The McGill Pain Questionnaire (MPQ), developed by Melzack (1987), is a self-report rating scale intended to quantify the severity of pain a person may be experiencing. The main instrument is composed of 20 subcategories in which the subject is asked to describe his or her pain by choosing, from a list of several, single-word verbal pain descriptors (1 to 5) for each subcategory. The descriptors (76) encompass 4 major domains: (1) sensory, (2) affective, (3) evaluative, and (4) miscellaneous (Melzack, 2005). The descriptors in each subcategory are of a hierarchical design such that they are ranked in value relative to their position in the word set. For example, the person may choose either (1) jumping, (2) flashing, or (3) shooting to describe spatial pain. A subsequent section of the measure includes an exploration of items that may exacerbate pain (20 choices) such as heat, cold, damp, or stimulants (coffee), as well as a 6-item section similar to the first to further describe the client’s pain. The total score is termed the Pain Rating Index (PRI) and ranges from 0 to 78, with higher scores associated with more pain. Scoring also provides for a unique Present Pain Index (PPI), which measures overall pain intensity drawn from six indicators (Strand, Ljunggren, Bogen, Ask, & Johnsen, 2008). A short form (MPQ-SF) derived from the original is also available, which consists of only 15 descriptors of pain, 11 from the sensory and 4 from the affective categories (Strand et al., 2008). The MPQ can be completed in less than 30 minutes with higher scores suggestive of more pain.
Examination of internal consistency of the original MPQ by Melzack (1975) reported significant correlations (≥ 0.89) with the PRI, the number of words chosen, and the PPI; however, only fair to moderate test-retest reliability (0.70) was determined. Using the short form in an osteoarthritis cohort, one study found high intra-class correlation coefficients (ICCs) of reliability for the total, sensory, affective, and average pain scores at r = 0.96, 0.95, 0.88, and 0.89, respectively, whereas the current pain component demonstrated only a moderate ICC of r = 0.75 (Grafton, Foster, & Wright, 2005). Using the MPQ-SF, Strand et al. (2008) established that test–retest reliability values for the total and sensory scores of patients with musculoskeletal pain were r = > 0.74, however, it was poor for the affective score (0.63). In patients with inflammatory rheumatic pain the ICC values for the total score (r = 0.93) and sensory score (0.95) were excellent as well as acceptable for the affective scores at (0.79). The same study explored MPQ-SF responsiveness to clinically important change as defined by a score of 63 on the Patients Global Impression of Change was 92% in rheumatic patients and 52% in patients with musculoskeletal pain. Comparing the MPQ-SF and the Visual Analog Scale (VAS), scores were found responsive to change, showing mostly large (> 0.80) SRM values in patients who reported to have improved. An SRM, or statistical region merging, is an algorithm that evaluates the grouping of values based on merging of criteria.
Both MPQ versions are client-centered, clinician-directed outcome measures that are easy to administer. They assess a number of pain indicators and do not require any specialized training. The MPQ can also provide the clinician with valuable information about an individual’s perception, reaction, and cognition of his or her pain state, which are important factors to consider when choosing treatment modalities and interventions (Strand et al., 2008).
The MPQ’s role as a self-administered assessment may be limited in certain populations due to the complicated adjectives used by some descriptors. The long-version MPQ can take up to 30 minutes to complete.
The MPQ is self-administered tool in which the client circles the most appropriate pain descriptor for each of the categories addressed where the pain descriptors are organized in a hierarchical fashion. For example, the evaluative item choices would be as follows: (1) annoying, (2) troublesome, (3) miserable, (4) intense, and (5) unbearable. There is also a 6-item section in which a person attempts to identify how strong his or her pain is. An example would be, “Which word describes your pain right now? (1) Mild, (2) discomforting, (3) distressing, (4) horrible, or (5) excruciating.” There is also a section relating to items that may exacerbate pain (20 choices) such as loud noises, going to work, or fatigue. Similarly, the MPQ-SF is composed of only 15 pain descriptors that are rated as either (0) none, (1) mild, (2) moderate, or (3) severe; however, the short form derives 3 pain scores from the sum of the intensity rank values of the words chosen for sensory, affective, and total descriptors and the PPI index of the standard MPQ as well as a VAS rating (Melzack, 1987). Higher scores for both assessments are associated with more pain.
The MPQ and the MPQ-SF can be accessed through the MAPI Research Trust: Education Information Dissemination website and can be used in clinical practice if requested first. There are user agreements and royalty fees if the scale is to be used for commercial or research purposes and distribution fees may be requested according to study design and context of use of the questionnaire. The following reference publications will give further insight into this assessment:
Melzack, R. (1975). The McGill Pain Questionnaire: Major properties and scoring methods. Pain, (3), 277 99.
Melzack. R. (1987). The short-form McGill Pain Questionnaire. Pain, 30, 191-197.
|TYPE OF MEASURE||Hierarchical rating scale|
|WHAT IT ASSESSES||Pain levels|
|TIME||< 30 minutes|
|COST||Free for private practice|
MAPI Research Trust
27, rue de la Villette
69003 Lyon, France
Phone: +33 (0) 472-13-65-75
Ronald Melzack, PhD,
Department of Psychology
Montreal, Ontario, Canada