Spine Outcome Measurements: Neck Disability Index

outcome measures Jun 24, 2023
Neck Disability Index

The Neck Disability Index (NDI) is a patient-reported outcome measure used to assess the impact of neck pain on daily activities and functional ability. It consists of 10 items that address pain, personal care, lifting, reading, headaches, concentration, work, driving, sleeping, and recreation. Each item is scored on a scale of 0 to 5, with higher scores indicating greater disability.

The NDI is commonly used in clinical practice and research to assess the severity of neck pain and disability, monitor changes over time, and evaluate the effectiveness of interventions. It can be used with individuals who have acute or chronic neck pain, as well as those with a variety of underlying conditions, such as cervical disc herniation, whiplash-associated disorder, and cervical spondylosis.

The NDI is typically administered as a self-report questionnaire, with patients completing the items on their own or with assistance from a healthcare provider. It takes only a few minutes to complete and is considered a reliable and valid measure of neck-related disability.

Interpretation of NDI scores depends on the purpose of assessment and the individual patient's condition. In general, higher scores indicate greater disability and poorer functional status. Clinicians may use the NDI scores to track the patient's progress over time and to guide treatment decisions.

There is no definitive "normal" range of NDI scores as the severity of neck pain and disability can vary widely among individuals. However, some studies have suggested that an NDI score of 0 to 4 indicates no disability, 5 to 14 indicates mild disability, 15 to 24 indicates moderate disability, and 25 to 50 indicates severe disability.



  1. Vernon H, Mior S. The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther. 1991;14(7):409-415.
  2. MacDermid JC, Walton DM, Avery S, et al. Measurement properties of the Neck Disability Index: a systematic review. J Orthop Sports Phys Ther. 2009;39(5):400-417.
  3. Cleland JA, Whitman JM, Houser JL, et al. Psychometric properties of selected tests in patients with lumbar spinal stenosis. Spine J. 2012;12(10):921-931.

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