QuickDASH

An 11-item questionnaire evaluating physical function and symptoms in upper limb musculoskeletal conditions. Streamlined version of the DASH questionnaire.

Instructions:

Answer every question about your symptoms and ability to perform activities over the last week. Select the response that best describes your condition. If you did not perform an activity, make your best estimate.

Daily Activities

1. Open a tight or new jar.

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

2. Do heavy household chores (e.g., wash walls, floors).

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

3. Carry a shopping bag or briefcase.

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

4. Wash your back.

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

5. Use a knife to cut food.

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

6. Recreational activities in which you take some force or impact through your arm, shoulder or hand (e.g., golf, hammering, tennis, etc.).

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

Symptoms and Impact

7. During the past week, to what extent has your arm, shoulder or hand problem interfered with your normal social activities with family, friends, neighbours or groups?

Not at all

Slightly

Moderately

Quite a bit

Extremely

8. During the past week, were you limited in your work or other regular daily activities as a result of your arm, shoulder or hand problem?

Not limited at all

Slightly limited

Moderately limited

Very limited

Unable

9. Arm, shoulder or hand pain.

None

Mild

Moderate

Severe

Extreme

10. Tingling (pins and needles) in your arm, shoulder or hand.

None

Mild

Moderate

Severe

Extreme

11. During the past week, how much difficulty have you had sleeping because of the pain in your arm, shoulder or hand?

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

So much difficulty that I can't sleep

Work Module (Optional)

Please indicate what your job/work is:

I do not work. (You may skip this section.)

Type: checkbox

1. Using your usual technique for your work?

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

2. Doing your usual work because of arm, shoulder or hand pain?

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

3. Doing your work as well as you would like?

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

4. Spending your usual amount of time doing your work?

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

Sports/Performing Arts Module (Optional)

Please indicate the sport or instrument which is most important to you:

I do not play a sport or an instrument. (You may skip this section.)

Type: checkbox

1. Using your usual technique for playing your instrument or sport?

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

2. Playing your musical instrument or sport because of arm, shoulder or hand pain?

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

3. Playing your musical instrument or sport as well as you would like?

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

4. Spending your usual amount of time practising or playing your instrument or sport?

No difficulty

Mild difficulty

Moderate difficulty

Severe difficulty

Unable

Patient Watch Form - 4/2/2026