Knee Pain Questionnaire

BAY AREA ORTHOPAEDIC & SPORTS SPECIALISTS
WARREN J. STRUDWICK, JR., M.D.

Knee Pain Questionnaire



    1 = Slight pain and/or no trouble
    2 = Slight pain and/or little trouble
    3 = Moderate pain and/or moderate trouble
    4 = Serious pain and/or extreme difficulty
    5 = Severe pain and/or impossible

    12345


    1 = Slight pain and/or no trouble
    2 = Slight pain and/or little trouble
    3 = Moderate pain and/or moderate trouble
    4 = Serious pain and/or extreme difficulty
    5 = Severe pain and/or impossible

    12345


    1 = Slight pain and/or no trouble
    2 = Slight pain and/or little trouble
    3 = Moderate pain and/or moderate trouble
    4 = Serious pain and/or extreme difficulty
    5 = Severe pain and/or impossible

    12345


    1 = more than 30 minutes
    2 = 16-30 minutes
    3 = 5-15 minutes
    4 = Less than five minutes
    5 = Can't walk without severe pain

    12345


    1 = Slight pain and/or no trouble
    2 = Slight pain and/or little trouble
    3 = Moderate pain and/or moderate trouble
    4 = Serious pain and/or extreme difficulty
    5 = Severe pain and/or impossible

    12345


    1 = Not at all
    2 = Sometimes or only at first
    3 = Often
    4 = Most of the time
    5 = Constantly

    12345


    1 = Yes, without any problem
    2 = Yes, with slight difficulty
    3 = Yes, with moderate difficulty
    4 = Yes, with extreme difficulty
    5 = Not possible

    12345


    1 = Never
    2 = Once in a while
    3 = Some nights
    4 = Most nights
    5 = Every night

    12345


    1 = Not at all
    2 = Occasionally
    3 = Fairly often
    4 = Most of the time
    5 = All the time

    12345


    1 = Not at all
    2 = Occasionally
    3 = Fairly often
    4 = Most of the time
    5 = All the time

    12345


    1= Yes, with minimal or no problem
    2= Yes, most of the time
    3= Yes, fairly often
    4= Sometimes
    5= Rarely or never

    12345


    1 = Yes, with minimal or no problem
    2 = Yes, most of the time
    3 = Yes, fairly often
    4 = Sometimes
    5 = Rarely or never

    12345

    Final Score =

    Results
    54 or higher: Indicates that your condition is fairly severe.
    43 to 53: Indicates a moderate problem.
    30 to 42: Indicates some problem or inhibited function.
    18 to 29: Indicates that your condition is relatively mild.
    18 or lower: Indicates that you have little to no knee problems.






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