Please enable JavaScript in your browser to complete this form.Name *Email *Phone * THE HIP QUIZOxford Hip Questionnaire*1. How would you describe the pain you usually have in your hip? *NoneVery MildMildModerateSevere* 2. Have you been troubled by pain from your hip in bed at night? *No nightsOnly 1 or 2 nightsSome nightsMost nightsEvery night* 3. Have you had any sudden, severe pain (shooting, stabbing, or spasms) from your affected hip? *No daysOnly 1 or 2 daysSome daysMost daysEvery day* 4. Have you been limping when walking because of your hip? *Rarely/neverSometimes or just at firstOften, not just at firstMost of the timeAll of the time* 5. For how long have you been able to walk before the pain in your hip becomes severe (with or without a walking aid)? *No pain for 30 minutes or more16 to 30 minutes5 to 15 minutesAround the house onlyNot at all* 6. Have you been able to climb a flight of stairs? *Yes, easilyWith little difficultyWith moderate difficultyWith extreme difficultyNo, impossible* 7. Have you been able to put on a pair of socks, stockings or tights? *Yes, easilyWith little difficultyWith moderate difficultyWith extreme difficultyNo, impossible* 8. After a meal (sat at a table), how painful has it been for you to stand up from a chair because of your hip? *Not at all painfulSlightly painfulModerately painfulVery painfulUnbearable* 9. Have you had any trouble getting in and out of a car or using public transportation because of your hip? *No trouble at allVery little troubleModerate troubleExtreme difficultyImpossible to do* 10. Have you had any trouble with washing and drying yourself (all over) because of your hip? *No trouble at allVery little troubleModerate troubleExtreme difficultyImpossible to do* 11. Could you do the household shopping on your own? *Yes, easilyWith little difficultyWith moderate difficultyWith extreme difficultyNo, impossible* 12. How much has pain from your hip interfered with your usual work, including housework? *Not at allA little bitModeratelyGreatlyTotallyYour ScoreDownload Submit
