Örebro Musculoskeletal Pain Screening

Instructions: Please complete the below questions.

1. How long have you had your current pain problem?

0-1
weeks 1-2
weeks 3-4
weeks 4-5
weeks 6-8
weeks 9-11
weeks 3-6
months 6-9
months 9-12
months Over 1
year

2. How would you rate the pain that you have had during the past week?

0
No pain 1 2 3 4 5 6 7 8 9 10
As bad as it could be

3. I can do light work for an hour.

0
Cannot do it because of pain 1 2 3 4 5 6 7 8 9 10
Can do it without pain

4. I can sleep at night

0
Cannot do it because of the pain 1 2 3 4 5 6 7 8 9 10
Can do it without pain

5. How tense or anxious have you felt in the past week?

0
Absolutely calm and relaxed 1 2 3 4 5 6 7 8 9 10
As tense and anxious as ever

6. How much have you been bothered by feeling depressed in the past week?

0
Not at all 1 2 3 4 5 6 7 8 9 10
Extremely

7. In your view, how large is the risk that your current pain may become persistent?

0
No risk 1 2 3 4 5 6 7 8 9 10
Very large risk

8. In your estimation, what are the chances you will be working your normal duties in 3 months?

0
No chance 1 2 3 4 5 6 7 8 9 10
Very large chance

Important

Here are some of the things which other people have told us about their pain. For each statement, choose one number to say how much physical activities, such as bending, lifting, walking, or driving affect your pain.

9. An increase in pain is an indication that I should stop what I'm doing until the pain decreases?

0
Completely disagree 1 2 3 4 5 6 7 8 9 10
Completely agree

10. I should not do my normal work with my present pain.

0
Completely disagree 1 2 3 4 5 6 7 8 9 10
Completely agree

Web Design 2020-2021 Orthopaedic Manipulation