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.

Introduction

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.  

Quick Summary

• 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

What Is the Örebro Musculoskeletal Pain Screening Questionnaire?

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.

Why It Is Used

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.

What It Measures

The Örebro measures factors associated with risk of persistent pain, disability and work absence.

Pain and Symptoms

The questionnaire may capture:

• pain duration
• pain intensity
• number of pain sites
• symptom burden
• pain interference

Function and Activity Limitation

It may capture difficulty with:

• daily activity
• movement
• work tasks
• physical function
• activity participation

Beliefs and Expectations

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

Mood and Distress

It may provide context about:

• worry
• low mood
• emotional response
• distress linked with pain

This does not diagnose anxiety, depression or any psychological condition.

Work and Return-to-Work Factors

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.  

Who It Is Useful For

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.

When to Use This Outcome Measure

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.  

When Not to Use or When to Be Cautious

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

Equipment or Resources Required

• 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

Administration Protocol / Practice

Setup

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.”

Format

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

Client Instructions

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

Completion Method

Record whether the Örebro was completed:

• independently
• digitally
• on paper
• verbally
• with assistance

This supports repeatability and helps interpret change over time.

Assistance Rules

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

Missing Item Handling

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

Scoring the Full Version

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.  

Scoring the Short Form

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.  

Retesting Considerations

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

Safety Notes

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

Scoring and Interpretation

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.

Full Version

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.

Short Form

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.

What a High Score May Suggest

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

What a Low Score May Suggest

A lower score may suggest:

• fewer reported risk factors
• greater confidence
• lower pain-related worry
• stronger recovery expectations
• lower reported disability risk

What the Score Does Not Prove

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

How to Explain the Result Safely

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.”

What the Score May Mean in Different Client Populations

General Fitness Clients

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

Sport and Performance Clients

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.

Workplace Clients

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

Clients Not Currently Working

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

Older Adults

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

Youth Clients

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

Persistent Pain Clients

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, MCID, MDC and Responsiveness

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

Örebro Meaningful Change Evidence

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.

Practical Interpretation

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

When Values Are Uncertain

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

Normative Data, Reference Values or Comparative Data

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

Reliability and Validity

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 and Limitations

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

Practical Applications

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

How to Record This in Measurz

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

Related Outcome Measures / Internal Links

• Fear-Avoidance Beliefs Questionnaire / FABQ
• Pain Self-Efficacy Questionnaire / PSEQ
• Tampa Scale for Kinesiophobia / TSK
• Oswestry Disability Questionnaire
• Quebec Back Pain Disability Scale
• Roland-Morris Lower Back Pain Disability Questionnaire
• Spine Function Index-10
• Neck Disability Index
• Lower Extremity Functional Scale / LEFS

FAQs

What does the Örebro Musculoskeletal Pain Screening Questionnaire measure?

It measures risk factors associated with persistent pain, disability and work absence, including pain, function, beliefs, expectations, mood and work-related concerns.

Is Örebro a diagnostic tool?

No. It is a screening and risk measure. It does not diagnose the cause of pain or identify a specific tissue problem.

How is the full Örebro scored?

The full version is commonly scored from 0 to 210, with higher scores indicating greater risk. Some items require reverse scoring.

How is the short-form Örebro scored?

The short form includes 10 items scored from 0 to 10, producing a score from 0 to 100. Some items are reverse scored.  

What does a high Örebro score mean?

A high score may indicate greater risk of persistent pain, disability or work absence. It should prompt supportive discussion and planning, not labelling.

What cut-off should be used?

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.  

Can Örebro be used if the client is not working?

It can still provide useful information, but work-related items and work-disability interpretation may be less relevant. Record work status and interpret cautiously.

Can Örebro be used for return-to-work decisions?

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.

Key Takeaways

• 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.

References

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/