HCI Orebro Questionniare Question Title * 1. Please enter your name below Question Title * 2. What is your date of birth? Question Title * 3. Are you: Male Female Other Question Title * 4. How long have you had your current pain problem? 0-1 Weeks 1-2 Weeks 3-4 Weeks 4-5 Weeks 6-8 Weeks 9-11 Weeks 3-6 Months 6-9 Months 9-12 Months More than a year Question Title * 5. How would you rate the pain that you have had during the past week? 0 (No Pain) 1 2 3 4 5 6 7 8 9 10 (Pain as bad as it could be) Question Title * 6. Can you do light work for an hour? (Gardening, washing up etc.) 0 (Can't do it because of the pain) 1 2 3 4 5 6 7 8 9 10 (Can do it without pain) Question Title * 7. Can you sleep at night? 0 (Can't do it because of the pain) 1 2 3 4 5 6 7 8 9 10 (Can do it without pain being a problem) Question Title * 8. How tense or anxious have you felt in the past week? 0 (Absolutely calm and relaxed) 1 2 3 4 5 6 7 8 9 10 (As tense and anxious as I'v ever felt) Question Title * 9. How much have you been bothered by feeling depressed in the past week? 0 (Not at all) 1 2 3 4 5 6 7 8 9 10 (Extremely) Question Title * 10. In your view, how large is the risk that your current pain may become persistent? 0 (No risk) 1 2 3 4 5 6 7 8 9 10 (Very large risk) Question Title * 11. In your estimation, what are the chances you will be working your normal duties in 3 months? 0 (No chance) 1 2 3 4 5 6 7 8 9 10 (Very high chance) Question Title * 12. Is an increase in your pain an indication that you should stop what you are doing until the pain decreases? 0 (Completely disadgree) 1 2 3 4 5 6 7 8 9 10 (Completely agree) Question Title * 13. I should not do my normal work with my present pain. 0 (Completely disagree) 1 2 3 4 5 6 7 8 9 10 (Completely agree) Done