Pain assessment in context: a state of the science review of the McGill pain questionnaire 40 years on

Abstract

The McGill pain questionnaire (MPQ) and its later derivative the short form-MPQ have been used widely both in experimental and clinical pain studies. They have been of considerable importance in stimulating research into the perception of pain and now, with the publication of its latest variant, the short form-MPQ-2, it is appropriate to appraise their utility in the light of subsequent research into the nature of pain and the purpose of pain assessment. Following a description of the content and development of the questionnaires, issues of validity, reliability, and utility are addressed, not only in terms of the individual pain descriptors and the scales, but also in terms of methods of quantification. In addition, other methods of pain depiction are considered. In the second part of the review, advances in pain measurement and methodology, in the elucidation of pain mechanisms and pathways, in the psychology of pain, and in the nature of pain behavior are presented and their implications for pain assessment in general and the MPQ family of measures in particular will be addressed. It is suggested that pain assessment needs to be cast in its social context. We need to understand the influences on pain expression using a socio-communication model of pain that recognizes the function of pain and the importance of both innate pain responses and the effects of social learning. The review concludes with recommendations for future use of the MPQ and identifies a number of research challenges which lie ahead.

The psycholinguistic and affective structure of words conveying pain

“…We use linguistic stimuli to convey our own experience of pain since early childhood [ 17 ]. From a medical viewpoint, assessing the sensory, affective, and cognitive impact of the pain experience to the sufferers still represents a challenge [ 18 , 19 ]. “Pain is defined and ultimately evaluated by subjective report.…”

“…Much can be inferred from objective measures of anatomy, physiology, and behavior, but verbal report remains the standard by which all other measures are compared” ([ 19 ], p.1309). In fact, medical doctors typically categorize the pain of sufferers primarily “translating” their pain reports into a finite set of descriptors that are thought to “capture and categorize facets of the pain experience as evidenced in the endorsement and ranking of pain descriptors” ([ 19 ], p. 1387). These descriptors are contained in pain questionnaires devised to assess different types of pain.…”

“…These descriptors are contained in pain questionnaires devised to assess different types of pain. For instance, in one of the sections of the McGill Pain Questionnaire (MPQ, [ 20 ]; for an overview see [ 18 , 19 ]), the pain sufferer is asked to indicate what his/her present pain feels like choosing among 78 descriptors (e.g., fearful , itching , hot-burning ). According to Melzack (1975), these pain descriptors reflect three distinct components of pain that be divided in “sensory descriptors” that convey the sensory qualities of pain (e.g., burning ), “affective descriptors” that convey the emotional components of pain (e.g., punishing ), and “evaluative descriptors” that provide a global evaluation of the pain experience (e.g., unbearable ).…”

Backs in the Future: A Journey Through the Spinal Landscape

“…PiP relies heavily on the cognitive-behavioral approach to pain management, although with an increasing emphasis on experiential learning and communication skills. However, while it is possible to declare some guiding principles and ways of doing business, context is all-important not only in the management of disability but in the assessment of pain [ 35 ] and its impact.…”

Both ipsilateral and contralateral localized vibratory stimulations modulated pain-related sensory thresholds on the foot in mice and humans

“…Although many scales for assessing clinical pain, such as the Visual Analog Scale,2 Faces Pain Scale,3 Verbal Numerical Rating Scale,4 Verbal Descriptor Scale,5 and McGill Pain Index,6,7 are available, none of them provide an objective measurement of pain. In contrast, several quantitative scales are used to assess pain in rodents, including the Von Frey filament test,8 tail flick test,9 and hot plate test 10.…”