Company Oxford Elbow Score Each question refers to your symptoms during the Last 4 weeks. All fields are required. Your name * Your DOB * 1. Have you had any difficulty lifting things in your home, such as putting out the rubbish, because of your elbow problem? * No difficultyA little bit of difficulty Moderate difficulty Extreme difficulty Impossible to do 2. Have you had difficulty carrying bags of shopping because of your elbow problem? * No difficultyA little bit of difficulty Moderate difficulty Extreme difficulty Impossible to do 3. Have you had any difficulty washing yourself all over, because of our elbow problem? * No difficultyA little bit of difficulty Moderate difficulty Extreme difficulty Impossible to do 4. Have you had any difficulty dressing yourself, because of your elbow problem? * No difficultyA little bit of difficulty Moderate difficulty Extreme difficulty Impossible to do 5. Have you felt that your elbow problem is * No, not at allOccasionallySome daysMost daysEvery day controlling your life 6. How much has your elbow problem been * No, not at allA little of the timeSome of the timeMost of the timeAll of the time on your mind 7.Have you been troubled by pain from your elbow at night? * No, not at all1 or 2 nightsSome nightsMost nightsEvery night 8. How often has your elbow pain interfered with your sleeping? * No, not at allOccasionallySome daysMost daysEvery day 9. How much has your elbow problem interfered with your usual work or everyday activities? * No, not at allA little bitModeratelyGreatlyTotally 10. Has your elbow problem limited your ability to take part in leisure activities that you enjoy doing? * No, not at allOccasionallySome daysMost daysAll of the time 11. How would you describe the worst pain you had from your elbow? * No PainMild painModerate painSevere painUnbearable 12. How would you describe the pain you usually had from your elbow? * No PainMild painModerate painSevere painUnbearable Score Total:
