Recently, there has been growing interest in the development of methods for recording disability as an outcome measure to monitor treatment effectiveness in chronic pain patients. Where these methods have relied on self-report, further information is needed about the validity and reliability of the results. Three such studies are reported on the Oswestry Low Back Pain Disability Questionnaire (ODQ. These involved comparing actual performance on lifting, sitting and walking tasks with reported limitation on the relevant subsections of the ODQ. The results were able to show encouraging validity and reliability. A factor-analytic study was also undertaken, which determined that there were two distinct factors of disability measured by this instrument. A small cohort of patients were followed up after a pain rehabilitation programme and reductions in disability were found to be reliably measured by the ODQ. The relationships between reported disability and the emotional and cognitive context in which the pain is experienced are discussed.