{"id":639,"date":"2022-11-22T23:07:20","date_gmt":"2022-11-22T23:07:20","guid":{"rendered":"https:\/\/backinstituteneurosurgery.com\/web\/?page_id=639"},"modified":"2023-07-22T23:30:22","modified_gmt":"2023-07-22T23:30:22","slug":"oswestry-form","status":"publish","type":"page","link":"https:\/\/backinstituteneurosurgery.com\/main\/oswestry-form\/","title":{"rendered":"Oswestry Form"},"content":{"rendered":"<p><strong>THE OSWESTRY* LOW BACK PAIN DISABILITY QUESTIONNAIRE<\/p>\n<p>Please Read: This questionnaire is designed to enable us to understand how much your low back and\/or leg pain has affected your ability to manage everyday activities. Please answer each Section by circling the ONE CHOICE that most applies to you. We realize that you may feel that more than one statement may relate to you, but PLEASE SELECT THE ONE CHOICE WHICH CLOSELY DESCRIBES YOUR PROBLEM RIGHT NOW.<br \/>\n<\/strong><\/p>\n<div class=\"wpforms-container wpforms-container-full wpforms-render-modern\" id=\"wpforms-900\"><form id=\"wpforms-form-900\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"900\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/main\/wp-json\/wp\/v2\/pages\/639\" data-token=\"eda4a3b1dfe488bac8f6fbfb87fee39a\" data-token-time=\"1776011021\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-hidden\" id=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/div><div class=\"wpforms-field-container\"><div id=\"wpforms-900-field_15-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"15\"><label class=\"wpforms-field-label\" for=\"wpforms-900-field_15\">Name<\/label><input type=\"text\" id=\"wpforms-900-field_15\" class=\"wpforms-field-medium\" name=\"wpforms[fields][15]\" aria-errormessage=\"wpforms-900-field_15-error\" ><\/div><div id=\"wpforms-900-field_16-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"16\"><label class=\"wpforms-field-label\" for=\"wpforms-900-field_16\">Email<\/label><input type=\"email\" id=\"wpforms-900-field_16\" class=\"wpforms-field-medium\" name=\"wpforms[fields][16]\" spellcheck=\"false\" aria-errormessage=\"wpforms-900-field_16-error\" ><\/div><div id=\"wpforms-900-field_17-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"17\"><fieldset><legend class=\"wpforms-field-label\">SECTION 1--Pain Intensity<\/legend><ul id=\"wpforms-900-field_17\"><li class=\"choice-7 depth-1\"><input type=\"radio\" id=\"wpforms-900-field_17_7\" name=\"wpforms[fields][17]\" value=\"NONE - No pain\" aria-errormessage=\"wpforms-900-field_17_7-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_17_7\">NONE - No pain<\/label><\/li><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-900-field_17_1\" name=\"wpforms[fields][17]\" value=\"A.\tThe pain comes and goes and is very mild.\" aria-errormessage=\"wpforms-900-field_17_1-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_17_1\">A.\tThe pain comes and goes and is very mild.<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-900-field_17_2\" name=\"wpforms[fields][17]\" value=\"B.\tThe pain is mild and does not vary much.\" aria-errormessage=\"wpforms-900-field_17_2-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_17_2\">B.\tThe pain is mild and does not vary much.<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-900-field_17_3\" name=\"wpforms[fields][17]\" value=\"C.\tThe pain comes and goes and is moderate.\" aria-errormessage=\"wpforms-900-field_17_3-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_17_3\">C.\tThe pain comes and goes and is moderate.<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"radio\" id=\"wpforms-900-field_17_6\" name=\"wpforms[fields][17]\" value=\"D.\tThe pain is moderate and does not vary much.\" aria-errormessage=\"wpforms-900-field_17_6-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_17_6\">D.\tThe pain is moderate and does not vary much.<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-900-field_17_5\" name=\"wpforms[fields][17]\" value=\"E.\tThe pain is severe but comes and goes.\" aria-errormessage=\"wpforms-900-field_17_5-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_17_5\">E.\tThe pain is severe but comes and goes.<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-900-field_17_4\" name=\"wpforms[fields][17]\" value=\"F.\tThe pain is severe and does not vary much.\" aria-errormessage=\"wpforms-900-field_17_4-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_17_4\">F.\tThe pain is severe and does not vary much.<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-900-field_18-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"18\"><fieldset><legend class=\"wpforms-field-label\">SECTION 2--Personal Care<\/legend><ul id=\"wpforms-900-field_18\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_18_1\" name=\"wpforms[fields][18][]\" value=\"A.\tI would not have to change my way of washing or dressing in order to avoid pain.\" aria-errormessage=\"wpforms-900-field_18_1-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_18_1\">A.\tI would not have to change my way of washing or dressing in order to avoid pain.<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_18_2\" name=\"wpforms[fields][18][]\" value=\"B.\tI do not normally change my way of washing or dressing even though it causes some pain.\" aria-errormessage=\"wpforms-900-field_18_2-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_18_2\">B.\tI do not normally change my way of washing or dressing even though it causes some pain.