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Pain Quiz
Neck Index
Pain Intensity
00
I have no pain at the moment.
01
The pain is very mild at the moment.
02
The pain comes and goes and is moderate.
03
The pain is fairly severe at the moment.
04
The pain is very severe at the moment.
05
The pain is the worst thing imaginable at the moment.
Sleeping
00
I have no trouble sleeping.
01
My sleep is slightly disturbed (less than 1hr sleepless).
02
My sleep is mildly disturbed (1-2 hrs sleepless).
03
My sleep is moderately disturbed (2-3 hrs sleepless).
04
My sleep is greatly disturbed (3-5 hrs sleepless).
05
My sleep is completely disturbed (5-7 hrs sleepless).
Reading
00
I can read as much as I want with no neck pain.
01
I can read as much as I want with slight neck pain.
02
I can read as much as I want with moderate neck pain.
03
I cannot read as much as I want because of moderate neck pain.
04
I can hardly read at all because of severe neck pain.
05
I cannot read at all because of neck pain.
Concentration
00
I can concentrate fully when I want with no difficulty.
01
I can concentrate fully when I want with slight difficulty.
02
I have a fair degree of difficulty concentrating when I want.
03
I have a lot of difficulty concentrating when I want.
04
I have a great deal of difficulty concentrating when I want.
05
I cannot concentrate at all.
Work
00
I can do as much work as I want.
01
I can only do my usual work but no more.
02
I can only do most of my usual work but no more.
03
I cannot do my usual work.
04
I can hardly do any work at all.
05
I cannot do any work at all.
Personal Care
00
I can look after myself normally without causing extra pain.
01
I can look after myself normally but it causes some extra pain.
02
It is painful to look after myself and I am slow and careful.
03
I need some help but I manage most of my personal care.
04
I need help every day in most aspects of self care.
05
I do not get dressed, I was with difficulty and stay in bed.
Lifting
00
I can lift heavy weights without extra pain.
01
I can lift heavy weights but it causes extra pain.
02
Pain prevents me from lifting heavy weights off the floor, but I can manage if they are conveniently positioned (e.g., on a table).
03
Pain prevents me from lifting heavy weights off the floor, but I can manage light to medium weights if they are conveniently positioned.
04
I can only lift very light weights.
05
I cannot lift or carry anything at all.
Driving
00
I can drive my car without any neck pain.
01
I can drive my car as long as I want with slight neck pain.
02
I can drive my car as long as I want with moderate neck pain.
03
I cannot drive my car as long as I want because of moderate neck pain.
04
I can hardly drive my car at all because of neck pain.
05
I cannot drive my car at all because of neck pain.
Recreation
00
I am able to engage in all my recreation activities without neck pain.
01
I am able to engage in all my usual recreation activities with some neck pain.
02
I am able to engage in most but not all my usual recreation activities because of neck pain.
03
I am only able to engage in a few of my usual recreation activities because of neck pain.
04
I can hardly do any recreation activities because of neck pain.
05
I cannot do any recreation activities at all.
Headaches
00
I have no headaches at all.
01
I have slight headaches which come infrequently.
02
I have moderate headaches which come infrequently.
03
I have moderate headaches which come frequently.
04
I have severe headaches which come frequently.
05
I have headaches almost all the time.
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Multiple Locations / 1 Number
(904) 743-2222
Arlington
6947 Merrill Road
Jacksonville, FL 32277
Southside / Baymeadows
8081 Philips Hwy Suite #4,#17
Jacksonville, FL 32256
West Side
5913-13 Normandy Blvd
Jacksonville, FL 32205
Springfield
1803 Boulevard Street
Jacksonville, FL 32208
Fernandina
817 South 8th Street
Fernandina Beach, FL 32034
Northside
2160 Dunn Ave.
Jacksonville, FL 32218
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