Shoulder Pain and Disability Index (SPADI) Clinical Workflow

Shoulder Pain and Disability Index flow


The shoulder pain and disability index (SPADI) [1] is a self-report questionnaire developed to measure the pain and disability associated with shoulder pathology. The SPADI consists of two dimensions. The pain dimension consists of five questions regarding severity of an individual's pain. Functional activities are assessed with eight questions designed to measure the degree of difficulty an individual has with various  activities of daily living that require upper-extremity use. The SPADI was originally published as a VAS scale, and subsequently validated as numeric scale of 0–10 [2].

The Shoulder Pain and Disability Index flow contains the Shoulder Pain and Disability Index (SPADI) questionnaire and associated calculation. After form submission, the Shoulder Pain and Disability Index calculation is executed automatically. It's easy to extend this flow with conditional logic based on the interpretation of the Shoulder Pain and Disability Index calculation.

Shoulder Pain and Disability Index (SPADI) questionnaire

Questions and Scoring

The SPADI consists of 13 items in two subscales: pain (5 items) and disability (8 items). Verbal anchors for the pain dimension are "no pain at all" (0) and "worst pain imaginable," (10) and those for the functional activities are "no difflciulty" (0) and "so difficult it required help." (10)

Pain dimension: How severe is your pain?

  • 1. At its worst?
  • 2. When lying on the involved side?
  • 3. Reaching for something on a high shelf?
  • 4. Touching the back of your neck?
  • 5. Pushing with the involved arm?

Disability dimension: How much difficulty do you have?

  • 1. Washing your hair?
  • 2. Washing your back?
  • 3. Putting on an underskirt or pullover sweater?
  • 4. Putting on a shirt that buttons down the front?
  • 5. Putting on your pants?
  • 6. Placing an object on a high shelf?
  • 7. Carrying a heavy object (eg, 10 Ib)?
  • 8. Removing something from your back pocket?


The total score ranges from 0 (best) to 100 (worst).


[1] Roach KE, Budiman-Mak E, Songsiridej N, Lertratanakul Y. Development of a shoulder pain and disability index. Arthritis Care Res. 1991;4(4):143-149.\
[2] Williams JW Jr, Holleman DR Jr, Simel DL. Measuring shoulder function with the Shoulder Pain and Disability Index. J Rheumatol. 1995;22(4):727-732.

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