Modified Oswestry Disability Index

Need to gauge the pain and discomfort that your patient is feeling because of their lower back? Then, issue the Modified Oswestry Disability Index to assess the severity of their pain and create a care plan accordingly!

By Matt Olivares on Jul 05, 2024.


Fact Checked by Nate Lacson.

Use Template
Modified Oswestry Disability Index PDF Example
ToolbarShare uiAI Icon

What is the Modified Oswestry Disability Index?

The is a nifty tool that was designed to help assign a subjective “qualitative” score to a patient’s experience with their lower back pain. It comes in the form of a questionnaire and it has ten sections, each one revolving around an activity of daily living. Some of the activities in question are personal care, walking, sitting, standing, and homemaking/work.

Each of these sections has six possible answers arranged by severity. Is the patient not feeling any lower back pain at all when it comes to a certain activity of daily living? Would they happen to be able to do a certain activity but feel a degree of pain? Or, does the lower back pain prevent them from engaging in a certain activity? These are the general questions that the patient will answer in the Modified Oswestry Disability Index.

Now, you are probably wondering given that this is called the Modified Oswestry Disability Index, what is the original like?

The answer to that is, there’s not much difference! It is almost identical to the original, with the only difference being that it replaces a certain section.

The original version has a section that revolves around sexual activity, which is a touchy subject made even more touchy given the context of lower back pain, so some people are uncomfortable when it comes to answering that. A lot of people who answer the original version usually leave that section blank.

As for the Modified Oswestry Disability Index, that section was replaced with Work/Homemaking, so people who answer it have no reason to not answer everything.

Modified Oswestry Disability Index Template

Download PDF Template

Modified Oswestry Disability Index Example

Download Example PDF

How to use the Oswestry Disability Index

The Modified Oswestry Disability Index is nowhere near complicated, making it a wonderful tool to include in your practice because it’s easy to use!

Issue this to your patient as soon as possible.

When you finally meet up with your patient, whether it’s face-to-face or through a video call, you should issue this to them at one point during your session. Make sure to explain what this is for, which is to assess their lower back pain severity.

What the patient needs to do is straightforward! They simply need to tick any of the six items for each section that best describes how their lower back pain is affecting them. Remember to remind them that they can only tick one answer per section.

Calculate the scores.

Once your patient submits a (hopefully) fully-accomplished Modified Oswestry Disability Index, then it’s time for you to calculate their scores.

Remember the following:

  • The six items per section are arranged by severity
  • The first one has a score of 0, which means they don’t feel any lower back pain for that activity
  • The last one has a score of 5, which means they can’t engage in that activity because of their lower back pain

Once you have the sum of all scores, you will calculate the percentage of their lower back pain severity. The equation for this is the total score ÷ the total possible score (supposedly always 50) x 100.

Now here’s an example of a calculation:

  • The total score they got is 16.
  • The total possible score is always 50.
  • Then the equation is 16 ÷ 50 x 100 = 32.
  • The final answer is always a percentage, so it’s 32% in this case

Not too bad, right?

Once you have calculated that, you are probably wondering what the final score means. All you need to do is to refer to this table, which has score ranges and designations to give you something to work with:

Score Ranges and Designations

Determine what goes into your care plan.

After calculating the final score, you’ll be able to see which score range it falls under and what its designation is. That, along with the patient’s specific answers, should help you determine what goes into your care plan.

Modified Oswestry Disability Index Example

Now you are aware of how the Modified Oswestry Disability Index works, it’s best you know what it looks like, especially when it’s fully accomplished:

If you like what you see in this Modified Oswestry Disability Index sample, then you might want to add this to your roster of orthopedic worksheets and assessments. You can download a free printable version of the Modified Oswestry Disability Index PDF on our platform! The digital version has tickable checkboxes!

Download this Modified Oswestry Disability Index Example (Sample) here:

Modified Oswestry Disability Index Example

When does one usually use the Modified Oswestry Disability Index?

Lower back pain should be taken seriously, even if it’s just mild because if it becomes worse, it could impact a person for the rest of their life.

When a patient sets up an appointment with you for the first time and you have finally met and had a discussion, you should issue this immediately so that you can get started with developing a care plan as soon as possible. It doesn’t matter if their lower back pain is currently mild. The sooner that it’s addressed, the better.

Once your patient is already committing to your care plan and is also undergoing rehabilitation, you may reissue this to them from time to time to see how they have progressed.

