Cited by 3,395Musculoskeletal pain and rehabilitationSpine and Intervertebral Disc PathologyPregnancy-related medical research

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A Study of the Natural History of Back Pain: Part I

ROLAND, MARTIN, MORRIS, RICHARD·1983·Spine

DOI 10.1097/00007632-198303000-00004

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Abstract

One of the problems in mounting a trial of treatment of back pain is the lack of suitable outcome measures. This paper describes the development and validation of a questionnaire designed to measure selfrated disability due to back pain. The questionnaire is short, simple, sensitive, and reliable. It would be suitable for use in future trials of treatment.

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“The psychometric properties of the RMDQ are good (9,18,19).”
BackgroundMethod
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Method
What are we measuring? an examination of self‐reported functional status measures
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Psychometric Properties of the Pain Self-Efficacy Questionnaire (PSEQ)
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“ca) or Roland–Morris Scale for low back pain [23, 24]), self-efficacy (Lorig’s pain and coping subscales only) [25] and rating of the severity of their problem (0–7, 7 1⁄4 very severe).”
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An App-Delivered Self-Management Program for People With Low Back Pain: Protocol for the selfBACK Randomized Controlled Trial
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Does questionnaire structure influence response in postal surveys?
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Focus Article Report of the NIH Task Force on Research Standards for Chronic Low Back Pain
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“The RMDQ is used widely in low back pain studies as a standardized measure of activity limitation and has demonstrated good validity, reliability and responsiveness [45,46].”
Method
Validity of Pain Behaviors in Persons with Mild to Moderate Cognitive Impairment
Shega, J. W., Rudy, T. E., Keefe, F. J., et al. (2008) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2008.01831.x · Cited by 58
Supportive colleague, unsupportive supervisor: The role of provider-specific constellations of social support at work in the development of low back pain.
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Spanish version of the Northwick Park Neck Pain Questionnaire: reliability and validity.
González, T. L., Balsa, A., de Murieta, J. S., Zamorano, E., González, I., & Martín-Mola, E. (2001) · PubMed · Cited by 57
Relationship Between Functional Evaluation Measures and Self-Assessment in Nonacute Low Back Pain
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Lumbar position sense and the risk of low back injuries in college athletes: a prospective cohort study
Silfies, S. P., Cholewicki, J., Reeves, N. P., et al. (2007) · BMC Musculoskeletal Disorders · doi:10.1186/1471-2474-8-129 · Cited by 57
“Prior to experimental testing, subjects completed a questionnaire containing personal data (age, height, weight, sport, years of participation at varsity level, past medical history), a 10-cm visual analog pain scale (0–100) [43], Roland Morris Disability Scale (0–24) [44], and additional questions regarding any previ…”
Method
Coordination of Spinal Motion in the Transverse and Frontal Planes During Walking in People With and Without Recurrent Low Back Pain
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Costs and Cost-Effectiveness of Spinal Cord Stimulation (SCS) for Failed Back Surgery Syndrome
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Computerized Adaptive Test for Patients With Lumbar Spine Impairments Produced Valid and Responsive Measures of Function
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Hip and Lumbar Spine Physical Examination Findings in People Presenting With Low Back Pain, With or Without Lower Extremity Pain
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Prenatal Yoga for Back Pain, Balance, and Maternal Wellness: A Randomized, Controlled Pilot Study
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“The primary outcome of interest was back pain-related disability as measured by the Roland Morris Disability Questionnaire (RMDQ).(33) Secondary outcomes included a visual analogue scale that measured back pain severity (01⁄4no pain, 101⁄4worst pain ever).”
Method
Physical performance: Differences in men and women with and without low back pain
Novy, D. M., Simmonds, M. J., Olson, S. L., Lee, C. E., & Jones, S. C. (1999) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/s0003-9993(99)90121-1 · Cited by 57
Low back pain patients in primary care: Subgroups based on the multidimensional pain inventory
Johansson, E., & Lindberg, P. (2000) · International Journal of Behavioral Medicine · doi:10.1207/s15327558ijbm0704_05 · Cited by 56
Early Patterns of Care for Occupational Back Pain
Côté, P., Baldwin, M. L., & Johnson, W. G. (2005) · Spine · doi:10.1097/01.brs.0000154613.17511.dd · Cited by 57
Relation between indicators for quality of occupational rehabilitation of employees with low back pain.
