The Oswestry Disability Index asks how low back pain affects ten parts of daily life, from pain intensity to travelling. Each section scores 0 to 5, and the total becomes a percent from 0 to 100: the higher, the more disability. See how to work out the percent, read the bands, judge a change after treatment or surgery, and record the result with the free template. The official form comes from its source.
ODI result template
FreeOSWESTRY DISABILITY INDEX Date: [Date] Patient: [Name or ID, age, occupation] Encounter: [New patient, re-evaluation, before surgery, weeks after surgery, or discharge] Form used: [ODI version 2.1a or 2.1b, or modified Oswestry; language; paper, tablet, or portal] PRESENTATION Main complaint: [Low back pain, leg pain, or both, and which is worse] Leg symptoms: [Side, how far down the leg, numbness, weakness, walking limit, or none] Diagnosis: [Working diagnosis, and imaging if done] Care to date: [Exercise, therapy, medicines, injections, or surgery, with dates] CALCULATION Sections answered: [Number out of 10, and which were blank] Section scores: [Pain intensity, personal care, lifting, walking, sitting, standing, sleeping, sex life, social life, travelling: each 0 to 5] Raw total: [Sum of the section scores] Possible total: [50, less 5 for each blank section] ODI: [Raw total divided by possible total, times 100, to the nearest whole percent] Band: [Minimal, moderate, severe, disabling, or bed-bound or overstated] PROGRESS First ODI: [Date and percent] Previous ODI: [Date and percent] Change from first: [Points and percent of the first score; meaningful at 10 points or 30 percent] RED FLAGS AND EXAM Red flags: [Bladder or bowel change, saddle numbness, progressive weakness, fever, weight loss, cancer history: present or absent] Neurological exam: [Strength, reflexes, sensation, straight leg raise] Function seen today: [Sitting tolerance, walking distance, transfers, as observed] DECISION Management: [Continue, progress, change treatment, inject, refer, operate, or discharge] Goal: [Target ODI and the activity it stands for, with a date] Work and activity: [Full duties, modified duties, or off work, with any limits] Next ODI: [Date or interval] Clinician: [Name, credentials]
Use it for
The patient fills in the official form on their own, choosing in each section the one statement that fits them now. It takes about 5 minutes.
Avoid: Retyping the form or rewording the sections as you read them. Changes alter how people answer, and the terms don’t allow them.
Score each section 0 to 5, add them, divide by the most possible for the sections answered, and multiply by 100.
Avoid: Dividing by 50 when a section is blank. It lowers the score every time, and it’s the most common scoring error.
Higher means more disability. The band describes daily life; the history, exam, and imaging decide the plan.
Avoid: Using the band as a rule for surgery or time off work. It describes; it doesn’t decide.
Take a baseline before treatment starts, then repeat at set points with the same version each time.
Several forms carry the Oswestry name. Record which one the patient filled in.
Avoid: Comparing a modified Oswestry score with an ODI score as if they were the same measure.
Each one follows the recording template. Use them to judge how much to write.
Outpatient physical therapy, re-evaluation at 12 weeks, form completed on a clinic tablet
46-year-old dental hygienist with left leg pain for 4 months, which began after lifting a box at home. MRI in July: left paracentral L4–L5 disc protrusion touching the L5 nerve root. At the start, leg pain was 7/10 down the outer shin to the top of the foot, worse than the back pain, and she could sit for only 15 minutes. Care to date: physical therapy twice a week for 6 weeks, then weekly, with a home program; naproxen for the first 3 weeks.
ODI version 2.1a in English. 9 of 10 sections answered; sex life left blank, as at the start. Section scores: pain intensity 1, personal care 0, lifting 2, walking 1, sitting 2, standing 1, sleeping 1, social life 1, travelling 1. Raw total 10 out of a possible 45: 10 ÷ 45 × 100 = 22%, moderate disability, 2 points above the minimal band.
First ODI on August 14: 20 out of 45, 44%, severe disability. Now 22%: down 22 points, half the starting score, well past both the 10-point and the 30% marks. The biggest gains were in sitting, from 4 to 2, and personal care, from 2 to 0.
No bladder or bowel change, saddle numbness, fever, or weight loss. Left big toe extension 5/5, up from 4/5; ankle reflexes equal; light touch normal. Straight leg raise negative on both sides; at the start it was positive at 40° on the left. Sat through the 40-minute visit without needing to stand.
Goals met: ODI under 25 and a full clinic day without leg pain above 2/10. Discharged to her home program: a daily walk, hip hinge and trunk exercises 3 times a week, and a break from sitting every 45 minutes at work. Back on full duties with her usual patient load. Return for leg pain above 4/10 or any new weakness or numbness; repeat the ODI then.
Spine surgery clinic, decision visit before a planned decompression, form completed on paper
70-year-old retired bus driver with 2 years of aching in both buttocks and thighs on walking, now after about one block, eased within minutes by sitting or leaning on a shopping cart. Back pain mild. MRI in September: severe central canal stenosis at L4–L5 and moderate at L3–L4; flexion and extension X-rays show no slip or abnormal movement. Care to date: 4 months of physical therapy with flexion exercises and a stationary bike, and an epidural steroid injection in June that helped for about 6 weeks.
