Oswestry Disability Index (ODI) For Low Back Pain
In the text below the calculator there is more information on the items in the index and instructions on how to interpret the results.
The Oswestry Disability Index for low back pain is a self report scale that takes about 5 minutes to complete and can offer information on how the patient perceives the impact low back and leg pain have on them performing lifestyle activities.
The topics for which the patient needs to choose answers on a scale from no disability to severe impairment include: intensity of pain, self-care, walking, sleeping or traveling.
Each of the 10 items in the ODI is scored between 0 and 5, where 0 reflects no or little impairment to the assessed activity and 5 reflects severe dysfunction.
The overall score ranges between 0 and 50. This can be multiplied by 2 to obtain a percentage which is then interpreted as follows:
■ 0% to 20% - Minimal disability;
■ 21% to 40% - Moderate disability;
■ 41% to 60% - Severe disability;
■ 61% to 80% - Patient crippled;
■ 81% to 100% - Patient bedbound.
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ODI items and usage
The Oswestry disability index is used in the pain management of spinal disorders to evaluate the impact of the patient’s condition on their ability to perform daily lifestyle activities.
The index is a self report questionnaire that takes less than 5 minutes to complete and consists of 10 items, each with 6 answer choices on a scale from 0 to 5.
Each item is aimed at reflecting the impairment caused by low back pain or leg pain:
■ Pain Intensity – the degree in which pain is tolerated before resorting to pain medication;
■ Personal Care – the patient’s ability to care after oneself without aid and if so, to what extent;
■ Lifting – ability to lift different size weights with or without pain;
■ Walking – distance that the patient is able to walk with or without aid;
■ Sitting – ability to sit or if this is prevented by pain;
■ Standing – evaluating the ability to stand unaided and if so, for how long;
■ Sleeping – whether the patient experiences sleep deprivation, insomnia and needs sleeping medication;
■ Sex Life – impairment and prevention of intercourse due to pain;
■ Social Life – dysfunctionalities in the way patient interacts socially, which are caused by pain;
■ Traveling – ability to travel short or long journeys with or without pain.
ODI has been praised for its psychometric properties and the fact that it can define outcome in condition specific spinal disorders. The Neck Disability Index (NDI) was build following the same pattern.
As mentioned above, each of the items in ODI is scored from 0 to 5. Answers closer to 0 reflect no or little impairment or inability to continue with the assessed activity.
Answers closer to 5 reflect an increased severity in the pain related dysfunction.
To obtain the ODI score, the individual points awarded to the chosen answers are summed and the overall score ranges between 0 and 50 or 0 and 100% (in order to obtain the percentage figure, the ODI score is multiplied by 2).
In practice, it was found that even patients who have been in treatment and are already recovering, still attain scores of 5 to 15 (10 – 30%).
The original study has specified cut off points for different impairment severity categories, as described in the table below:
|ODI score (percentage)||Interpretation|
|0% to 20%||Minimal disability - No treatment may be indicated except for suggestions on lifting, posture, physical fitness and diet. In the case of sedentary patients, more problems may need to be addressed.|
|21% to 40%||Moderate disability - Conservative treatment may be sufficient. The level of impairment increases and patients may experience more problems with sitting, standing, sexual activity or traveling.|
|41% to 60%||Severe disability – Recommendation for detailed evaluation as pain is primary problem.|
|61% to 80%||Patient is crippled – back or leg pain are impacting daily living. Recommendation for active treatment.|
|81% to 100%||Patient bedbound or exaggerating their symptoms.|
About the study
The development of the Oswestry disability index was started in 1976 after interviews with a cohort of patient suffering from low back pain.
The first index was published in 1980 as a condition-specific outcome measure for patients with spinal disorders.
Since then, there have been several revisions and the index has been validated in various languages.
The Minimum Detectable Change at 90% confidence is of 10%, meaning that for clinical meaningfulness, at least a 10% change is required in monitoring reassessments, which are recommended every 2 weeks.
Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine (Phila Pa 1976). 2000; 25(22):2940-52; discussion 2952.
1. Fairbank JC, Couper J, Davies JB, O'Brien JP. The Oswestry low back pain disability questionnaire. Physiotherapy. 1980; 66(8):271-3.
2. Tonosu J, Takeshita K, et al. The normative score and the cut-off value of the Oswestry Disability Index (ODI). Eur Spine J. 2012; 21(8):1596-602.
App Version: 1.0.1
Coded By: MDApp
No. Of Items: 10
Year Of Study: 1980
Published On: April 8, 2017 · 08:11 AM
Last Checked: April 8, 2017
Next Review: April 8, 2018