The Örebro Musculoskeletal Pain Screening Questionnaire, or ÖMPSQ, is a patient-reported screening tool used to identify psychosocial, functional and work-related risk factors that may be associated with persistent pain, disability or work absence. Higher scores indicate greater risk, but the Örebro does not diagnose a condition, label a client psychologically or determine work, training or sport clearance on its own.
Musculoskeletal pain is influenced by more than tissue status alone. Pain intensity, function, beliefs, expectations, mood, confidence, work demands and activity exposure can all affect recovery and participation.
The Örebro Musculoskeletal Pain Screening Questionnaire, commonly shortened to ÖMPSQ or Örebro, is a patient-reported questionnaire designed to identify risk factors associated with persistent pain, disability and work absence.
It is commonly used for:
low back pain
neck pain
general musculoskeletal pain
soft tissue injury recovery
work-related musculoskeletal pain
return-to-work planning
persistent pain risk screening
biopsychosocial assessment support
early identification of clients who may need more structured support
The ÖMPSQ was developed to identify psychological and functioning-related risk factors among people with musculoskeletal pain who may be at risk of work disability. A short-form version has also been developed and evaluated for work-disability prediction.
Outcome measure: Örebro Musculoskeletal Pain Screening Questionnaire
Abbreviations: ÖMPSQ, ÖMPQ, OMPQ
Short version: ÖMPSQ-SF / ÖMPSQ-10
Body region: Musculoskeletal pain, commonly low back and soft tissue injury contexts
Type: Patient-reported screening and risk measure
Full version score range: commonly 0–210
Short-form score range: commonly 0–100
Higher score means: Greater risk of persistent pain, disability or work absence
Lower score means: Lower reported psychosocial, functional and work-disability risk
Best used for: Screening, early risk identification, education planning and progress tracking
Key limitation: It does not diagnose a condition, prove prognosis or determine return-to-work readiness on its own
The Örebro Musculoskeletal Pain Screening Questionnaire is a self-report measure used to screen for factors that may contribute to ongoing pain, disability or delayed recovery.
It can include questions about:
pain duration
pain intensity
pain location
activity limitation
work status
work ability
beliefs about pain
fear or worry
mood
coping
expectations of recovery
The original version is longer, while the short form uses 10 selected items. Örebro University notes that the questionnaire has been used in many settings, translated into different languages and modified into a 10-item short version.
The Örebro is best understood as a risk and screening tool, not a diagnosis.
The Örebro is used because musculoskeletal pain outcomes are influenced by physical and non-physical factors.
A client may have similar pain intensity to another person but very different recovery risk because of:
low confidence
high worry
low expectations of recovery
high disability
work stress
fear of activity
low coping confidence
ongoing work absence
high pain interference
The Örebro can help professionals:
identify risk factors early
guide supportive education
support graded activity planning
inform return-to-work conversations
identify when extra support may be helpful
monitor risk-factor change over time
combine self-report findings with physical assessment
improve documentation in Measurz
The Örebro should support assessment reasoning. It should not be used to label the client or predict their future with certainty.
The Örebro measures factors associated with risk of persistent pain, disability and work absence.
The questionnaire may capture:
pain duration
pain intensity
number of pain sites
symptom burden
pain interference
It may capture difficulty with:
daily activity
movement
work tasks
physical function
activity participation
The questionnaire may capture beliefs about:
whether activity is safe
whether work is harmful
whether recovery is expected
whether pain will persist
whether normal activity should be avoided
It may provide context about:
worry
low mood
emotional response
distress linked with pain
This does not diagnose anxiety, depression or any psychological condition.
The questionnaire may capture:
work ability
work absence
work expectations
perceived ability to return to normal duties
A short-form Örebro resource from the Transport Accident Commission describes the short form as an easier-to-use version that helps identify risk of disability and long-term work absence, with a score of 50 or higher indicating risk of long-term disability.
