PI - Oswestry Neck Pain Scale

Neck Disability Index Questionnaire

This questionnaire is designed to enable us to understand how much your neck pain has affected your ability to manage everyday activities. Please answer each Section by circling the ONE CHOICE that most applies to you. We realize that you may feel that more than one statement may relate to you, but please just click the one choice which closely describes your problem right now.

Section 1: Pain Intensity*
Please select at least one option
SECTION 2--Personal Care (Washing, Dressing etc.)*
Please select at least one option
SECTION 3--Lifting*
Please select at least one option
SECTION 4 --Reading*
Please select at least one option
SECTION 5--Headache*
Please select at least one option
SECTION 6 -- Concentration*
Please select at least one option
SECTION 7--Work*
Please select at least one option
SECTION 8--Driving*
Please select at least one option
SECTION 9--Sleeping*
Please select at least one option
SECTION 10--Recreation*
Please select at least one option

Thank you for taking the time to fill out this form.

Contact Us

Send us an email