Modified OSWESTRY Low Back Pain Disability Questionnaire

  • MM slash DD slash YYYY
  • This questionnaire has been designed to give your therapist information as to how your back pain has affected your ability to manage in every day life. Please answer every question. For each question, place a check mark by the statement that BEST describes your condition today. We realize you may feel that two of the statements may describe your condition, but please mark only the line which most closely describes your current condition.
  • Today's Date: 06/22/2024
  • This field is for validation purposes and should be left unchanged.