Shoulder joint is the third most-frequently involved structure in musculoskeletal conditions globally. More than 30 shoulder specific questionnaires have been generated in English in order to measure shoulder related quality of life and incidence of pain. Among all these questionnaires, Shoulder Pain and Disability Index (SPADI) is one of the most useful tools, therefore it has been translated, culturally adapted and validated to many languages. This study was carried out to translate and

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... ally adapt SPADI into Urdu language. Material & Methods: Study was conducted over a timeframe of three months, that's March 2019 to May 2019 in Helping Hand Institute of Rehabilitation Sciences, Mansehra. Translation and cultural adaptation of Shoulder Pain and Disability Index (SPADI) was carried out according to internationally published six-step guidelines. In accordance with the provided directions a number of changes were made to the six-step guidelines. Through consensus of the expert panel, its final version was field in and tested on forty individuals with and without shoulder pathologies in an equal proportion. Results: Changes were required during each step of Beaton's guidelines for cross-cultural adaptation. Translators during 'forward and backward translations' had faced a number of obstacles. Minor differences were found during reconciliation process and expert panel review. The pilot testing highlighted, misinterpretation among target population regarding item 3, 5, 7 and 8 of disability scale due to cultural differences. These items were adjusted according to cultural relevance and conceptual equivalence to the original version. Final version was found relevant and easily understood by the patients having shoulder pathology. Conclusion: SPADI-U has good face and content validity and it can be used to measure shoulder related quality of life in Urdu speaking population.