Oh! My back hurts!

1. How would you describe the intensity of your back pain?
Mild Moderate Severe

2. Does your back pain limit your daily activities or work?
Mildly Limited Moderately Limited Greatly Limited

3. Does your back pain affect sleep?
Not at all Mildly Moderately Greatly Cannot sleep

4. Apart from back pain, do you experience pain radiating down to lower limbs?
Not at all Down to thigh Down to leg No, but pins and needles felt
Both pain and pins and needles

5. Do you feel pain at back even with cough or sneezeĦH
No Yes

6. Does your back pain hinder you from going outĦH
No Yes

7. Do you lose temper easily because of back pain?
No Yes

8. Do you spend most of the time lying on bed because of back pain?
No Yes

9. Do you feel weakness of both lower limbs when comparing to before?
No Yes

10. Do you find yourself unable to control your bowel or bladder?
No Yes


0-10: occasional back pain which may be provoked by heavy work load, poor posture or poor lifting techniques. Advice for posture, working environment or lifting techniques are suggested.
11-20: frequent back pain causing interruption on daily life or work, medical advice is suggested to prevent worsening.
21 or more: severe back pain which may indicate pathological changes on lumbar region. Medical consultation is strongly advised.

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