van der Weide, W. E., Verbeek, J. H. A. M., & van Dijk, F. J. H. (1999) · Occupational and Environmental Medicine · doi:10.1136/oem.56.7.488 · Cited by 55
Functional outcome in patients with thoracolumbar burst fractures treated with dorsal instrumentation and transpedicular cancellous bone grafting
Leferink, V. J. M., Keizer, H. J. E., Oosterhuis, J. K., van der Sluis, C. K., & ten Duis, H. J. (2003) · European Spine Journal · doi:10.1007/s00586-002-0518-3 · Cited by 57
Advancing practice for back pain through stratified care (STarT Back)
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Multidisciplinary Rehabilitation Treatment of Patients With Chronic Low Back Pain: A Prognostic Model for Its Outcome
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“Sex Male 60% 62% Female 40% 38% RMDQ (0-24) 13 (4) 13 (5) SF-36: PCS (0-100) 31 (7) 32 (7) SF-36: MCS (0-100) 49 (10) 52 (10) VAS (0-100) median*/range 5 (0-10) 5 (1-9) MPI-DLV Dysfunctional 30% 26% Interpersonally Distressed 12% 15% Adaptive copers 15% 26% Average 39% 31% Anomalous 4% 2% Work status Working 21% 20% N…”
Influential
Auricular Point Acupressure to Manage Chronic Low Back Pain in Older Adults: A Randomized Controlled Pilot Study
Yeh, C. H., Morone, N. E., Chien, L.-C., Cao, Y., Lu, H., Shen, J., Margolis, L., Bhatnagar, S., Hoffman, S. L., Liang, Z., et al. (2014) · Evidence-based Complementary and Alternative Medicine · doi:10.1155/2014/375173 · Cited by 57
Development of a French-Canadian Version of the Oswestry Disability Index
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Rasch Analysis Supports the Use of the Pain Self-Efficacy Questionnaire
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“amount of self-perceived disability due to their CLBP (mean scores of approximately 15/24 on the RMDQ).(7,48,49) Most of Table 2”
Background
Pain, Quality of Life, and Safety Outcomes of Kyphoplasty for Vertebral Compression Fractures: Report of a Task Force of the American Society for Bone and Mineral Research
Rodríguez, A. J., Fink, H. A., Mirigian, L. S., Guañabens, N., Eastell, R., Åkesson, K., Bauer, D. C., & Ebeling, P. R. (2017) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.3170 · Cited by 56
Clinical predictors of lumbar provocation discography: a study of clinical predictors of lumbar provocation discography
Laslett, M., Aprill, C. N., McDonald, B. W., & Öberg, B. (2006) · European Spine Journal · doi:10.1007/s00586-006-0062-7 · Cited by 57
Problems with the Sickness Impact Profile: a theoretically based analysis and a proposal for a new method of implementation and scoring
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A multifaceted implementation strategy versus passive implementation of low back pain guidelines in general practice: a cluster randomised controlled trial
Riis, A., Jensen, C. E., Bro, F., Maindal, H. T., Petersen, K. D., Bendtsen, M. D., & Jensen, M. B. (2016) · Implementation Science · doi:10.1186/s13012-016-0509-0 · Cited by 55
Effectiveness of physical and cognitive-behavioural intervention programmes for chronic musculoskeletal pain in adults: A systematic review and meta-analysis of randomised controlled trials
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“Functional disabilities were assessed by the Roland Morris Disability Questionnaire [42]– 8 studies, Oswestry Disability Index [43]– 3 studies, Neck Disability Index [44]– 1 study, Neck Pain and Disability Scale [45]– 1 study, the Western Ontario and McMaster Universities Osteoarthritis Index: Function subscale [46]–…”
Method
Cognitive profile and mild cognitive impairment in people with chronic lower back pain
Corti, E. J., Gasson, N., & Loftus, A. M. (2021) · Brain and Cognition · doi:10.1016/j.bandc.2021.105737 · Cited by 59
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Blinding protocols, treatment credibility, and expectancy: methodologic issues in clinical trials of osteopathic manipulative treatment.
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A Comparison Between Chiropractic Management and Pain Clinic Management for Chronic Low-Back Pain in a National Health Service Outpatient Clinic
Wilkey, A., Gregory, M., Byfield, D. C., & McCarthy, P. W. (2008) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2007.0796 · Cited by 55
The Role of Experiential Avoidance, Resilience and Pain Acceptance in the Adjustment of Chronic Back Pain Patients Who Have Experienced a Traumatic Event: a Path Analysis
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“This questionnaire consists of 24 items in which the responders are asked to rate the degree to which pain interferes with functioning in different areas of life [55].”
Background
The contribution of self‐efficacy and depression to disability and work status in chronic pain patients: A comparison between Australian and Brazilian samples
Sardá, J., Nicholas, M. K., Asghari, A., & Pimenta, C. A. D. M. (2008) · European Journal of Pain · doi:10.1016/j.ejpain.2008.03.008 · Cited by 57
Integrating Pain Management in Clinical Practice
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The Effect of Core Stability Exercises on Variations in Acceleration of Trunk Movement, Pain, and Disability During an Episode of Acute Nonspecific Low Back Pain: A Pilot Clinical Trial
Aluko, A., DeSouza, L., & Peacock, J. L. (2013) · Journal of Manipulative and Physiological Therapeutics · doi:10.1016/j.jmpt.2012.12.012 · Cited by 59