<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_18_3\" name=\"wpforms[fields][18][]\" value=\"C.\tWashing and dressing increase the pain, but I manage not to change my way of doing it.\" aria-errormessage=\"wpforms-900-field_18_3-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_18_3\">C.\tWashing and dressing increase the pain, but I manage not to change my way of doing it.<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_18_6\" name=\"wpforms[fields][18][]\" value=\"D.\tWashing and dressing increase the pain and I it necessary to change my way of doing it.\" aria-errormessage=\"wpforms-900-field_18_6-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_18_6\">D.\tWashing and dressing increase the pain and I it necessary to change my way of doing it.<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_18_5\" name=\"wpforms[fields][18][]\" value=\"E.\tBecause of the pain, I am unable to do any washing and dressing without help.\" aria-errormessage=\"wpforms-900-field_18_5-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_18_5\">E.\tBecause of the pain, I am unable to do any washing and dressing without help.<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_18_4\" name=\"wpforms[fields][18][]\" value=\"F.\tBecause of the pain, I am unable to do any washing or dressing without help.\" aria-errormessage=\"wpforms-900-field_18_4-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_18_4\">F.\tBecause of the pain, I am unable to do any washing or dressing without help.<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-900-field_19-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"19\"><fieldset><legend class=\"wpforms-field-label\">SECTION 3--Lifting<\/legend><ul id=\"wpforms-900-field_19\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_19_1\" name=\"wpforms[fields][19][]\" value=\"A.\tI can lift heavy weights without extra pain.\" aria-errormessage=\"wpforms-900-field_19_1-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_19_1\">A.\tI can lift heavy weights without extra pain.<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_19_2\" name=\"wpforms[fields][19][]\" value=\"B.\tI can lift heavy weights, but it causes extra pain\" aria-errormessage=\"wpforms-900-field_19_2-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_19_2\">B.\tI can lift heavy weights, but it causes extra pain<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_19_3\" name=\"wpforms[fields][19][]\" value=\"C.\tPain prevents me from lifting heavy weights off the floor.\" aria-errormessage=\"wpforms-900-field_19_3-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_19_3\">C.\tPain prevents me from lifting heavy weights off the floor.<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_19_6\" name=\"wpforms[fields][19][]\" value=\"D.\tPain prevents me from lifting heavy weights off the floor, but I can manage if they are conveniently positioned, e.g. on the table.\" aria-errormessage=\"wpforms-900-field_19_6-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_19_6\">D.\tPain prevents me from lifting heavy weights off the floor, but I can manage if they are conveniently positioned, e.g. on the table.<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_19_5\" name=\"wpforms[fields][19][]\" value=\"E.\tPain prevents me from lifting heavy weights, but I can manage light to medium weights if they are conveniently positioned.\" aria-errormessage=\"wpforms-900-field_19_5-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_19_5\">E.\tPain prevents me from lifting heavy weights, but I can manage light to medium weights if they are conveniently positioned.<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_19_4\" name=\"wpforms[fields][19][]\" value=\"F.\tI can only lift very light weights, at the most\" aria-errormessage=\"wpforms-900-field_19_4-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_19_4\">F.\tI can only lift very light weights, at the most<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-900-field_20-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"20\"><fieldset><legend class=\"wpforms-field-label\">SECTION 4 --Walking<\/legend><ul id=\"wpforms-900-field_20\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_20_1\" name=\"wpforms[fields][20][]\" value=\"A.\tPain does not prevent me from walking any distance.\" aria-errormessage=\"wpforms-900-field_20_1-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_20_1\">A.\tPain does not prevent me from walking any distance.<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_20_2\" name=\"wpforms[fields][20][]\" value=\"B.\tI have some pain with walking but it does not increase with distance.\" aria-errormessage=\"wpforms-900-field_20_2-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_20_2\">B.\tI have some pain with walking but it does not increase with distance.<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_20_3\" name=\"wpforms[fields][20][]\" value=\"C.\tPain prevents me from walking more than one mile.\" aria-errormessage=\"wpforms-900-field_20_3-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_20_3\">C.\tPain prevents me from walking more than one mile.<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_20_6\" name=\"wpforms[fields][20][]\" value=\"D.\tPain prevents me from walking more than 1\/2 mile.\" aria-errormessage=\"wpforms-900-field_20_6-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_20_6\">D.