The Örebro may be useful for:
exercise professionals
rehabilitation practitioners
workplace health professionals
allied health support teams
movement assessment professionals
strength and conditioning coaches working with injured clients
students learning biopsychosocial outcome measures
professionals using Measurz or MAT for structured progress tracking
It may be relevant for clients with:
low back pain
neck pain
persistent musculoskeletal pain
soft tissue injury
work-related musculoskeletal pain
delayed recovery concerns
fear of movement
high pain-related worry
low confidence returning to activity
difficulty returning to work or training
It is especially relevant when work participation, disability risk or longer-term recovery risk are important parts of the assessment.
Use the Örebro when you want to understand risk factors that may influence recovery, function or work participation.
It may be useful at:
initial assessment
early post-injury screening
persistent pain review
work-disability risk review
return-to-work planning
flare-up review
reassessment
progress review
discharge planning
The short form is often used because it is faster to complete and easier to score. Several Australian compensation and injury resources recommend using it early after injury to help identify risk of long-term disability.
Use caution when:
the client cannot complete the questionnaire independently
language or literacy affects responses
the wrong version is used
work items are not relevant
the client is not working
scores are treated as a fixed prognosis
the score is used to label the client
the result is interpreted without discussion
the score is used as return-to-work clearance
the measure is used outside its intended context without noting limitations
The Örebro should not be used to:
diagnose pain cause
diagnose anxiety or depression
label the client as “psychological”
prove that pain is not physical
determine whether pain is real
predict recovery with certainty
clear someone for work, training or sport
replace a full clinical conversation
replace professional judgement
Örebro Musculoskeletal Pain Screening Questionnaire
Short-form ÖMPSQ / ÖMPSQ-10 if using the short version
Scoring guide or calculator
Measurz recording workflow
Client-reported symptom and function notes
Baseline and retest dates
Optional related measures, such as:
Oswestry Disability Index
Roland-Morris Disability Questionnaire
Quebec Back Pain Disability Scale
Neck Disability Index
Fear-Avoidance Beliefs Questionnaire
Pain Self-Efficacy Questionnaire
Tampa Scale for Kinesiophobia
pain score
work status notes
activity exposure notes
Explain the purpose of the questionnaire before the client completes it.
Example wording:
“This questionnaire helps us understand factors that may influence recovery, confidence, activity and work participation. It does not diagnose anything on its own, but it helps us identify where extra support, education or planning may be useful.”
The Örebro can be completed:
on paper
digitally
independently
verbally if assistance is needed
before a session
during reassessment
as part of a Measurz workflow
Ask the client to:
answer based on their current pain problem
read each item carefully
choose the answer that best reflects their situation
answer every item where possible
ask for clarification if they do not understand wording
complete the same version at each retest
Record whether the Örebro was completed:
independently
digitally
on paper
verbally
with assistance
This supports repeatability and helps interpret change over time.
If assistance is needed:
explain instructions without leading the answer
avoid telling the client which score to choose
avoid challenging beliefs during completion
record that assistance was provided
use the same assistance approach at retest where possible
Do not guess missing responses.
For best practice:
record missing items
record which version was used
avoid calculating a total score if key scoring items are missing unless the scoring guide allows it
interpret incomplete scores cautiously
use the same version and scoring rules at retest
The full Örebro is commonly scored from 0 to 210.
Most scored items use a 0–10 scale.
Some items need reverse scoring so that higher values consistently indicate greater risk.
Scoring guidance from a Transport Accident Commission resource describes the ÖMPQ as a screening questionnaire used to predict long-term disability and failure to return to work, and includes scoring instructions for reverse-scored items.
The short-form Örebro includes 10 items scored from 0 to 10.
Score range:
0–100
Some items are reverse scored so all items point in the same risk direction. Australian and New Zealand scoring guides note that the short form includes 10 items, with three items requiring reverse scoring.
Retest at meaningful points, such as:
baseline
after education
after graded exposure progressions
after return-to-work planning
after a flare-up
after increased activity exposure
progress review
discharge review
For consistency, record:
date
current work status
current activity exposure
current pain behaviour
recent flare-ups
current work duties
training or sport exposure
education or support provided
major life or work changes
The Örebro is a self-report questionnaire, so it does not create physical testing risk.
