NECK DISABILITY INDEX

This questionnaire has been designed to give the doctor information as to how your neck pain has affected your ability to manage everyday life. Please answer every section and mark in each section only the ONE box that applies to you. We realize that you may consider that two of the statements in any one section relate to you, but please just mark the box that most closely describes your problem.

Pain Intensity
Personal Care (Washing, Dressing, etc.)
Lifting
Reading
Headaches
Concentration
Work
Driving
Sleeping
Recreation

PAIN IS NOT A LIFESTYLE

Get your quality of life back today.

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