Pain education to prevent chronic low back pain: a study protocol for a randomised controlled trial
Traeger, A. C., Moseley, G. L., Hübscher, M., Lee, H., Skinner, I., Nicholas, M. K., Henschke, N., Refshauge, K. M., Blyth, F., Main, C. J., et al. (2014) · BMJ Open · doi:10.1136/bmjopen-2014-005505 · Cited by 56
Implicit evaluations and physiological threat responses in people with persistent low back pain and fear of bending
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The role of functional status questionnaires for low back pain
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The Pain Course: 12- and 24-month outcomes from a randomized controlled trial of an internet-delivered pain management program provided with different levels of clinician support
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Osteopathic Manipulation in the Management of Chronic Pain: Current Perspectives
Licciardone, J. C., Schultz, M. J., & Amen, B. (2020) · Journal of Pain Research · doi:10.2147/jpr.s183170 · Cited by 59
A Primary Care–Based Cognitive Behavioral Therapy Intervention for Long-Term Opioid Users With Chronic Pain: A Randomized Pragmatic Trial
DeBar, L., Mayhew, M., Benes, L., Bonifay, A., Deyo, R. A., Elder, C. R., Keefe, F. J., Leo, M. C., McMullen, C., Owen-Smith, A., et al. (2022) · Annals of Internal Medicine · doi:10.7326/m21-1436 · Cited by 54
Association Between Substance Use Disorder Status and Pain-Related Function Following 12 Months of Treatment in Primary Care Patients With Musculoskeletal Pain
Morasco, B. J., Corson, K., Turk, D. C., & Dobscha, S. K. (2010) · Journal of Pain · doi:10.1016/j.jpain.2010.07.010 · Cited by 55
Double-blind, randomized, controlled, crossover trial of pregabalin for neurogenic claudication
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Predictors of Persistent Disability and Back Pain in Older Adults with a New Episode of Care for Back Pain
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Long-term outcomes from training in self-management of chronic pain in an elderly population: a randomized controlled trial
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Applying causal mediation methods to clinical trial data: What can we learn about why our interventions (don't) work?
Whittle, R., Mansell, G., Jellema, P., & van der Windt, D. (2016) · European Journal of Pain · doi:10.1002/ejp.964 · Cited by 55
Validation of the Japanese Version of the Roland–Morris Disability Questionnaire for Japanese Patients With Lumbar Spinal Diseases
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“The Roland–Morris Disability Questionnaire (RMDQ) was first established by Martin Roland and Richard Morris in 1986.(1,17,18) The RMDQ consists of 24 questions.”
Method
Efficacy of Noradrenergic and Serotonergic Antidepressants in Chronic Back Pain
Atkinson, J. H., Slater, M. A., Capparelli, E. V., Wallace, M. S., Zisook, S., ABRAMSON, I. S., Matthews, S. C., & Garfin, S. R. (2007) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e3180333ed5 · Cited by 53
“The secondary outcome measure was impairment in activities of daily living as determined by the Roland and Morris Disability Scale.(20) In ambulatory samples with persistent back pain, report mean scores are 8 (±6).”
Method
Does Clinician Treatment Choice Improve the Outcomes of Manual Therapy for Nonspecific Low Back Pain? A Metaanalysis
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Comparison between posterior lumbar fusion with pedicle screws and posterior lumbar interbody fusion with pedicle screws in adult spondylolisthesis
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“2 (5-20); mean post-operative score was 7.”
Eszopiclone for insomnia
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Pressure pain thresholds in patients with chronic nonspecific low back pain
Imamura, M., Alfieri, F. M., Filippo, T. R. M., & Battistella, L. R. (2016) · Journal of Back and Musculoskeletal Rehabilitation · doi:10.3233/bmr-150636 · Cited by 53
“One point was added for each af-ﬁrmative answer, with the minimum score being zero (no disability) and the maximum score being 24, that is, total functional disability [41–43].”
Responsiveness of the 24-, 18- and 11-item versions of the Roland Morris Disability Questionnaire
Macedo, L. G., Maher, C. G., Latimer, J., Hancock, M. J., Machado, L. A. C., & McAuley, J. H. (2010) · European Spine Journal · doi:10.1007/s00586-010-1608-2 · Cited by 53
Letting the CAT out of the Bag
Cook, K. F., Choi, S., Crane, P. K., Deyo, R. A., Johnson, K. L., & Amtmann, D. (2008) · Spine · doi:10.1097/brs.0b013e3181732acb · Cited by 53
Predictors for postpartum pelvic girdle pain in working women: The Mom@Work cohort study
den Berg, S. G. M. S., Hendriksen, I. J. M., Bruinvels, D. J., Twisk, J. W. R., van Mechelen, W., & van Poppel, M. N. M. (2012) · Pain · doi:10.1016/j.pain.2012.08.003 · Cited by 53
Daily functioning and self-management in patients with chronic low back pain after an intensive cognitive behavioral programme for pain management
van Hooff, M. L., van der Merwe, J. D., O'Dowd, T. J., Pavlov, P. W., Spruit, M., de Kleuver, M., & van Limbeek, J. (2010) · European Spine Journal · doi:10.1007/s00586-010-1435-5 · Cited by 59