However, high or worsening scores may suggest the need to:
explore concerns respectfully
discuss beliefs and expectations
review work or activity exposure
consider graded exposure
consider broader support
collaborate with other professionals where appropriate
The Örebro is interpreted as a risk score.
Higher scores suggest greater risk of persistent pain, disability or work absence.
Lower scores suggest lower reported risk based on the questionnaire.
Commonly reported score range:
0–210
General direction:
Lower score: lower risk
Higher score: higher risk
Some resources describe approximate groupings such as:
lower risk below 90
moderate risk around 91–105
higher risk above 105
These cut-offs vary by setting and population and should not be used as strict labels.
Commonly reported score range:
0–100
A Transport Accident Commission resource notes that a score of 50 or higher on the short-form Örebro indicates risk of long-term disability.
This should be interpreted as a screening prompt, not a diagnosis or fixed prediction.
A higher score may suggest:
greater pain interference
lower confidence
higher worry
lower recovery expectations
greater activity limitation
stronger work-related concerns
higher risk of ongoing disability or work absence
A lower score may suggest:
fewer reported risk factors
greater confidence
lower pain-related worry
stronger recovery expectations
lower reported disability risk
An Örebro score does not prove:
the diagnosis
pain source
tissue damage
psychological disorder
motivation
effort level
future outcome with certainty
readiness to return to work
readiness to return to sport
whether one intervention caused change
Example wording:
“Your Örebro score suggests there may be several factors affecting recovery, including confidence with activity and expectations about work. This does not mean anything is wrong with you psychologically. It gives us a useful guide for education, planning and monitoring.”
For general fitness clients, the Örebro may help identify whether pain-related concerns are affecting:
gym participation
walking
lifting
confidence
return to normal activity
fear of flare-ups
Interpretation cautions:
work items may be less relevant if work is not affected
recent pain flare-ups may increase scores
physical capacity should still be assessed
For athletes, the Örebro may help identify broad risk factors but may not capture sport-specific confidence fully.
Interpretation should also include:
sport-specific confidence
return-to-training exposure
workload history
pain response to sport tasks
psychological readiness measures where relevant
sport-specific functional testing
A low score should not be treated as return-to-sport clearance on its own.
The Örebro is especially relevant in work-related contexts because it was designed to help identify risk of disability and work absence.
Interpretation should include:
job demands
work status
modified duties
supervisor support
work expectations
compensation context where relevant
functional capacity
return-to-work planning
For clients who are retired, unemployed, studying or not in paid work, work-related items may be less directly relevant.
Record:
work status
whether work items were applicable
how work-related responses were interpreted
whether activity-related concerns were more relevant
For older adults, the Örebro may help identify factors that influence participation and confidence.
Interpretation should also consider:
general health
balance confidence
comorbidities
social support
walking tolerance
independent living goals
The Örebro is more commonly used in adults.
For youth clients, consider:
comprehension
school and sport context
parent or guardian influence
whether a youth-specific tool is more suitable
whether work-related items are relevant
For persistent pain, Örebro results may help guide supportive conversations about:
expectations
confidence
activity pacing
graded exposure
work participation
beliefs about pain
support needs
Interpret alongside pain self-efficacy, kinesiophobia, disability scores and physical assessment.
Meaningful change helps interpret whether a score change is likely to matter.
Key terms:
MCID / MIC: the smallest change that may be meaningful to clients or professionals, depending on method used
MDC: the amount of change likely needed to exceed measurement error
SEM: estimated measurement error around a score
Responsiveness: ability of the measure to detect change over time
The Örebro was originally designed as a screening tool, not primarily as an outcome measure.
A recent study noted that although the Örebro was originally designed as a screening tool, it has become more commonly used as an outcome measure, and that limited previous research had investigated its performance as an outcome measure or its MCID.
