Complete all 10 sections of the Oswestry questionnaire to quantify the functional impact of low back pathology.
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Patient-reported outcome measure (PROM) for lumbar degenerative disk disease, radiculopathy, and stenosis.
Standardized metric for comparing pre-operative baseline to post-operative (Lumbar Fusion/Microdiscectomy) outcomes.
Section 2
Literature
Development
First published by Fairbank et al. in 1980 from the Oswestry and District Hospital in England. It revolutionized spine research by forcing the field to measure success not by "did the X-ray look fused?" but by "can the patient sit in a chair without pain?"
Section 3
Pearls/Pitfalls
MCID (Minimal Clinically Important Difference)
A reduction in the ODI by 30% (or roughly 15 percentage points) from the pre-operative baseline is considered the MCID. Anything less indicates an ineffective surgical outcome or failed back surgery syndrome (FBSS).
Section 4
Evidence Appraisal
Primary Reference
The Oswestry low back pain disability questionnaire
Fairbank JC et al. • Physiotherapy. 1980;66(8):271-3
Last Comprehensive Review: 2026
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Measuring functional disability caused by lumbar spine pain.
Evaluating surgical and conservative treatment outcomes for low back pain.
Tracking progression or recovery in athletes with lumbar pathology.
Clinical Objective
The ODI is the "gold standard" for lumbar spine functional disability assessment and one of the most widely cited PROMs in orthopaedic spine surgery.
Section 2
Formula & Logic
Scoring Structure
Total Items
10 Sections
Score per Section
0 – 5
Formula
(Total Score / 50) x 100 = % Disability
Disability Grades
01
0–20%: Minimal disability
02
21–40%: Moderate disability
03
41–60%: Severe disability
04
61–80%: Crippling back pain
05
81–100%: Bed-bound / symptom exaggeration
Section 3
Pearls/Pitfalls
Sections Covered
Pain intensity, personal care, lifting, walking, sitting, standing, sleeping, sex life, social life, travelling.
Clinical Pearls
MCID: 10 percentage points.
If a section is not applicable, adjust denominator: (Total / (5 × answered)) × 100.
A score > 40% at baseline predicts poorer surgical and conservative outcomes without psychosocial intervention.
Section 4
Next Steps
Management Decisions
01
Score 20–40%: Core stabilisation, McKenzie or directional preference exercises.
02
Score > 40%: Combined physiotherapy + pain psychology; evaluate for surgical candidacy if neurological deficit present.
03
Athletes: Serial ODI every 4–6 weeks to track return-to-sport trajectory.