ODI version 2.1a. All 10 sections answered. Section scores: pain intensity 2, personal care 1, lifting 2, walking 4, sitting 0, standing 4, sleeping 1, sex life 1, social life 2, travelling 2. Raw total 19 out of 50, doubled: 38%, moderate disability. Walking and standing carry 8 of the 19 points, and sitting scores 0, a pattern stenosis often gives.
First ODI at the start of physical therapy in April: 32%. Up 6 points since, within measurement error, so best read as no improvement despite the therapy and the injection.
No bladder or bowel change or saddle numbness; no fever, weight loss, or cancer history. Strength 5/5 in both legs; ankle reflexes reduced on both sides, equally; light touch normal; straight leg raise negative. Foot pulses easy to feel on both sides, so a circulation cause for the leg pain is unlikely. Walked about 100 meters in the corridor before stopping to lean forward.
An ODI of 38% sits in the moderate band, where most back problems are managed without surgery; here the case rests on the walking limit, the failed conservative care, and an MRI that matches his symptoms. After talking through the risks and benefits, he chose decompression at L3–L4 and L4–L5 without fusion. Goal: walk his dog for 30 minutes without stopping, and an ODI at least 15 points lower by 12 months. Repeat the ODI at 6 weeks, 3 months, and 12 months after surgery.
A raw total of 20 with sex life blank is 44%, not 40%. In one hospital audit, every form with a blank section had been scored wrong; training and a scoring chart cut those errors to 1 in 7.
A raw total of 19 is 38%, not 19%. Record both, labelled, so the trend reads right.
Version 1.0 and the modified Oswestry give scores that don’t line up exactly with version 2.1a. Record the version, and compare like with like.
The bands describe disability; they don’t decide treatment. A score of 38% can sit beside a clear case for surgery, and 55% beside a plan for active rehab.
Above 80%, the person is either confined to bed or the score overstates the problem. Watch how they move during the visit, and look for distress and fear of movement, which need care of their own.
Vero Scribe records the ODI result in your template from the visit, with the patient’s consent, or from your dictation: the sections answered, the raw total and percent, the band, the change from the first score, and the decision. You review and edit every line, then copy it into your record. Vero works in 60+ languages.
Each of the 10 sections scores 0 to 5, from its first statement to its last. Add the section scores, divide by the most possible, which is 50 when every section is answered, and multiply by 100. With all 10 answered that’s the raw total doubled, so 19 becomes 38%. For each blank section, take 5 off the most possible: 20 over 9 sections is 20 ÷ 45 × 100 = 44%.
Higher means more disability. The published bands from Fairbank and Pynsent are 0 to 20% minimal disability, 21 to 40% moderate, 41 to 60% severe, 61 to 80% back pain that limits every part of life, and 81 to 100% confined to bed or overstating symptoms. They describe daily life; the treatment decision also rests on the history, the exam, and any imaging.
An international consensus put the minimal important change at 10 points, or a 30% fall from the baseline score. Studies after lumbar surgery found about 13 points, and device trials for spinal fusion have used 15 points as success. For the modified Oswestry used in many physical therapy clinics, the original study found about 6 points.
Score the sections answered, and take 5 off the most possible for each blank one. Sex life is the section most often left blank, and scaling handles it. If two statements in one section are marked, score the higher. Ask about any blank before the patient leaves, and record how many sections the score rests on.
Version 2.1a is the one most studies and clinics use, and Mapi Research Trust now distributes version 2.1b, updated in 2019; both score the same way. Version 1.0 from 1980 framed the pain section around painkillers, and the modified Oswestry swaps the sex life section for one on work and homemaking. Pick one, use it every time, and record it.
Both measure disability from low back pain. The Roland-Morris has 24 yes-or-no statements about today, scored 0 to 24, and suits milder problems, as often seen in primary care. The ODI has 10 sections of six statements each, scored as a percent, and separates people better when disability is moderate to severe, as in spine clinics. The Neck Disability Index was built on the ODI’s design, for neck pain.
The patient fills it in, so any member of the team can hand it out: physical therapists, chiropractors, physicians, nurses, or clinic staff. It takes about 5 minutes to complete and a minute to score, and needs no training. It was developed for adults. A clinician goes over the result with the patient.
For students, clinicians using it in patient care, and unfunded academic research, yes: download the form and its translations from ePROVIDE after a free sign-up. Funded research, healthcare organizations, and commercial users, including software companies, apply to Mapi Research Trust, and fees may apply. The recording template on this page is free to copy or download.
Patient-reported measures of symptoms and function, scored as T-scores with 50 as the average: short forms, CATs, and the PROMIS-29.
Six basic self-care activities rated independent or dependent, scored 0 to 6, for function and care needs in older adults.
Eight independent living tasks, from shopping to finances, each scored 0 or 1: a total from 0, dependent, to 8, independent.
Eleven questions on arm, shoulder, and hand function over the past week, scored 0 to 100: the higher, the more disability.
Twenty everyday activities rated for difficulty: lower limb function scored 0 to 80, higher is better, and 9 points is a real change.
History, exam, and goals for low back pain, with the ODI as the baseline.
Functional limits and work capacity for insurers and employers, backed by scores.
Evaluations, daily notes, and progress reports.
Initial exams, re-exams, and outcome scores for back pain.
Vero records scores, findings, and plans in the templates you choose, so you review instead of type.
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