Section 2 – Personal Care* I can look after myself normally, without causing extra neck pain. (0) I can look after myself normally, but it a causes extra neck pain. (1) It is painful to look after myself, and I am slow and careful (2) I need some help but manage most of my personal care (3) I need help every day in most aspects of self-care (4) I do not get dressed. I wash with difficulty and stay in bed. (5)
Section 3 – Lifting* I can lift heavy weights without causing extra neck pain (0) I can lift heavy weights, but it gives me extra neck pain (1) Neck pain prevents me from lifting heavy weights off the floor but I can manage if items are conveniently positioned, i.e. on a table (2) Neck pain prevents me from lifting heavy weights, but I can manage light weights if they are conveniently positioned (3) I can lift only very light weights (4) I cannot lift or carry anything at all (5)
Section 4 – Reading* I can read as much as I want with no neck pain (0) I can read as much as I want with slight neck pain (1) I can read as much as I want with moderate neck pain (2) I can't read as much as I want because of moderate neck pain (3) I can't read as much as I want because of severe neck pain (4) I can't read at all (5)
Section 7 – Work* I can do as much work as I want (0) I can only do my usual work, but no more (1) I can do most of my usual work, but no more. (2) I can't do my usual work (3) I can hardly do any wort at all (4) I can't do any work at all (5)
Section 8 – Driving* I can drive my car without neck pain (0) I can drive my car with only slight neck pain (1) I can drive as long as I ant with moderate neck pain (2) I can't drive as long as I want because of moderate neck pain (3) I can hardly drive at all because of severe neck pain (4) I can't drive my car at all because of neck pain (5)
Section 9 – Sleeping* I have no trouble sleeping (0) My sleep is slightly disturbed for less than 1 hour (1) My sleep is mildly disturbed for up to 1-2 hours (2) My sleep is moderately disturbed for up to 2-3 hours (3) My sleep is greatly disturbed for up to 3-5 hours (4) My sleep is completely disturbed for up to 5-7 hours (5)
Section 10 – Recreation* I am able to engage in all my recreational activities with no neck pain at all (0) I am able to engage in all my recreational activities with some neck pain (1) I am able to engage in most, but not all of my recreational activities because of pain in my neck (2) I am able to engage in a few of my recreational activities because of neck pain (3) I can hardly do recreational activities due to neck pain (4) I can't do any recreational activities due to neck pain (5)
