1. Pain Intensity
I have no pain at the moment
2. Personal Care (e.g., Washing, Dressing)
I can look after myself normally without causing extra pain
3. Lifting
I can lift heavy weights without extra pain.
4. Reading
I can read as much as I want to with no pain in my neck
5. Headaches
I have no headaches at all
6. Concentration
I can concentrate fully when I want to with no difficulty
7. Work
I can do as much work as I want to
8. Driving
I can drive my car without any neck pain
9. Sleeping
I have no trouble in sleeping
10. Recreation
I am able to engage in all my recreational activities with no neck pain at all
Neck Disability Index - Vernon and Mior Cervical Spine Questionnaire
INSTRUCTIONS:
This questionnaire has been designed to give your therapist information as to how your neck pain has affected your ability to manage in everyday life. Please answer every question by placing a mark in the box that best describes your condition today.
During the past 4 weeks......
1. Pain Intensity
2. Personal Care (e.g., Washing, Dressing)
3. Lifting
4. Reading
5. Headaches
6. Concentration
7. Work
8. Driving
9. Sleeping
10. Recreation