Oswestry Disability Scale: Initial Visit
This survey is meant to help us obtain information from our patients regarding their current levels of discomfort and capability. Please select the answers below that best apply.
Name *
Name
(0= no pain, 10= severe pain)
1. Pain Intensity *
2. Personal Care (washing, dressing, etc.) *
3. Lifting *
4. Walking *
5. Sitting *
6. Standing *
7. Sleeping *
8. Social Life *
9. Traveling *
10. Employment/Homemaking *

ODI © Jeremy Fairbank 1980, All rights reserved. ODI contact information and permissions to use: MAPI Research Trust, Lyon, France. E-mail: contact@mapi-trust.org -Internet: www.mapi-trust.org