Who can use the Modified Oswestry Disability Index?

The Modified Oswestry Disability Index can be used by the following healthcare practitioners:

  • Orthopaedic doctors
  • Orthopaedic assistants
  • Physical therapists
  • Physiatrists
  • Chiropractors

Any healthcare professional can use this index so long as they are certified experts when it comes to treating lower back pain.

Physical Therapy Software Feedback

What are the benefits of using the Modified Oswestry Disability Index?

It has a better chance of being answered than the original version.

Given that this version takes out the sexual activity section that was present in the original, it’s more likely that patients will hand you a fully-accomplished index. Given that the sexual activity section is highly personal, it’s understandable why some would feel uncomfortable answering it.

It can give the healthcare practitioner something to work with.

The Modified Oswestry Disability Index assigns a subjective severity score for the patient. Even though it’s ultimately subjective, this doesn’t mean that it’s unreliable. In fact, it gives the healthcare practitioner a semblance of objectivity through the inclusion of score ranges and designations so they have something to work with to further their discussions and better inform their decisions when making care plans.

At the end of the day, even if the score is “subjective,” the practitioner will still consider how the patient perceives pain and they will be able to treat them appropriately.

The index helps with monitoring a patient’s progress and how effective their care plan is.

Let’s say you have finally implemented your care plan and your patient is following it. You may reuse this index to get a good picture of how they are doing. Is their condition improving or are they getting worse? You’ll be able to answer that by using the index again.

Additionally, you can also reuse it to determine if your care plan is effective or not. Hopefully, it’s working, but in the event that it isn’t, it probably needs some tweaking.

It’s a good tool to use to help patients realize and accept their limitations.

The index will mostly be used by the patient since they will be ticking the answers that apply to how they are feeling. Since they have to reflect on themselves and how their pain is affecting them, using this tool may also give them the clarity they need to accept what is going on and whether or not it is possible to improve their condition. Your care plan should also help with that.

Why use Carepatron for physical therapy software and clinical documentation?

In need of worksheets and assessments to better gauge your clients? Then look no further than Carepatron!

Our platform hosts a wide range of worksheets and assessments from various kinds of medical practices, including orthopedics and physical therapy!

If you specialize in orthopedics and physical therapy, then we definitely have clinical documents that you can add to your roster of tools to help you gauge your patients better, like the Oswestry Disability Index, both the original and modified versions.

We also provide intuitive and secure storage for your clinical documents, so if you have fully-accomplished Modified Oswestry Disability Indexes, you can store them in a HIPAA-compliant manner and even set up who can access them besides you.

Storing them on our platform makes them easily accessible to you anytime, anywhere on your preferred devices, may it be a desktop, laptop, or even your smartphone!

Convenience. Accessibility. Security. You get all three with Carepatron.

Physical Therapy Software
Does it ultimately matter whether I use the original version of this index or the modified one?
Does it ultimately matter whether I use the original version of this index or the modified one?

Commonly asked questions

Does it ultimately matter whether I use the original version of this index or the modified one?

No. They’re almost completely identical save for the fact that the modified version replaces the sexual activity part of the original with Homemaking/Work. The advantage of the modified version is that it is more likely that patients will answer all sections.

Since you said that it’s more likely for the patient to complete the modified version, what if they do not answer one section?

There are two possible reasons: 1) they forgot to, so you can remind them to tick the answer, or 2) they, for whatever reason, do not want to answer the section. If that’s the case, you’ll have to adjust the equation to the total score ÷ the total possible score (now 45 because they didn’t answer one section) x 100.

It should look like this: 16 ÷ 45 x 100 = 35.5%.

For every section they don’t answer, you just have to subtract 5 from the total possible score. So if they don’t answer two, then it’s 16 ÷ 40 x 100.

The last score range designation says that the patient might be exaggerating their symptoms. Is it okay to assume that?

Yes, because if the pain is that severe, they’re supposed to be bedridden and can’t move. If you happen to be in a face-to-face session and they give you a fully-accomplished index that has a total score of 81%-100%, then it’s obvious that they might be exaggerating a little bit. The person wouldn’t be there at all, unless they are bound on a stretcher and a companion answered the index for them.

In the event that you get a score that falls in that score range and the patient is not bed-bound, have them retake it and remind them to be more realistic about it and not exaggerate how they feel.

Join 10,000+ teams using Carepatron to be more productive

One app for all your healthcare work