Oswestry Disability Index (ODI)
Pain and function evaluation in patients with low back disability
The Oswestry Disability Index (ODI) is a 10-item measure for low back pain evaluation. It is one of the most common validated instruments for low back pain measurement and has also been used for patients with spinal deformities, with symptomatic degenerative disc disease and with degenerative lumbar spinal stenosis.
The items of the questionnaire assess pain as well as deficits in physical and social functioning and activities of daily living.
In comparison with the Roland–Morris disability questionnaire (RMDQ), another low back pain tool, the ODI may be a better measure for patients with severe and persistent symptoms, whereas the RMQ has advantages for assessing patients with mild to moderate disability 1.
Items - Dimensions - Completion time
The responses concerning each item are given a score of 0 to 5. All 10 items are scored in this manner. After all items have been completed, the final score is calculated as follows:
(sum of all scored points / highest possible total score) × 100%
Example: (16 points scored / 50) x 100% = 32%
If an item is skipped or not applicable, the highest possible total score will be 45 instead of 50. The final score is always a percentage to allow for skipped or nonapplicable items.
The lower the score, the better the patient’s state of back health.
0% to 20%: minimal disability: The patient can cope with most activities of daily living. Usually no treatment is indicated apart from advice on lifting, sitting and exercise.
21%–40%: moderate disability: The patient experiences pain and difficulty with sitting, lifting and standing. Travel and social life are difficult, and he or she may be disabled with regard to employment. Personal care, sexual activity and sleeping are not grossly affected. The patient can usually be managed by conservative means.
41%–60%: severe disability: Pain is the main problem in this patient, and activities of daily living are affected. This patient requires detailed examination.
61%–80%: crippled: Back pain impinges on all aspects of the patient’s life. Positive intervention is required.
81%–100%: The patient is either bedridden or exaggerating his or her symptoms.
For students, physicians, nonfunded academic users and routine clinical use, the questionnaire can be accessed directly and translations are available at no cost.
For funded academic users, healthcare organizations, commercial users, and IT companies, fees may apply and a licensing agreement must be entered into. 18