ÖMSQ-12

Tell us about your pain or problem.

  1. How long ago did your current pain or problem start?

  2. Rate how much of a burden it is to perform all the things you need to do in a normal day.
    0 = not at all, 10 = extremely

  3. For the last 2–3 days, rate on average how bothersome your pain or problem is.
    0 = not at all, 10 = extremely

  4. For the last 2–3 days, what percentage of the day do you notice your pain or problem?
    0 = never, 100 = all the time

We also need a bit more information on your thoughts and feelings.

  1. During the past 2–3 days, rate how tense or anxious you have felt.
    0 = not at all, 10 = extremely

  2. During the past 2–3 days, rate how "depressed" or "down" you have felt.
    0 = not at all, 10 = extremely

  3. What do you think is the risk that your current pain or problem will not improve?
    0 = no risk, 10 = very large risk

  4. Think of your life. Rate how satisfied you are with your current situation.
    0 = not at all, 10 = extremely

How true are the next two statements for you?

  1. Physical activity makes my pain or problem worse.
    0 = not at all, 10 = extremely

  2. I should not do my normal daily routine or work with my present pain or problem.
    0 = not at all, 10 = extremely

Help us to better understand your current physical abilities.

  1. I can walk for an hour or participate in my normal light recreational or sporting activities
    0 = not at all, 10 = completely normal

  2. I manage my daily routine and social activities (shopping, transportation, seeing friends, etc.)
    0 = not at all, 10 = completely normal