ability to perform everyday tasks and activities. The Oswestry Disability Index includes questions about the symptoms and severity of low back pain and how much those symptoms interfere with daily activities.

Read on to learn about the Oswestry Disability Index, what it’s used for, and how it works.

what is this

The Oswestry Disability Index is used to determine the severity of a patient’s low back pain and the degree to which it limits daily activities. The Oswestry Disability Index can help provide objective data about a patient’s low back pain and is a research-backed, validated measure that can be used to justify medical need.

Low back pain can be caused by a number of different causes, including:

  • back muscle strain
  • Herniated or bulging disc
  • nerve root compression
  • spinal stenosis
  • Compression fractures of the lumbar spine, usually caused by trauma or osteoporosis
  • lower back surgery, including spinal fusion, Discectomyand Laminectomy
  • Arthritis, including inflammatory types of arthritis such as psoriatic arthritis and ankylosing spondylitis
  • Spondylolisthesis
  • Scoliosis
  • sacroiliac joint dysfunction
  • pregnant
  • Poor posture and muscle imbalances

how does this work

The Oswestry Disability Index is a questionnaire consisting of 10 questions about the impact of low back pain on daily life. The 10 questions include the following categories:

  • Pain intensity: the intensity of the pain and the extent to which pain medication is used to relieve symptoms
  • Personal care: Whether the patient can perform personal care activities, such as bathing and dressing, with significant pain or limitation, and whether they need physical assistance from others
  • Weightlifting: Whether the patient can lift heavy objects with or without pain, whether the weight is light, moderate, or heavy, and whether they can lift weights from a higher surface such as the floor or table
  • Walking: whether and to what extent pain limits the patient’s walking distance and independence, or whether assistive devices such as canes or crutches are required
  • Sitting: whether and to what extent pain limits the patient’s sitting tolerance
  • Standing: whether and to what extent pain limits the patient’s standing tolerance
  • Sleep: whether and to what extent pain limits the patient’s sleep time, and whether pain medication is needed to help the patient sleep comfortably
  • Social life: whether and to what extent the patient’s social activities are limited by pain
  • Travel: whether and to what extent pain limits a patient’s ability to travel
  • Employment or housework duties: Does pain limit the patient’s ability to perform work-related and/or housework activities, including physically demanding and relaxed jobs
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Patients self-reported information based on their knowledge of low back pain and disability levels and completed it on their own.

Each question can be rated between 0 and 5, where 0 corresponds to no limitation at all and 5 corresponds to complete disability. The scores for all 10 questions are added together for a total of 50 points.


The Oswestry Disability Index assesses the degree to which a patient’s low back pain limits daily activities, which may be useful in clinical documentation for healthcare services.

Unlike other outcome measures where higher scores are generally higher, higher scores on the Oswestry Disability Index indicate higher levels of disability according to the following scoring criteria:

  • 0–4: No disability
  • 5-14: Mild disability
  • 15-24: Moderate disability
  • 25-34: Severely disabled
  • 35–50: completely disabled

In order to develop a treatment plan and be authorized by insurance companies, physical therapists must develop individualized goals for each patient. One of the most important aspects of a physical therapy goal is that it must be measurable.

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In addition to monitoring range of motion (how far a joint can stretch) and strength tests, the Oswestry Disability Index provides a numerical score to track functional limitations. Baseline measurements were taken at the start of treatment, and progress was followed at follow-up, and the new score was used as a treatment goal.

According to a 2013 study, the minimum clinically important difference (MCID) for the Oswestry Disability Index was 12.88. The MCID is the minimum score a healthcare provider needs to confirm a patient’s functional progress from treatment.

By tracking changes in the Oswestry Disability Index total score before, during, and after treatment, healthcare providers can better assess whether treatment is effective in improving symptoms. A drop of 13 points or more in the total score indicates that the treatment helped improve the patient’s low back pain and disability.

In addition to the results of a physical examination by a physical therapist, a patient’s score on the Oswestry Disability Index and the severity of symptoms can help healthcare providers determine an appropriate treatment plan.

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  • No disability: No indication of treatment other than recommendations for improved mechanics and general physical activity to maintain health.
  • Mild disability: Conservative measures such as physical therapy, exercise, heat and cold therapy, pain medication, and rest are required to help relieve symptoms.
  • Moderate disability: Interventions requiring greater involvement, including extensive physical therapy services and pain management.
  • Severe disability: requires extensive medical intervention, which may include surgery, pain management, adaptive equipment such as wheelchairs, and caregiver assistance.
  • Total disability: The patient is either bedridden or exaggerates their symptoms. For bedridden patients, a caregiver is required to complete daily activities and self-care tasks.

VigorTip words

The Oswestry Disability Index is a useful measure of how low back pain affects a patient’s daily activities. It is important for physical therapists to incorporate this outcome measure into a patient’s treatment plan.

Along with other changes, such as improvements in range of motion, strength, and quality of motion, a decrease in the Oswestry Disability Index total score helps to show the positive impact of treatment on treating low back pain. Keep in mind that because patients self-report this outcome measure, it has its limitations and may not always accurately reflect a patient’s disability.