This means meaningful change should be interpreted cautiously and matched to the version used.
When interpreting Örebro change:
compare the score with baseline
use the same version at retest
check whether risk factors have changed
check whether activity or work exposure has increased
compare with pain, function and confidence measures
avoid over-interpreting small score changes
use change as a conversation guide, not proof of recovery
Reported meaningful change values may vary by:
full versus short form
low back pain versus broader musculoskeletal pain
work status
baseline risk
follow-up timeframe
compensation context
language version
rehabilitation setting
When no matching MCID, MDC or SEM exists, interpretation should rely more heavily on:
baseline comparison
repeated measurement
client conversation
work participation
activity exposure
disability scores
professional judgement
Universal normative values for the Örebro are limited because it is primarily a risk-screening tool.
Use:
baseline comparison
version-specific score
risk grouping where appropriate
work context
activity exposure
client goals
related pain and disability measures
Practical guidance:
Lower scores generally suggest fewer reported risk factors.
Higher scores suggest greater risk of persistent pain, disability or work absence.
Short-form scores of 50 or higher are commonly treated as indicating increased long-term disability risk in some Australian resources.
Full-version cut-offs vary across settings and should not be used rigidly.
Risk categories should prompt support, not judgement.
Comparison should consider:
work status
injury stage
pain duration
current activity exposure
compensation context
language version
job demands
psychosocial context
comorbidities
current disability level
The Örebro has evidence supporting its predictive use, especially for work disability risk, but interpretation should remain population-specific.
A 2023 study reported that the ÖMPSQ-SF was developed to identify psychological and functioning-related risk factors among people with musculoskeletal pain at risk of work disability, and examined whether the short version could predict registered work disability over 2 years.
A 2011 short-form development study is listed in multiple official short-form resources and describes the development of the 10-item version from the full questionnaire.
The short form has also been compared with the STarT Back Tool in large low back pain samples, with research noting that both tools were developed for systematic identification of psychosocial and symptom-related risk factors.
Reliability and validity are stronger when:
the correct version is used
reverse scoring is done correctly
the correct language version is used
missing items are handled consistently
work status is recorded
results are interpreted in context
scores are paired with pain, disability and function measures
Interpret cautiously when:
the client is not working and work-risk interpretation is central
the score is used outside musculoskeletal pain contexts
multiple items are missing
the score is used to label the client
the score is used as a stand-alone return-to-work decision
cut-offs are applied to populations unlike the validation group
Common errors include:
treating Örebro as a diagnosis
using the score to label the client
using it as return-to-work clearance
ignoring work status
using full-form and short-form scores interchangeably
forgetting reverse scoring
over-interpreting cut-off values
not recording missing items
not discussing results respectfully
failing to pair the score with physical and functional assessment
Limitations include:
originally designed as a screening tool
cut-offs vary across settings
work items may not suit non-working clients
self-report may be influenced by recent pain, stress or work context
high scores do not prove poor motivation
low scores do not guarantee recovery
universal norms are limited
meaningful change evidence is still developing
should be paired with physical, functional and psychosocial assessment
The Örebro may help professionals:
document baseline risk factors
identify clients who may need more support
guide pain education
support graded exposure planning
support return-to-work discussions
monitor risk-factor change over time
improve client-centred communication
strengthen Measurz reports
For fitness clients, it can help show whether pain-related beliefs and confidence are affecting activity progression.
For workplace clients, it can help identify risk factors related to disability and work absence.
For persistent pain clients, it can help monitor whether beliefs, expectations and function are changing alongside pain and disability scores.
