RDQ
Age: ____________
Score:
_______________________
When your back (neck, etc.) hurts, you may find if difficult to
do some of the things you normally do.
Mark only the sentences that describe you lately….
1. [ ] I stay at home most of the time because of my back.
2. [ ] I walk more slowly than usual because of my back.
3. [ ] Because of my back, I am not doing any jobs that I usually do around the house.
4. [ ] Because of my back, I use a handrail to get upstairs.
5. [ ] Because of my back, I lie down to rest more often.
6. [ ] Because of my back, I have to hold onto something to get out of an easy chair.
7. [ ] Because of my back, I try to get other people to do things for me.
8. [ ] I get dressed more slowly than usual because of my back.
9. [ ] I stand up only for short periods of time because of my back.
10. [ ] Because of my back, I try not to bend or kneel down.
11. [ ] I find it difficult to get out of a chair because of my back.
12. [ ] My back or leg is painful almost all of the time.
13. [ ] I find it difficult to turn over in bed because of my back.
14. [ ] I have trouble putting on my socks (or stockings) because of pain in my back.
15. [ ] I sleep less well because of my back.
16. [ ] I avoid heavy jobs around the house because of my back.
17. [ ] Because of back pain, I am more irritable and bad tempered with people than usual.
18. [ ] Because of my back, I go upstairs more slowly than usual.