During the past 4 weeks…
How would you describe the pain you usually have in your hip?
Have you been troubled by pain from your hip in bed at night?
Have you had any sudden, severe pain (shooting, stabbing, or spasms) from your affected hip?
Have you been limping when walking because of your hip?
For how long have you been able to walk before the pain in your hip becomes severe (with or without a walking aid)?
Have you been able to climb a flight of stairs?
Have you been able to put on a pair of socks, stockings or tights?
After a meal (sat at a table), how painful has it been for you to stand up from a chair because of your hip?
Have you had any trouble getting in and out of a car or using public transportation because of your hip?
Have you had any trouble with washing and drying yourself (all over) because of your hip?
Could you do the household shopping on your own?
How much has pain from your hip interfered with your usual work, including housework?