OXFORD HIP SCORE QUIZ

Please complete the form below and we will get in touch with you the next business day.

Name *

First

Last

Age *

Hip Side

• Left
• Right
• Both

Email *

Hip score quiz

Answer the below questions about how you feel in the last 4 weeks.

Layout

How would you describe the pain in your hip?

• None
• Very Mild
• Mild
• Moderate
• Severe

Have you had any sudden, severe pain (shooting/stabbing or spasms) from the hip?

• No days
• Only 1 or 2 days
• Some days
• Most days
• Every day

How long can you walk (with or without stick) before the pain in your hip becomes severe?

• No pain/more than 30 mins
• 16-30 mins
• 5-15 mins
• Around the house only
• Not at all/pain severe

Have you been able to put on a 
pair of socks, stockings or tights?

• No trouble at all
• Very little trouble
• Moderate trouble
• Extreme trouble
• Impossible to do

Have you had any trouble getting 
in and out of a car or using public 
transport because of your hip?

• No trouble at all
• Very little trouble
• Moderate trouble
• Extreme trouble
• Impossible to do

Could you do the household shopping on your own?

• Yes, easily
• With little difficulty
• With moderate difficulty
• With extreme difficulty
• No, impossible

Have you been troubled by pain 
from your hip in bed at night?

• No nights
• Only 1 or 2 nights
• Some nights
• Most nights
• Every night

Have you been limping when 
walking because of your hip?

• Rarely/never
• Sometimes, or just at first
• Often, not just at first
• Most of the time
• All of the time

Have you been able to climb a flight of stairs?

• Yes easily
• With little difficulty
• With moderate difficulty
• With extreme difficulty
• No impossible

After a meal (sat at a table), how 
painful is the hip to stand up?

• Not at all painful
• Slightly painful
• Moderately painful
• Very painful
• Unbearable

Have you had any trouble with washing and drying yourself (all over) because of your hip?

• No trouble at all
• Very little trouble
• Moderate trouble
• Extreme trouble
• Impossible to do

How much has pain from your hip interfered with your usual work (including housework)?

• Not at all
• A little bit
• Moderately
• Greatly
• Totally

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