\tPain prevents me from walking more than 1\/2 mile.<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_20_5\" name=\"wpforms[fields][20][]\" value=\"E.\tI can only walk while using a cane or on crutches.\" aria-errormessage=\"wpforms-900-field_20_5-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_20_5\">E.\tI can only walk while using a cane or on crutches.<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_20_4\" name=\"wpforms[fields][20][]\" value=\"F.\tI am in bed most of the time and have to crawl to the toilet\" aria-errormessage=\"wpforms-900-field_20_4-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_20_4\">F.\tI am in bed most of the time and have to crawl to the toilet<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-900-field_21-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"21\"><fieldset><legend class=\"wpforms-field-label\">SECTION 5--Sitting<\/legend><ul id=\"wpforms-900-field_21\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_21_1\" name=\"wpforms[fields][21][]\" value=\"A.\tI can sit in any chair as long as I like without pain.\" aria-errormessage=\"wpforms-900-field_21_1-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_21_1\">A.\tI can sit in any chair as long as I like without pain.<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_21_2\" name=\"wpforms[fields][21][]\" value=\"B.\tI can only sit in my favorite chair as long as I like.\" aria-errormessage=\"wpforms-900-field_21_2-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_21_2\">B.\tI can only sit in my favorite chair as long as I like.<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_21_3\" name=\"wpforms[fields][21][]\" value=\"C.\tPain prevents me from sitting more than one hour\" aria-errormessage=\"wpforms-900-field_21_3-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_21_3\">C.\tPain prevents me from sitting more than one hour<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_21_6\" name=\"wpforms[fields][21][]\" value=\"D.\tPain prevents me from sitting more than 1\/2 hour.\" aria-errormessage=\"wpforms-900-field_21_6-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_21_6\">D.\tPain prevents me from sitting more than 1\/2 hour.<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_21_5\" name=\"wpforms[fields][21][]\" value=\"E.\tPain prevents me from sitting more than ten minutes.\" aria-errormessage=\"wpforms-900-field_21_5-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_21_5\">E.\tPain prevents me from sitting more than ten minutes.<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_21_4\" name=\"wpforms[fields][21][]\" value=\"F.\tPain prevents me from sitting at all.\" aria-errormessage=\"wpforms-900-field_21_4-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_21_4\">F.\tPain prevents me from sitting at all.<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-900-field_22-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"22\"><fieldset><legend class=\"wpforms-field-label\">SECTION 6 -- Standing<\/legend><ul id=\"wpforms-900-field_22\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_22_1\" name=\"wpforms[fields][22][]\" value=\"A\t    I can stand as long as I want without pain\" aria-errormessage=\"wpforms-900-field_22_1-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_22_1\">A\t    I can stand as long as I want without pain<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_22_2\" name=\"wpforms[fields][22][]\" value=\"B.\tI have some pain while standing, but it does not increase with time.\" aria-errormessage=\"wpforms-900-field_22_2-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_22_2\">B.\tI have some pain while standing, but it does not increase with time.<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_22_3\" name=\"wpforms[fields][22][]\" value=\"C.\tI cannot stand for longer than one hour without increasing pain.\" aria-errormessage=\"wpforms-900-field_22_3-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_22_3\">C.\tI cannot stand for longer than one hour without increasing pain.<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_22_6\" name=\"wpforms[fields][22][]\" value=\"D.\tI cannot stand for longer than 1\/2 hour without increasing pain\" aria-errormessage=\"wpforms-900-field_22_6-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_22_6\">D.\tI cannot stand for longer than 1\/2 hour without increasing pain<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_22_5\" name=\"wpforms[fields][22][]\" value=\"E.\tI can&#039;t stand for more than 10 minutes without increasing pain\" aria-errormessage=\"wpforms-900-field_22_5-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_22_5\">E.\tI can't stand for more than 10 minutes without increasing pain<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_22_4\" name=\"wpforms[fields][22][]\" value=\"F.\tI avoid standing because it increases pain right away.\" aria-errormessage=\"wpforms-900-field_22_4-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_22_4\">F.\tI avoid standing because it increases pain right away.<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-900-field_23-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"23\"><fieldset><legend class=\"wpforms-field-label\">SECTION 7--Sleeping <\/legend><ul id=\"wpforms-900-field_23\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_23_1\" name=\"wpforms[fields][23][]\" value=\"A.