Primary Image

Rehabilitation Measures

McGill Pain Questionnaire

Last Updated

Purpose

The MPQ is a self-reported measure of pain.

Link to Instrument

Instrument Details

Acronym MPQ

Area of Assessment

Pain

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

Diagnosis/Conditions

  • Pain Management

Key Descriptions

  • The MPQ is a self-reported measure of pain studied with a number of diagnoses, and it assesses both the quality and intensity of subjective pain.
  • The MPQ is composed of 78 words. Respondents choose those that best describe their experience of pain.
  • Seven words are selected from the following categories:
    1) dimension 1 to 10 (pain descriptors), three words
    2) dimensions 11 to 15 (affective components of pain), two words
    3) dimension 16 (evaluation of pain), one word
    4) dimension 17 to 20 (miscellaneous), one word
  • MPQ Pain Dimension:
    1) Flickering/beating
    2) Jumping/shooting
    3) Pricking/lancinating
    4) Sharp/lacerating
    5) Pinching/crushing
    6) Tugging/wrenching
    7) Hot/searing
    8) Tingling/stinging
    9) Dull/heavy
    10) Tender/splitting
  • MPQ Affective Dimension:
    11) Tiring/exhausting
    12) Sickening/suffocating
    13) Fearful/terrifying
    14) Punishing/killing
    15) Wretched/blinding
  • MPQ Evaluative Dimension:
    16) Annoying/unbearable
  • MPQ Miscellaneous Dimension:
    17) Spreading/piercing
    18) Tight/tearing
    19) Cold/freezing
    20) Nagging/torturing
  • Scores are tabulated by summing values associated with each word; scores range from 0 (no pain) to 78 (severe pain). Qualitative differences in pain may be reflected in respondent’s word choice (Melzack, 1975).

Number of Items

1

Time to Administer

Up to 30 minutes

The MPQ long version may take as long as 30 minutes to complete.
Short forms of the measure are available.

Required Training

No Training

Age Ranges

Adolescent

13 - 17

years

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Jason H. Raad

ICF Domain

Body Function

Measurement Domain

Sensory

Considerations

Translated into 26 languages including (common translations include):

  • Turkish
  • Dutch
  • Iranian
  • Swedish
  • Danish
  • Japanese
  • Thai
  • Spanish
  • French
  • German
  • Italian 
  • Norwegian
  • Amharic
  • Chinese
  • Slovak
  • Greek
  • Brazilian/European Portuguese

 

  • Patient language proficiency may present a problem, the test administrator should be able to define unknown words / concepts (Hawker et al., 2011)
  • The MPQ may help to distinguish neuropathic from nocioceptive type pain
  • Useful in both epidemiological and clinical studies
  • Ethnic or sex differences may affect terms used when describing pain
  • Differentiating groups based on subscale scores may lead to patients being erroneously classified (Turk, Rudy and Salovey 1985)
  • The Dartmouth Pain Questionnaire (Corson and Schneider, 1984) can be used as an adjunct to the MPQ 

Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

Mixed Populations

back to Populations

Cut-Off Scores

Various Diagnoses:

(Wilke et al., 1990; meta-analytic results of 51 studies; total subjects across studies = 3,624; mean ages ranged from 19 to 62 years)

  • Scores across all conditions = 25% to 39% of maximum scores
  • PRI-affective scores = 11% to 39% of maximum scores
  • PRI-evaluative scores = 44% to 54% of maximum scores
  • PRI-Misc scores = 22% to 33% of maximum scores

Normative Data

Various Diagnoses:

(Wilke et al., 1990)

Dimension

Possible Score

Cancer

Low Back

Mixed Chronic

Acute / Post-up

Labor / GYN

Dental

Total

Sensory

42

12.1 (3.6-17.4)

16.3 (10.8-20)

15.2 (9.8-23.7)

14.2(11.5-26.3)

16.3 (6.8-22.5)

10.7 (8-13.4)

13.9 (3.6-26)

Pain Rating Index (Affective)

14

4.8 (0.5-14.1)

5.5 (2.6-12.3)

3.8 (1.7-7.5)

2.3 (0.9-3.3)

2.7 (0.7-5.1)

1.8 (0.8-2.6)

3.3 (0.4-14.1)

Pain Rating Index (Evaluative)

5

2.7 (1-4.3)

2.4 (1.5-3.3)

2.7 (1.1-3.8)

2.3 (1.3-2.9)

2.2 (0.5-3.3)

2.5 (1.1-4.5)

2.5 (0.5-6.4)

Pain Rating Index (Misc)

