1. I stay home most of the time because of my back problem or leg pain (sciatica) |
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2. I change position frequently to try and get my back or leg comfortable |
3. I walk more slowly than usual because of my back problem or leg pain (sciatica) |
4. Because of my back problem, I am not doing any of the jobs I usually do around the house |
5. Because of my back problem, I use handrail to get upstairs |
6. Because of my back problem, I have to hold onto something to get out of an easy chair (comfortable padded chair) |
7. I get dressed more slowly than usual because of my back problem or leg pain (sciatica) |
8. I only stand for short periods of time because of my back problem or leg pain (sciatica) |
9. Because of my back problem, I try not to bend or kneel down |
10. I find it difficult to get out of a chair because of my back problem or leg pain (sciatica) |
11. I have trouble putting on my socks (or stockings) because of the pain in my back or leg |
12. I find it difficult to turn over in bed because of my back problem or leg pain |
13. I sleep less well because of my back problem |
14. I avoid heavy jobs around the house because of my back problem |
15. Because of my back problem, I am more irritable and bad tempered with people than usual |
16. Because of my back problem, I go upstairs more slowly than usual |
17. I stay in bed most of the time because of my back or leg pain (sciatica) |
18. I keep rubbing or holding areas of my body that hurt or are uncomfortable |
19. My back or leg is painful almost all the time |
20. I only walk short distances because of my back problem |
21. Because of my back problem, my sexual activity is decreased |
22. Because of my back problem, I am doing less of the daily work around the house than I would usually do |
23. I often express concern to other people what might be happening to my health |