\tI get no pain in bed. \" aria-errormessage=\"wpforms-900-field_23_1-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_23_1\">A.\tI get no pain in bed.<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_23_2\" name=\"wpforms[fields][23][]\" value=\"B.\tI get pain in bed, but it does not prevent me from sleeping\" aria-errormessage=\"wpforms-900-field_23_2-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_23_2\">B.\tI get pain in bed, but it does not prevent me from sleeping<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_23_3\" name=\"wpforms[fields][23][]\" value=\"C.\tBecause of pain, my normal night&#039;s sleep is reduced by less    \tthan one-quarter.\" aria-errormessage=\"wpforms-900-field_23_3-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_23_3\">C.\tBecause of pain, my normal night's sleep is reduced by less    \tthan one-quarter.<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_23_6\" name=\"wpforms[fields][23][]\" value=\"D.\tBecause of pain, my normal night&#039;s sleep is reduced by less   than one-half.\" aria-errormessage=\"wpforms-900-field_23_6-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_23_6\">D.\tBecause of pain, my normal night's sleep is reduced by less   than one-half.<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_23_5\" name=\"wpforms[fields][23][]\" value=\"E.\tBecause of pain, my normal night&#039;s sleep is reduced by less   than three-quarters.\" aria-errormessage=\"wpforms-900-field_23_5-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_23_5\">E.\tBecause of pain, my normal night's sleep is reduced by less   than three-quarters.<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_23_4\" name=\"wpforms[fields][23][]\" value=\"F.\tPain prevents me from sleeping at all.\" aria-errormessage=\"wpforms-900-field_23_4-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_23_4\">F.\tPain prevents me from sleeping at all.<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-900-field_24-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"24\"><fieldset><legend class=\"wpforms-field-label\">SECTION 8--Social Life<\/legend><ul id=\"wpforms-900-field_24\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_24_1\" name=\"wpforms[fields][24][]\" value=\"A.\tMy social life is normal and gives me no pain.\" aria-errormessage=\"wpforms-900-field_24_1-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_24_1\">A.\tMy social life is normal and gives me no pain.<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_24_2\" name=\"wpforms[fields][24][]\" value=\"B.\tMy social life is normal, but increases the degree of my pain. \" aria-errormessage=\"wpforms-900-field_24_2-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_24_2\">B.\tMy social life is normal, but increases the degree of my pain.<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_24_3\" name=\"wpforms[fields][24][]\" value=\"C.\tPain has no significant effect on my social life apart from   \t limiting my more energetic interests, e.g., dancing, etc. \" aria-errormessage=\"wpforms-900-field_24_3-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_24_3\">C.\tPain has no significant effect on my social life apart from   \t limiting my more energetic interests, e.g., dancing, etc.<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_24_6\" name=\"wpforms[fields][24][]\" value=\"D.\tPain has restricted my social life and I do not go out very often.\" aria-errormessage=\"wpforms-900-field_24_6-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_24_6\">D.\tPain has restricted my social life and I do not go out very often.<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_24_5\" name=\"wpforms[fields][24][]\" value=\"E.\tPain has restricted my social life to my home\" aria-errormessage=\"wpforms-900-field_24_5-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_24_5\">E.\tPain has restricted my social life to my home<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_24_4\" name=\"wpforms[fields][24][]\" value=\"F.\tPain prevents me from social life at all\" aria-errormessage=\"wpforms-900-field_24_4-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_24_4\">F.\tPain prevents me from social life at all<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-900-field_25-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"25\"><fieldset><legend class=\"wpforms-field-label\">SECTION 9--Traveling<\/legend><ul id=\"wpforms-900-field_25\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_25_1\" name=\"wpforms[fields][25][]\" value=\"A.\tI get no pain while traveling.\" aria-errormessage=\"wpforms-900-field_25_1-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_25_1\">A.\tI get no pain while traveling.<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_25_2\" name=\"wpforms[fields][25][]\" value=\"B.\tI get some pain while traveling, but none of my usual forms of   \ttravel makes it any worse\" aria-errormessage=\"wpforms-900-field_25_2-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_25_2\">B.\tI get some pain while traveling, but none of my usual forms of   \ttravel makes it any worse<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_25_3\" name=\"wpforms[fields][25][]\" value=\"C.\tI get extra pain while traveling, but it does not compel me to seek alternative forms of travel.\" aria-errormessage=\"wpforms-900-field_25_3-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_25_3\">C.\tI get extra pain while traveling, but it does not compel me to seek alternative forms of travel.