WOMAC

Assesses the health status of patients with osteoarthritis of the knee and hip.

What is the WOMAC?

The Western Ontario and McMaster Universities Arthritis Index (WOMAC) is the gold-standard questionnaire for assessing osteoarthritis of the hip and knee. Originally developed in 1982, it evaluates pain, stiffness, and physical function in patients with osteoarthritis.

Scoring System

The WOMAC uses a 5-point Likert scale (0-4) for each question: 0 = None, 1 = Mild, 2 = Moderate, 3 = Severe, 4 = Extreme. Higher scores indicate worse symptoms. Domain scores are summed, and total scores can be converted to a 0-100 scale. The WOMAC consists of 24 items divided into 3 subscales: Pain (5 items, score range 0-20), Stiffness (2 items, score range 0-8), and Physical Function (17 items, score range 0-68).

General Information

Importance:
Essential
Scoring:
Lower is Better
Time to Complete:
12 minutes
Pages:
3
Questions:
24
Licensed:
Yes

Clinical Information

Medical Specialties:
rheumatology orthopaedics sports medicine
Anatomic Areas:
knee hip
Indications:
Knee osteoarthritis assessment Hip osteoarthritis assessment Osteoarthritis research

Instructions

The WOMAC takes approximately 12 minutes to complete and can be administered on paper, over the telephone, or electronically. Patients should be instructed to consider their symptoms over the past 48 hours. The questionnaire is self-administered and requires no special training.

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WOMAC

Assesses the health status of patients with osteoarthritis of the knee and hip.

Instructions:

The WOMAC takes approximately 12 minutes to complete and can be administered on paper, over the telephone, or electronically. Patients should be instructed to consider their symptoms over the past 48 hours. The questionnaire is self-administered and requires no special training.

Pain Subscale

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Stiffness Subscale

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Physical Function Subscale

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Patient Watch Form - 10/31/2025

Detailed Scoring Methodology

The WOMAC uses a 5-point Likert scale (0-4) for each question: 0 = None, 1 = Mild, 2 = Moderate, 3 = Severe, 4 = Extreme. Higher scores indicate worse symptoms. Domain scores are summed, and total scores can be converted to a 0-100 scale. The WOMAC consists of 24 items divided into 3 subscales: Pain (5 items, score range 0-20), Stiffness (2 items, score range 0-8), and Physical Function (17 items, score range 0-68).

Assessment Subscales

Pain

Pain during walking, stairs, bed, sitting, standing

Questions: 5
Score Range: 0-20
Physical Function

Difficulty with daily activities and mobility

Questions: 17
Score Range: 0-68
Stiffness

Stiffness after waking and later in day

Questions: 2
Score Range: 0-8

Meaningful Change Threshold

A change of about 10% in any domain is usually considered a meaningful improvement or worsening. For the total score, a change of 8-12 points represents clinically meaningful change.

About the Developers

The WOMAC was developed by a collaborative team from Western Ontario and McMaster Universities, led by Dr. Nicholas Bellamy and colleagues. The questionnaire was created specifically for osteoarthritis assessment and has become the international standard.

Copyright Information

The WOMAC questionnaire is copyrighted by Western Ontario and McMaster Universities. Permission for use must be obtained from the copyright holders.

Administration Instructions

The WOMAC takes approximately 12 minutes to complete and can be administered on paper, over the telephone, or electronically. Patients should be instructed to consider their symptoms over the past 48 hours. The questionnaire is self-administered and requires no special training.

Limitations & Considerations

The stiffness subscale has low test-retest reliability and limited evidence for its measurement properties. Some studies report inadequate factorial validity in the pain and physical function subscales. The questionnaire is self-reported and may be influenced by patient mood or external factors.

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