17

4.5 (0.3-8.5)

5.6 (4.1-6.7)

5.4 (1.3-6.5)

3.9 (2.4-9.7)

5.1 (0-7.2)

3.8 (2.4-4.6)

4.9 (0-9.7)

Pain Rating Index (Total)

78

24 (5.4-44.4)

27.9 (17.8-34.4)

25.4 (14.0-32.9)

20.5 (7.4-40.7)

24.7 (14.0-37.2)

17.8 (13-27.5)

23 (5.4-44.4)

Number of words chosen

20

9.3 (2.9-14.4)

9.7 (6.7-12.6)

11 (6.3-17.2)

9 (3.8-11.5)

6.9 (3.8-7.8)

8.2 (6.6-11.2)

9.2 (2.9-17.2)

Present Pain Index

5

2.2 (1-4)

2.3 (1.5-3.3)

2.6 (1.8-3.6)

1.6 (1.4-2.8)

2.4 (2.4)

2.2 (1.6-2.5)

2.3 (1-4.0)

Grand Weighted-Mean scores (range of mean scores)

 

Criterion Validity (Predictive/Concurrent)

Lung, Head or Neck, and Prostate Cancer:

(Fisher et al., 2009; n = 302; mean age = 60.5 (11.5) years; all patients undergoing radiation treatment)

  • Concurrent validity: number of words chosen predicted by (using standardized regression coefficients, Beta):

    • State Anxiety (Beta = 0.06)

    • Depression (Beta = 0.07)

    • Greater number of coping strategies used (Beta = 0.16)

Arthritis

back to Populations

Test/Retest Reliability

Rheumatoid Arthritis:

(Ferraz et al., 1990; n = 91 (66 literate & 25 illiterate)

  • Excellent test-retest reliability (literate) r = 0.96

  • Excellent test-retest reliability (illiterate) r = 0.95

Content Validity

Arthritis:

(Burckhardt, 1984; n = 188 (from two samples, one impatient, one outpatient); approximately 50% presented with rheumatoid arthritis, 30% had osteoarthritis, and 20% had a less common forms of rheumatic disease; MPQ sores (outpatient) = 23.8 (12.8) and (inpatient = 28.8 (13.8) points)

  • Six factors explained 58.3% of the variance. Most variance (29%) was accounted for by sensory reactive components.
  • "Aching" was the most commonly cited term, "Sharp" and Throbbing" were also commonly cited.
  • Ratings of intensity was consistent to severity of arthritis.

Cancer

back to Populations

Internal Consistency

Cancer:

(Mystakidou et al, 2004; n = 114; Greek language version of the MPQ)

  • Excellent internal consistency (Cronbach's alpha = 0.96)

 

Leukemia:

(Donaldson; n = 191; patients with oral mucositis pain due to bone marrow transplants assessed at 3 and 10 days; mean age = 35 (18-57) years)

  • Internal consistency (calculated using factor scores)
    • 0.88 (at 3 days)
    • 0.87 (at 10 days)

Criterion Validity (Predictive/Concurrent)

Lung, Head or Neck, and Prostate Cancer:

(Fisher et al., 2009; n = 302; mean age = 60.5 (11.5) years; all patients undergoing radiation treatment)

  • Concurrent validity: number of words chosen predicted by (using standardized regression coefficients, Beta):

    • State Anxiety (Beta = 0.06)

    • Depression (Beta = 0.07)

    • Greater number of coping strategies used (Beta = 0.16)

 

Lung Cancer:

(Wilkie et al., 2001, MPQ pain rating index mean scores = 19 (12) points with 8 words chosen; mean Sensory scores = 12 (7), mean Affective scores = 2 (2), mean Evaluative scores = 2 (2) and mean Misc scores = 3 (3) points)  

  • Predictive validity: 10 neuropathic pain discriptors were selected for lung cancer pain sites

Back Pain

back to Populations

Construct Validity

Low Back Pain:

(Byrne et al, 1981; n = 98 (63 female, 35 male); mean age 41.7 (male); 48.1 (female) years; mean duration of back pain 5.5 and 7.7 years respectively)

  • Factor analyses was used, loadings were compared to prior research (e.g. Prieto et al., 1980). Comparisons suggest a similar pattern of factor loadings.

Content Validity

Low Back Pain:

(Byrne et al, 1981)

  • A four factor solution accounted for most of the variance, with the first factor (sensory pressure) accounting for 71.9% of the variance.