Authors: ROLAND, M., & MORRIS, R.
Affiliations: St Thomas' Hospital (GB)
Corresponding author: ROLAND, MARTIN
ORCID: ROLAND, MARTIN
MORRIS, RICHARD
Venue: Spine
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1983-03
Volume: 8
Issue: 2
Pages: 141-144
ISSN: 0362-2436 (ISSN-L)
DOI: 10.1097/00007632-198303000-00004
OpenAlex: W2118516436
Cited by: 3,395
References: 0
Citations by year: 2026: 80 · 2025: 90 · 2024: 88 · 2023: 105 · 2022: 136 · 2021: 148 · 2020: 137 · 2019: 128 · 2018: 125 · 2017: 124 · 2016: 130 · 2015: 125 · 2014: 127 · 2013: 145 · 2012: 146
FWCI: 5.03
Type: journal article
Language: en
Open access: closed
Locations: Spine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Orthopedics and Sports Medicine › Spine and Intervertebral Disc Pathology
Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy-related medical research
Keywords: back pain, natural history (disease), self-rated disability, questionnaire development, outcome measures, disability assessment, treatment trials
MeSH terms: Activities of Daily Living, Adolescent, Adult, Back Pain, Disability Evaluation, Humans, Middle Aged, Movement

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A Study of the Natural History of Back Pain: Part I

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