Roland Morris Disability Questionnaire

A 24-item self-report measure of physical disability and activity limitation due to low back pain

Instructions:

When your back hurts, you may find it difficult to carry out some of your usual activities. Below are some statements about those difficulties. For each statement, answer Yes if it applies to you today, or No if it does not. If a statement does not apply to you, answer No.

Statements 1 to 12

1. I stay at home most of the time because of my back.

Yes

2. I change position frequently to try and get my back comfortable.

Yes

3. I walk more slowly than usual because of my back.

Yes

4. Because of my back, I am not doing any of the jobs that I usually do around the house.

Yes

5. Because of my back, I use a handrail to get upstairs.

Yes

6. Because of my back, I lie down to rest more often.

Yes

7. Because of my back, I have to hold on to something when getting out of an easy chair.

Yes

8. Because of my back, I try to get someone else to do things for me.

Yes

9. I get dressed more slowly than usual because of my back.

Yes

10. I only stay up for short periods because of my back.

Yes

11. Because of my back, I try not to bend or kneel down.

Yes

12. I find it difficult to get out of a chair because of my back.

Yes

Statements 13 to 24

13. My back is painful almost all the time.

Yes

14. I find it difficult to turn over in bed because of my back.

Yes

15. My appetite is not very good because of my back pain.

Yes

16. I have trouble putting on my socks (or stockings) because of the pain in my back.

Yes

17. I only walk short distances because of my back.

Yes

18. I sleep less well because of my back.

Yes

19. Because of my back pain, I get dressed with help from someone else.

Yes

20. I sit down for most of the day because of my back.

Yes

21. I avoid heavy jobs around the house because of my back.

Yes

22. Because of the pain in my back, I am more irritable and bad tempered with people than usual.

Yes

23. Because of my back, I go upstairs more slowly than usual.

Yes

24. I stay in bed most of the time because of my back.

Yes

Patient Watch Form - 4/2/2026