Pain, spine & orthopaedic care in Ocean & Monmouth County, NJ
Disability forms

Oswestry Disability Index (ODI)

Ten short sections about how back or leg pain affects your everyday life. Your score updates as you answer.

Your answers stay on this device. This form does not send or save anything. Your answers are not sent to GSMC, and they are cleared when you close or reset the page. To share your results, print the page or save it as a PDF and bring it to your visit or give it to our staff.

Patient details (for your printout only)
These fields only appear on your printout or PDF. They are not sent or saved.

This questionnaire tells us how your back (or leg) trouble affects your ability to manage in everyday life. Please answer every section. Choose one statement in each section that most closely describes you today. If two statements seem to fit, choose the one that describes you best. If a section does not apply to you, you can skip it.

Your ODI score

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What your score means

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  • 0–20%Minimal disability
  • 21–40%Moderate disability
  • 41–60%Severe disability
  • 61–80%Very severe disability
  • 81–100%Bed-bound

How it is scored: each section is scored 0 to 5. Your score is the total of your answers divided by the highest possible total for the sections you answered (5 × number of sections answered), shown as a percentage. Lower scores mean less disability.

All disability forms

Talk with a GSMC specialist

We will review your history and imaging and explain your options. Many plans, including Medicare, are accepted. We verify benefits before scheduling procedures.