In a previous article in the Broadgate Journal, we reviewed how pain is measured and quantified.

This article will take a look at how clinicians are able to measure the ability of patients to manage daily activities and work.

These measuring instruments have been developed by the research community in order to compare the clinical effects of one treatment versus another. They are called Disability Scales and in the recent past, clinics have begun to employ these scales in order to carry out a validated audit of their practices.

The two most widely known scales are the Neck Disability Index, which was developed by the Canadian Chiropractor, Dr Howard Vernon and the Copenhagen Neck Functional Disability Scale, which this author developed and validated. In the English-speaking world, the NDI (Neck Disability Index) is the most commonly used.

Patients are asked to fill out questionnaires that ask a series of questions related to daily activities and the impact that their neck pain is having on their ability to carry out these functions.

A few sample questions are given below:

• Can you sleep without neck discomfort?
• Can you drive a car without neck discomfort?
• Can you work at your desk without neck discomfort?
• Do you avoid social contact due to neck discomfort?
• Have you reduced your reading due to neck pain?

This information assists clinicians in determining the severity of the neck pain and how significantly it is impacting patients. This information is essential for clinicians to design an appropriate treatment plan for individual patients and furthermore, it can be administered during the course of treatment in order to determine if the treatment is having the desired effect.

At the Broadgate Spine & Joint Clinic, we strive to improve all aspects of our care, and clinical audit is an area where we are actively developing appropriate instruments that measure the effect that patients are undergoing.