The McGill Pain Questionnaire consists primarily of 3 major classes of word descriptors--sensory, affective and evaluative--that are used by patients to specify subjective pain experience. It also contains an intensity scale and other items to determine the properties of pain experience. The questionnaire was designed to provide quantitative measures of clinical pain that can be treated statistically. This paper describes the procedures for administration of the questionnaire and the various measures that can be derived from it. The 3 major measures are: (1) the pain rating index, based on two types of numerical values that can be assigned to each word descriptor, (2) the number of words chosen; and (3) the present pain intensity based on a 1-5 intensity scale. Correlation coefficients among these measures, based on data obtained with 297 patients suffering several kinds of pain, are presented. In addition, an experimental study which utilized the questionnaire is analyzed in order to describe the nature of the information that is obtained. The data, taken together, indicate that the McGill Pain Questionnaire provides quantitative information that can be treated statistically, and is sufficiently sensitive to detect differences among different methods to relieve pain.

The nature of pain has been the subject of bitter controversy since the turn of the century (1). There are currently two opposing theories of pain: (i) specificity theory, which holds that pain is a specific modality like vision or hearing, "with its own central and peripheral apparatus" (2), and (ii) pattern theory, which maintains that the nerve impulse pattern for pain is produced by intense stimulation of nonspecific receptors since "there are no specific fibers and no specific endings" (3). Bo,th theories derive from earlier concepts proposed by von Frey (4) and Goldscheider (5) in 1894, and historically they are held to be mutually exclusive. Since it is our purpose here to propose a new theory of pain mechanisms, we shall state ex,plicitly at the outset where we agree and disagree with specificity and pattern theories. Specificity TheorySpecificity theory proposes that a mosaic of specific pain receptors in body tissue projects to a pain center in the brain. It maintains that free nerve endings are pain receptors (4) and generate pain impulses that are carried by A-delta and C fibers in peripheral nerves (6) and by the lateral spinothalamic tract in the spinal cord (2) to a pain center in the thalamus (7). Despite its apparent simplicity, the theory contains an explicit statement of physiological spe- 19 NOVEMBER 1965 cialization and an imr cal assumption (8, 9 proposition that the ski receptors." To say tha sponds only to intense lation of the skin is statement of fact; it s ceptor is specialized 1 particular kind of stin receptor a "pain recc is a psychological ass plies a direct connecti ceptor to a brain cent felt (Fig. 1), so that the receptor must al and only the sensatio distinction between p cialization and psych( tion also applies to and central projection The facts of physi4 zation provide the pov theory. Its psychologic its weakness. As in theories, there is impl theory the conceptiot system; and the mod fixed, direct-line contem fr'om the skin to facet of specificity th putes a direct, invar between stimulus and amined here in the li cal, psychological, ai evidence concerning pa Clinical evidence. pain states of causalgis ing pain that may res tial lesion of a pe phantom limb pain (v SCIENCE after amputation of a limb), and the peripheral neuralgias (which may occur after peripheral nerve infections or degenerative diseases) provide a dra-r^y?r matic refutation of the concept of a J,r> Yfixed, direct-line nervous system. Four features of these syndromes plague pathe tient, physician, and theorist (8, 10). 1) Surgical lesions of the peripheral nse. and central nervous system have been singularly unsuccessful in abolishing these pains permanently, although the Wall lesions have been made at almost every level (Fig. 2). Even after such operations, pain can often still be elicited by stimulation below the level of seclicit psychologi-tion and may be more severe than ). Consider the before the operation (8, 10). in contains "pain 2) Gentle touch, vibration, and it a receptor reother nonnoxious st...

A short form of the McGill Pain Questionnaire (SF-MPQ) has been developed. The main component of the SF-MPQ consists of 15 descriptors (11 sensory; 4 affective) which are rated on an intensity scale as 0 = none, 1 = mild, 2 = moderate or 3 = severe. Three pain scores are derived from the sum of the intensity rank values of the words chosen for sensory, affective and total descriptors. The SF-MPQ also includes the Present Pain Intensity (PPI) index of the standard MPQ and a visual analogue scale (VAS). The SF-MPQ scores obtained from patients in post-surgical and obstetrical wards and physiotherapy and dental departments were compared to the scores obtained with the standard MPQ. The correlations were consistently high and significant. The SF-MPQ was also shown to be sufficiently sensitive to demonstrate differences due to treatment at statistical levels comparable to those obtained with the standard form. The SF-MPQ shows promise as a useful tool in situations in which the standard MPQ takes too long to administer, yet qualitative information is desired and the PPI and VAS are inadequate.

No abstract