Neck Disability Index

Neck Disability Index (NDI) is a 10 item questions that measures a patient’s neck pain related disability, it was first published in 1991 by Dr. Howard Vernon and was based on the Oswestry Low Back Pain Disability Questionnaire. The NDI was reviewed in 2008 by the same author.

The 10 Questions of NDI include activities of daily living, such as: personal care, lifting, reading, work, driving, sleeping, recreational activities, pain intensity, concentration and headache.

A study of the psychosocial, physical and workplace features of female office workers found that those with neck pain and disability can be differentiated from those with no disability using the Neck Disability Index. 

Download Neck Disability Index PDF

Neck Disability Index Scoring

The items are scored in descending order with the top statement = 0 and the bottom statement = 5

All subsections are added together for a cumulative score. The higher the score, the greater the disability.

See Also: Lower Extremity Functional Scale

Pain Intensity

0. I have no pain at the moment
1. The pain is very mild at the moment
2. The pain is moderate at the moment
3. The pain is fairly severe at the moment
4. The pain is very severe at the moment
5. The pain is the worst imaginable at the moment

Work

0. I can do as much as I want to
1. I can only do my usual work but not more
2. I can do most of my usual work, but not more
3. I cannot do my usual work
4. I can hardly do any usual work at all
5. I can’t do any work at all

Personal Care (washing, dressing, etc.)

0. I can look after myself normally w/o causing extra pain
1. I can look after myself normally but it causes extra pain
2. It is painful to look after myself & I am slow & careful
3. I need some help but manage most of my personal care
4. I need help every day in most aspect of self care
5. I cannot get dressed, wash with difficulty & stay in Bed

Concentration

0. I can concentrate fully when I want to with no difficulty
1. I can concentrate fully when I want to with slight difficulty
2. I have a fair degree of difficulty concentrating when I want
3. I have a lot of difficulty concentrating when I want
4. I have a great deal of difficulty concentrating when I want
5. I cannot concentrate at all

Lifting

0. I can lift heavy weights without extra pain
1. I can lift heavy weights but it gives extra pain
2. Pain prevents me from lifting heavy weights off the floor, but I can manage if they are on a table
3. Pain prevents me from lifting heavy weights but I can manage if they are conveniently placed
4. I can lift only very light weights
5. I cannot lift or carry anything at all

Driving

0. I can drive my car without neck pain
1. I can drive my car as long as I want with slight neck pain
2. I can drive my car as long as I want with moderate neck pain
3. I can’t drive my car as long as I want because of moderate neck pain
4. I can hardly drive at all because of severe neck pain
5. I can’t drive my car at all

Reading

0. I can read as much as I want with no pain in my neck
1. I can read as much as I want with slight pain in my neck
2. I can read as much as I want with moderate pain in my neck
3. I can’t read as much as I want because of moderate pain in my neck
4. I can hardly read at all because of severe pain in my neck
5. I cannot read at all

Recreation

0. I am able to engage in all my recreational activities with no neck pain
1. I am able to engage in all my recreational activities with some neck pain
2. I am able to engage in most but not all of my usual recreational activities because of neck pain
3. I am able to engage in a few of my usual recreational activities with some neck pain
4. I can hardly do any recreational activities because of neck pain
5. I can’t do any recreational activities at all

Headache

0. I have no headaches at all
1. I have slight headaches which come infrequently
2. I have moderate headaches which come infrequently
3. I have moderate headaches which come frequently
4. I have severe headaches which come infrequently
5. I have headaches almost all the time

Sleeping

0. I have no trouble sleeping
1. My sleep is slightly disturbed (<1-hr sleep loss)
2. My sleep is mildly disturbed (1- to 2-hr sleep loss)
3. My sleep is moderately disturbed (2- to 3-hr sleep loss)
4. My sleep is greatly disturbed (3- to 5-hr sleep loss)
5. My sleep is completely disturbed (5- to 7-hr sleep loss)

References

1. Howell ER. The association between neck pain, the Neck Disability Index and cervical ranges of motion: a narrative review. J Can Chiropr Assoc. 2011 Sep;55(3):211-21. PMID: 21886283; PMCID: PMC3154067.
2.  Johnston V, Jimmieson NL, Jull G, Souvlis T. Contribution of individual, workplace, psychosocial and physiological factors to neck pain in female office workers. Eur J Pain. 2009;13:985–991