Spine
Low back pain
Low back pain disability is measured with either the Roland-Morris questionnaire or the Oswestry Disability Index, and the choice between them depends on how severe the population is.
What you are actually deciding
Roland-Morris is more responsive in primary care and acute back pain; Oswestry discriminates better in severe and surgical populations. Adding a psychological measure such as the PSEQ usually predicts outcome better than either disability score alone.
Patient-reported outcome measure7
- Modified Oswestry Calculator10 itemsModified Oswestry Low Back Pain Disability QuestionnaireThe Modified Oswestry Low Back Pain Disability Questionnaire is the Oswestry with one change — an employment and homemaking section replaces the sex life section — scored the same way: ten sections rated 0 to 5, added and doubled to give a percentage from 0% (no disability) to 100% (maximum disability).
- ODI Calculator10 itemsOswestry Disability IndexThe Oswestry Disability Index measures how far low back pain restricts ten everyday activities, scoring each section from 0 to 5 and expressing the total as a percentage from 0% (no disability) to 100% (maximum disability).
- PSEQ Calculator10 itemsPain Self-Efficacy QuestionnaireThe Pain Self-Efficacy Questionnaire measures how confident a person is in carrying out activities despite their pain, scoring ten statements from 0 to 6 for a total of 0 to 60, where higher scores indicate stronger self-efficacy and 40 or more is the commonly cited threshold for a good functional prognosis.
- RMDQ Calculator24 itemsRoland-Morris Disability QuestionnaireThe Roland-Morris Disability Questionnaire measures physical disability from low back pain by counting how many of 24 statements a patient agrees with, giving a score from 0 (no disability) to 24 (maximum disability).
- STarT Back Calculator9 itemsSTarT Back Screening ToolThe STarT Back Screening Tool stratifies patients with low back pain into low, medium and high risk of persistent disabling pain using nine items, of which five form a psychosocial subscale, so that treatment can be matched to risk rather than given uniformly.
- Tampa Scale of Kinesiophobia Calculator17 itemsTampa Scale of KinesiophobiaThe Tampa Scale of Kinesiophobia is a 17-item self-report questionnaire of fear of movement and (re)injury in people with pain, scored 1 to 4 per item (four items reverse-scored) for a total of 17 to 68, where a higher total means more fear and a total above 37 is widely used as the cut-off for high kinesiophobia.
- TSK-11 Calculator11 itemsTampa Scale of Kinesiophobia, 11-item versionThe TSK-11 is the 11-item short form of the Tampa Scale of Kinesiophobia, which drops the four reverse-scored items and items 9 and 14 of the original, scores each remaining statement 1 to 4 for a total of 11 to 44, and reads a higher total as more fear of movement and (re)injury.
Thresholds that apply here
Published change thresholds across the instruments above. Check the population matches your patient before using a value — a threshold derived in a different cohort will mislead you.
| Instrument | Type | Value | Subscale | Population |
|---|---|---|---|---|
| ODI | MCID | 10 percentage points | — | Chronic low back pain |
| ODI | MCID | 12.8 points | — | Lumbar spine surgery |
| ODI | MCID | 30% change from baseline | — | Low back pain, IMMPACT consensus recommendation |
| ODI | MDC | 10–15 points | — | Chronic low back pain |
| PSEQ | MCID | 8.5 points | — | Chronic pain, multidisciplinary pain management programme |
| PSEQ | MDC | 11 points | — | Chronic low back pain |
| RMDQ | MCID | 2–3 points | — | Acute low back pain |
| RMDQ | MCID | 5 points | — | Chronic low back pain |
| RMDQ | MCID | 30% change from baseline | — | Low back pain, recommended by the IMMPACT consensus |
| RMDQ | MDC | 4–5 points | — | Chronic low back pain |
See the full threshold database for every instrument on the site.