Chronic Pain

back to Populations

Floor/Ceiling Effects

Chronic Pain:

(Dworkin et al., 2009; n = 882; mean experience of chronic pain >8 years; SF-MPQ-2)

SF-MPQ-2 Floor and Ceiling Effects:

 

 

 

 

Dimension

n

mean (SD) score

% Floor

% Ceiling

Total score

853

4.93 (2.04)

0.0

0.0

Continuous pain

867

5.82 (2.28)

0.2

1.8

Intermittent pain

863

4.92 (2.72)

3.9

1.7

Neuropathic pain

870

4.26 (2.57)

4.1

0.9

Affective descriptors

868

5.46 (2.84)

3.2

6.5

Musculoskeletal Conditions

back to Populations

Floor/Ceiling Effects

Musculoskeletal Pain:

(Menezes et al., 2011; n = 203; 38% = lower limb conditions, 29% = upper limb conditions, 23% = back pain, 8% = neck pain, and 3% = fibromyalgia; mean age = 42.5 (15.5) years; Brazilian-Portuguese Short Form of the MPQ used)

  • No floor or ceiling effects observed for the SF-MPQ (calculated as > 15% highest or lowest possible score; no data for the)

Note: No studies could be located that assessed floor or ceiling effects for the original MPQ

Non-Specific Patient Population

back to Populations

Content Validity

Literature Review:

(Melzack, 1975; measure development)

  • Subject Matter Experts classified 102 words gleaned from the extant literature.

  • Words were categorized into 3 classes and 16 subclasses, these include:

    • Sensory qualities: temporal, spatial, pressure, thermal and "other" properties of pain

    • Affective qualities: tension fear and automatic properties of pain

    • Evaluative terms: a subjective assessment of overall pain intensity.

  • Groups of doctors, patients and students then assigned numeric intensity values to each word

    • High levels of agreement were observed despite difference in cultural, socio-economic and educational levels

Bibliography

Burckhardt, C. S. (1984). "The use of the McGill Pain Questionnaire in assessing arthritis pain." Pain 19(3): 305-314. Find it on PubMed

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

Corson, J. A. and Schneider, M. J. (1984). "The Dartmouth Pain Questionnaire: an adjunct to the McGill Pain Questionnaire." Pain 19(1): 59-69. Find it on PubMed

Donaldson, G. W. (1995). "The factorial structure and stability of the McGill Pain Questionnaire in patients experiencing oral mucositis following bone marrow transplantation." Pain 62(1): 101-109. Find it on PubMed

Dworkin, R. H., Turk, D. C., et al. (2009). "Development and initial validation of an expanded and revised version of the Short-form McGill Pain Questionnaire (SF-MPQ-2)." Pain 144(1-2): 35-42. Find it on PubMed

Ferraz, M. B., Quaresma, M. R., et al. (1990). "Reliability of pain scales in the assessment of literate and illiterate patients with rheumatoid arthritis." J Rheumatol 17(8): 1022-1024. Find it on PubMed

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

Hawker, G. A., Mian, S., et al. (2011). "Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP)." Arthritis Care Res (Hoboken) 63 Suppl 11: S240-252. Find it on PubMed

Melzack, R. (1975). "The McGill Pain Questionnaire: major properties and scoring methods." Pain 1(3): 277-299. Find it on PubMed

Menezes Costa Lda, C., Maher, C. G., et al. (2011). "The Brazilian-Portuguese versions of the McGill Pain Questionnaire were reproducible, valid, and responsive in patients with musculoskeletal pain." J Clin Epidemiol 64(8): 903-912. Find it on PubMed

Mystakidou, K., Katsouda, E., et al. (2004). "Use of the Greek McGill Pain Questionnaire in cancer patients." Expert Rev Pharmacoecon Outcomes Res 4(2): 227-233. Find it on PubMed

Prieto, E. J., Hopson, L., et al. (1980). "The language of low back pain: factor structure of the McGill pain questionnaire." Pain 8(1): 11-19. Find it on PubMed

Turk, D. C., Rudy, T. E., et al. (1985). "The McGill Pain Questionnaire reconsidered: confirming the factor structure and examining appropriate uses." Pain 21(4): 385-397. Find it on PubMed

Wilkie, D. J., Huang, H. Y., et al. (2001). "Nociceptive and neuropathic pain in patients with lung cancer: a comparison of pain quality descriptors." J Pain Symptom Manage 22(5): 899-910. Find it on PubMed

Wilkie, D. J., Savedra, M. C., et al. (1990). "Use of the McGill Pain Questionnaire to measure pain: a meta-analysis." Nurs Res 39(1): 36-41. Find it on PubMed

Save now, read later.