=====Japanese Orthopaedic Association Back Pain Evaluation Questionnaire=====
The [[Japanese Orthopaedic Association]] (JOA) has developed a clinical symptom score for [[lumbar disc herniation]] and for [[lumbar spinal canal stenosis]] . This can help determine the degree of improvement following surgical intervention. 

The score range −2 to 16.


Parameters in the score:

(1) subjective symptoms (9 points): low back pain leg pain and/or tingling gait

(2) clinical signs (6 points): straight-leg raising test sensory disturbance motor disturbance

(3) restriction in activities (14 points): turn over while lying standing washing leaning forward sitting about 1 hour lifting or holding a heavy object walking

(4) urinary bladder function (-6 points maximum)

====Low back pain====

none 3

occasional mild pain 2

frequent mild 1

occasional severe pain 1

frequent pain 0

continuous pain 0

====Leg pain and/or tingling====

none 3

occasional slight symptoms 2

frequent slight symptoms 1

occasional severe symptoms 1

frequent severe symptoms 0

continuous severe symptoms 0

====Gait====

normal  3 able to walk 

500 meters or more although it results in pain tingling and/or muscle weakness 2

unable to walk > 500 meters owing to leg pain tingling and/or muscle weakness 1

unable to walk > 100 meters owing to leg pain tingling and/or muscle weakness 0

====Straight leg raising (includes a tight hamstring)====

normal (> 70°) 2

30 to 70° 1

< 30° 0

====Sensory disturbance====

none 2

slight disturbance (not subjective) 1

marked disturbance 0

====Motor disturbance====

normal (Grade 5) 2

slight weakness (Grade 4) 1

marked weakness (Grades 0 to 3) 0

====Turn over while lying====
no restriction 2

moderate restriction 1

severe restriction 0

====Standing====
no restriction 2

moderate restriction 1

severe restriction 0

====Washing====
no restriction 2

moderate restriction 1

severe restriction 0

====Leaning forward====
no restriction 2

moderate restriction 1

severe restriction 0

====Sitting about 1 hour====
no restriction 2

moderate restriction 1

severe restriction 0

====Lifting or holding a heavy object====
no restriction 2

moderate restriction 1

severe restriction 0

====Walking====
no restriction 2

moderate restriction 1

severe restriction 0 
====Urinary bladder function=====
normal 0

mild dysuria -3

severe dysuria -6

where:
• I used dysfunction in the implementation for urinary bladder function.

total score = SUM(points for all parameters)

Interpretation:

• minimum score: -6

• maximum score: 29

• The higher the score the more normal the patient's overall status.

postoperative improvement in percent = (postoperative score) – (preoperative score) / (29 – (preoperative score) * 100% 
((Japanese Orthopaedic Association (JOA). Japanese Orthopaedic Association Assessment Criteria Guidelines Manual. 1996. paegs 46-49.))
((Osawa T Ogura T et al. Evaluation of lumbosacral nerve root lesions using evoked potentials recorded by a surface electrode technique. Spine. 2003; 28: 496-501)).