<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_25_6\" name=\"wpforms[fields][25][]\" value=\"D.\tI get extra pain while traveling which compels me to seek alternative forms of travel.\" aria-errormessage=\"wpforms-900-field_25_6-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_25_6\">D.\tI get extra pain while traveling which compels me to seek alternative forms of travel.<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_25_5\" name=\"wpforms[fields][25][]\" value=\"E.\tPain restricts all forms off travel.\" aria-errormessage=\"wpforms-900-field_25_5-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_25_5\">E.\tPain restricts all forms off travel.<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_25_4\" name=\"wpforms[fields][25][]\" value=\"F.\tPain prevents all forms of travel except that done lying down.\" aria-errormessage=\"wpforms-900-field_25_4-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_25_4\">F.\tPain prevents all forms of travel except that done lying down.<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-900-field_26-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"26\"><fieldset><legend class=\"wpforms-field-label\">SECTION 10--Changing Degree of Pain <\/legend><ul id=\"wpforms-900-field_26\"><li class=\"choice-7 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_26_7\" name=\"wpforms[fields][26][]\" value=\"NONE - No pain\" aria-errormessage=\"wpforms-900-field_26_7-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_26_7\">NONE - No pain<\/label><\/li><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_26_1\" name=\"wpforms[fields][26][]\" value=\"A.\tMy pain is rapidly getting better.\" aria-errormessage=\"wpforms-900-field_26_1-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_26_1\">A.\tMy pain is rapidly getting better.<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_26_2\" name=\"wpforms[fields][26][]\" value=\"B.\tMy pain fluctuates, but overall is definitely getting better.\" aria-errormessage=\"wpforms-900-field_26_2-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_26_2\">B.\tMy pain fluctuates, but overall is definitely getting better.<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_26_3\" name=\"wpforms[fields][26][]\" value=\"C.\tMy pain seems to be getting better, but improvement is slow at present.\" aria-errormessage=\"wpforms-900-field_26_3-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_26_3\">C.\tMy pain seems to be getting better, but improvement is slow at present.<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_26_6\" name=\"wpforms[fields][26][]\" value=\"D.\tMy pain is neither getting better nor worse.\" aria-errormessage=\"wpforms-900-field_26_6-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_26_6\">D.\tMy pain is neither getting better nor worse.<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_26_5\" name=\"wpforms[fields][26][]\" value=\"E.\tMy pain is gradually worsening.\" aria-errormessage=\"wpforms-900-field_26_5-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_26_5\">E.\tMy pain is gradually worsening.<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-900-field_26_4\" name=\"wpforms[fields][26][]\" value=\"F.        My pain is rapidly worsening.\" aria-errormessage=\"wpforms-900-field_26_4-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-900-field_26_4\">F.        My pain is rapidly worsening.<\/label><\/li><\/ul><\/fieldset><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"900\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/backinstituteneurosurgery.com\/main\/wp-json\/wp\/v2\/pages\/639\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-900\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/backinstituteneurosurgery.com\/main\/wp-content\/plugins\/wpforms\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Loading\"><\/div><\/form><\/div>  <!-- .wpforms-container -->\n","protected":false},"excerpt":{"rendered":"<p>THE OSWESTRY* LOW BACK PAIN DISABILITY QUESTIONNAIRE Please Read: This questionnaire is designed to enable us to understand how much your low back and\/or leg pain has affected your ability to manage everyday activities. Please answer each Section by circling the ONE CHOICE that most applies to you. We realize that you may feel that more than one statement may relate to you, but PLEASE SELECT THE ONE CHOICE WHICH CLOSELY DESCRIBES YOUR PROBLEM RIGHT NOW.<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-639","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/backinstituteneurosurgery.com\/main\/wp-json\/wp\/v2\/pages\/639","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/backinstituteneurosurgery.com\/main\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/backinstituteneurosurgery.com\/main\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/backinstituteneurosurgery.com\/main\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/backinstituteneurosurgery.com\/main\/wp-json\/wp\/v2\/comments?post=639"}],"version-history":[{"count":1,"href":"https:\/\/backinstituteneurosurgery.com\/main\/wp-json\/wp\/v2\/pages\/639\/revisions"}],"predecessor-version":[{"id":926,"href":"https:\/\/backinstituteneurosurgery.com\/main\/wp-json\/wp\/v2\/pages\/639\/revisions\/926"}],"wp:attachment":[{"href":"https:\/\/backinstituteneurosurgery.com\/main\/wp-json\/wp\/v2\/media?parent=639"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}