McGill Pain Questionnaire

McGill Pain Questionnaire Explained

The McGill Pain Questionnaire (also known as the McGill Pain Index) or MPQ is a self-report scale developed by Melzack and Torgerson in 1971, to allow people experiencing significant pain to give their clinician an exact description of the quality and intensity of pain that they are experiencing.

The tool can be used to assess pain on the spot, or monitor it over time, for example in determining the effectiveness of a pain management intervention, as well as be of use in epidemiological and clinical studies. This is the most widely used measurement tool for multidimensional pain assessment in chronic pain.

The questionnaire can also be divided into four domains: Sensory (sections 1-10), Affective (sections 11-15), Evaluative (section 16) and Miscellaneous (sections 17-20).

Sensory descriptors are used to describe how the pain feels in the present moment at the time of reporting:

1. Flickering, Quivering, Pulsing, Throbbing, Beating, Pounding
2. Jumping, Flashing, Shooting
3. Pricking, Boring, Drilling, Stabbing, Lancinating
4. Sharp, Cutting, Lacerating
5. Pinching, Pressing, Gnawing, Cramping, Crushing
6. Tugging, Pulling, Wrenching
7. Hot, Burning, Scalding, Searing
8. Tingling, Itchy, Smarting, Stinging
9. Dull, Sore, Hurting, Aching, Heavy
10. Tender, Taut, Rasping, Splitting

Affective descriptors are used to offer an understanding into how an individual’s pain changes with time:

11. Tiring, Exhausting
12. Sickening, Suffocating
13. Fearful, Frightful, Terrifying
14. Punishing, Gruelling, Cruel, Vicious, Killing
15. Wretched, Blinding

Evaluative descriptors are used to assess how strong the pain feels:

16. Annoying, Troublesome, Miserable, Intense, Unbearable

Miscellaneous descriptors

17. Spreading, Radiating, Penetrating, Piercing
18. Tight, Numb, Drawing, Squeezing, Tearing
19. Cool, Cold, Freezing
20. Nagging, Nauseating, Agonizing, Dreadful, Torturing

Present Pain Intensity

No pain (0); Mild (1); Discomforting (2); Distressing (3); Horrible (4); Excruciating (5)

McGill Pain Questionnaire Scores

• Sensory score = sum of answers from 1 to 10
• Affective score = sum of answers from 11 to 15
• Evaluative score = score from question 16
• Miscellaneous score = sum of answers from 17 to 20
• Pain Rating Index (PRI) = sum of answers from 1 to 20
• Present Pain Intensity (PPI) – score from the PPI question

Pain score interpretation: The higher the score, the greater the perceived pain. Should there be any suspicions regarding the patient language proficiency, the test administrator should define the unknown words/concepts.

The use of the MPQ has demonstrated that different pain syndromes/conditions can be consistently described with specific groups of adjectives. The questionnaire has to date been used in over 500 research studies and benefits from 26 different language versions.

The questionnaire has been validated in patients with fibromyalgia, chronic pelvic pain, herniated intervertebral discs, ischemic muscular pain, low back pain, lumbago-sciatica, rheumatic pain or malignancy.

References

Original references

Melzack R, Torgerson WS: On the language of pain. Anesthesiology 1971; 34:50–9.

Melzack R. The McGill Pain Questionnaire: Major properties and scoring methods. Pain. 1975; 1: 277-299.

Validation

Byrne, M., Troy, A., et al. Cross-validation of the factor structure of the McGill Pain Questionnaire. Pain. 1982; 13(2): 193-201.

Fischer, D. J., Villines, D., et al. Anxiety, depression, and pain: differences by primary cancer. Support Care Cancer 2010; 18(7): 801-810.

Other references

Charter RA, Nehemkis AM. The language of pain intensity and complexity: new methods of scoring the McGill Pain Questionnaire. Percept Mot Skills. 1983; 56(2):519-537.

Kremer EF, Atkinson JH Jr, Ignelzi RJ. Pain measurement: the affective dimensional measure of the McGill pain questionnaire with a cancer pain population. Pain. 1982; 12(2):153-163.