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HERSHEY ORTHOPEDIC & SPINE REHABILITATION MODIFIED ANCESTRY QUESTIONNAIRE NAME: DATE: CHOOSE ONLY ONE IN EACH CATEGORY THAT BEST DESCRIBES YOUR CONDITION PAIN INTENSITY I have no pain at all. I have

How to fill out modified oswestry form

How to fill out modified oswestry:

1. Start by providing your personal information, including your name, age, and contact details.
2. Proceed to the first section of the modified oswestry form, which involves assessing your pain intensity. Rate your level of pain on a scale of 0 to 10 for each activity listed.
3. Move on to the second section, which focuses on your ability to perform various daily activities. Indicate the degree of difficulty you experience for each activity by choosing the appropriate answer.
4. The third section involves addressing how your pain affects your mood and mental well-being. Again, provide the most accurate response that represents your current state.
5. In the final section, you will be asked to rate your overall quality of life despite your pain. Choose the option that best describes your situation.
6. Review your answers before submitting the modified oswestry form to ensure accuracy.

Who needs modified oswestry:

1. Individuals suffering from chronic back pain can benefit from the use of the modified oswestry. It helps assess the impact of pain on their daily lives and measure their functional limitations.
2. Patients undergoing treatment for back-related conditions, such as herniated disc, spinal stenosis, or degenerative disc disease, may be required to fill out the modified oswestry to track their progress and evaluate the effectiveness of interventions.
3. Medical professionals, including physicians, physical therapists, and chiropractors, often administer the modified oswestry as part of their clinical assessment to gather comprehensive information about a patient's back pain and its impact on their functionality.

For pdfFiller’s FAQs

What is modified oswestry?

Modified Oswestry is a questionnaire used to assess disability related to low back pain.

Who is required to file modified oswestry?

Healthcare professionals may require patients to fill out the Modified Oswestry questionnaire.

How to fill out modified oswestry?

Patients can fill out the Modified Oswestry questionnaire by answering the questions related to their low back pain and disability.

What is the purpose of modified oswestry?

The purpose of Modified Oswestry is to assess the impact of low back pain on a patient's daily activities and overall functioning.

What information must be reported on modified oswestry?

The Modified Oswestry questionnaire asks about the patient's pain intensity, ability to perform daily activities, and impact on quality of life.

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