For Measurz users, Örebro is most useful when combined with:
Oswestry Disability Index
Roland-Morris Disability Questionnaire
Quebec Back Pain Disability Scale
Fear-Avoidance Beliefs Questionnaire
Pain Self-Efficacy Questionnaire
Tampa Scale for Kinesiophobia
pain score
activity exposure notes
work participation notes
Record:
outcome measure name: Örebro Musculoskeletal Pain Screening Questionnaire
version used: full version or short form
date completed
completion method: paper, digital, interview or assisted
language/version used
condition or presentation being tracked
work status
current work duties or activity role
total score
score range:
full version: commonly 0–210
short form: commonly 0–100
direction of scoring: higher score indicates greater risk
reverse-scored items checked: yes / no
missing items, if any
assistance provided, if any
current pain score, if relevant
current disability score, if relevant
current activity exposure
current work exposure
key risk-factor themes
confidence or participation goals
education or graded exposure notes
baseline comparison
risk category if used
MCID/MIC/MDC comparison where supported
related physical assessment findings
interpretation notes
retest date
referral or collaboration notes where appropriate
Record whether the main concern appears to be:
activity confidence
work confidence
recovery expectations
high pain interference
high disability
psychological distress or worry
mixed risk factors
not work-relevant
unclear due to incomplete responses
This improves:
repeatability
communication
client education
assessment reasoning
monitoring over time
team consistency
reporting quality
It measures risk factors associated with persistent pain, disability and work absence, including pain, function, beliefs, expectations, mood and work-related concerns.
No. It is a screening and risk measure. It does not diagnose the cause of pain or identify a specific tissue problem.
The full version is commonly scored from 0 to 210, with higher scores indicating greater risk. Some items require reverse scoring.
The short form includes 10 items scored from 0 to 10, producing a score from 0 to 100. Some items are reverse scored.
A high score may indicate greater risk of persistent pain, disability or work absence. It should prompt supportive discussion and planning, not labelling.
Cut-offs vary by setting and version. Some Australian resources use 50 or higher on the short form to indicate risk of long-term disability.
It can still provide useful information, but work-related items and work-disability interpretation may be less relevant. Record work status and interpret cautiously.
It can support return-to-work reasoning, but it should not be the only decision measure. It should be combined with function, work demands, symptoms, confidence and professional judgement.
The Örebro is a musculoskeletal pain risk-screening questionnaire.
It is used to identify factors associated with persistent pain, disability and work absence.
The full version is commonly scored from 0 to 210.
The short form is commonly scored from 0 to 100.
Higher scores indicate greater reported risk.
Örebro does not diagnose pain cause, label clients psychologically or clear someone for work or sport.
Cut-offs vary by version and setting, so they should be used as support prompts rather than strict labels.
Measurz should record version, score, work status, reverse scoring, missing items, key risk themes, activity exposure, baseline comparison and related physical findings.
Heikkala, E., Oura, P., Ruokolainen, O., Ala-Mursula, L., Linton, S. J., & Karppinen, J. (2023). The Örebro Musculoskeletal Pain Screening Questionnaire-Short Form and 2-year follow-up of registered work disability. European Journal of Public Health, 33(3), 442–447. https://doi.org/10.1093/eurpub/ckad079
Linton, S. J., Nicholas, M., & MacDonald, S. (2011). Development of a short form of the Örebro Musculoskeletal Pain Screening Questionnaire. Spine, 36(22), 1891–1895.
Miyamoto, G. C., et al. (2025). Minimum clinically important difference of the original and short-form Örebro Musculoskeletal Pain Questionnaire. Musculoskeletal Science and Practice. https://doi.org/10.1016/j.msksp.2025.103352
Schultz, I. Z., et al. (2013). Clinical and occupational screening for work disability risk: A systematic review. Journal of Occupational Rehabilitation, 23, 492–509.
TAC. (2026). Short Form Orebro Musculoskeletal Pain Screening Questionnaire. Transport Accident Commission. https://www.tac.vic.gov.au/providers/working-with-the-tac/outcome-measures/screening-measures
SIRA. (2022). Örebro Musculoskeletal Pain Screening Questionnaire: Short form scoring guide. State Insurance Regulatory Authority. https://www.sira.nsw.gov.au/
Örebro University. (2023). Questionnaires: Örebro Musculoskeletal Pain Screening Questionnaire. https://www.oru.se/english/research/research-environments/hs/champ/questionnaires/
