Japanese Orthopedic Association Back & Neck Questionnaire

June 14, 2019


In 1986, the Japanese Orthopaedic Association (JOA) developed the original version of this tool, which was used to measure both low back and neck pain. In 2007, the Japanese Society for Spine Surgery and Related Research and the Japanese Society of Lumbar Spine Disorders, decided to revise the JOA scoring system into two different questionnaires which are now known as the JOA Back Pain Evaluation Questionnaire (JOABPEQ) and the JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). This change was initiated to create a “self-administered, disease-specific method for measuring low back pain” in order to track outcomes for patients with cervical spondylotic myelopathy.

The JOABPEQ includes twenty-five questions that are subdivided into five subscales: lower back pain, lumbar function, walking ability, social life function, and mental health. These questions are Intended to evaluate individuals with low back pain from five different perspectives.
The JOACMEQ contains twenty-four questions subdivided into five subscales: lower extremity function, quality of life, cervical spine function, bladder function, and upper extremity function. These questions are intended to evaluate individuals’ health-related quality of life for those who suffer from cervical spondylotic myelopathy.

The JOABPEQ and JOACMEQ scores range from 0 to 100, with higher scores indicating a better patient condition. To determine whether a treatment has been effective, compare patients before and after the assessment; if a patient’s score has increased ≥ 20, or if the overall score is >90, this indicates improvement.
The overarching goal of the revision from the original assessment was to make it more patient-oriented and conducted in a way that is through the patient’s view rather than the physician’s. As a result, the JOABPEQ and JOACMEQ are much more reliable scoring systems now that they have been revised. Another strength is that entities do not need a license to use this tool and can download it for free. The JOA website offers other valuable tools for free, such as the excel file that calculates scores.

One of the biggest considerations of the JOABPEQ and the JOACMEQ is that both questionnaires were translated from Japanese into English by a professor and as a result, some of the wording is awkward. For example, some questions include double negatives which may be confusing for the patient, however the professor wanted to ensure the meaning of the question did not change. However, they have been found to be valid through statistical analysis.

Licensing and Cost

The JOACMEQ and JOABPEQ do not require a license and may be downloaded for free on the JOA Website.


Sources | Asian Spine Journal | Journal of Orthopaedic Science (1) | Journal of Orthopaedic Science (2)

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