Neck Disability Index (NDI)
10-item self-report questionnaire assessing neck pain-related disability. Each section scored 0–5. Total 0–50. Originally designed for whiplash but used broadly for cervical spine conditions. Percentage disability = score × 2.
Score interpretation
NDI 0–4 — no neck pain-related disability
→ No specific intervention required; reassurance; posture advice; neck strengthening exercises; ergonomic assessment if work-related; reassess if symptoms change
NDI 5–14 — mild disability (10–28% disability)
→ Physiotherapy referral for neck exercises; posture correction; analgesics (paracetamol ± NSAIDs); heat/cold therapy; ergonomic advice; reassess at 4–6 weeks; check for red flags (myelopathy symptoms)
NDI 15–24 — moderate disability (30–48% disability)
→ Physiotherapy; consider MRI cervical spine if not done; stronger analgesia (short-term opioids if appropriate); review for neuropathic component (pregabalin/amitriptyline); pain clinic referral; psychological assessment for pain behaviours; occupational therapy; consider DVLA implications if driving affected
NDI 25–50 — severe disability (50–100%)
→ Urgent spinal/neurosurgical or pain clinic referral; MRI if not done; look for cervical myelopathy (weakness, bladder/bowel symptoms); multidisciplinary pain management programme; psychological support (CBT for pain); assess for surgical decompression if myelopathy confirmed; disability assessment; consider welfare and work incapacity
Interpretation bands for the Neck Disability Index. Apply clinical judgement and local guidance.
References
- Vernon H, Mior S. The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther. 1991;14(7):409–415.
Related
Curated clinical cross-links plus same-class fallbacks.
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- Critical-Care Pain Observation Tool (CPOT) · Pain Assessment
- Behavioral Pain Scale (BPS) for Ventilated Patients · Pain Assessment
- Pain Assessment in Advanced Dementia Scale (PAINAD) · Pain Assessment
- Abbey Pain Scale for Dementia · Pain Assessment
- DN4 Questionnaire for Neuropathic Pain · Pain Assessment
- Methoxyflurane · Inhaled Analgesic — Acute Pain
- Cetuximab · Anti-EGFR Monoclonal Antibody — Head and Neck Cancer
- Cisplatin · Platinum Chemotherapy — Head and Neck Cancer
- Methotrexate · Chemotherapy / Immunosuppressant — Head and Neck / Granulomatosis
- Pembrolizumab (Head and Neck SCC) · PD-1 Inhibitor
- Nivolumab (Head and Neck SCC) · PD-1 Inhibitor
- Hip Fracture Management · NICE CG124 / BOA 2020
- Distal Radius Fracture · BOA / NICE
- Ankle Fracture Management · BOA / Lauge-Hansen classification
- Metastatic Spinal Cord Compression · NICE CG75 2020
- Open Fracture Management · BOA/BAPRAS 2017
- OrthoPath: Upper Limb ED Triage · OrthoPath ED Tool — ReviseMRCEM.com
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.