How to Measure Pain



Use the McGill Pain Questionnaire (MPQ).,
Fill out the Brief Pain Inventory (BPI) questionnaire.,
Use the Oswestry Disability Index (ODI) questionnaire for low back pain.,
Consider the Treatment Outcomes of Pain Survey (TOPS) instead.,
Measure pain with the visual analog scale (VAS).,
Use the numerical rating scale (NRS) instead.,
Use the Patient Global Impression of Change (PGIC) to gauge pain progress.,
Try the Wong-Baker FACES pain rating scale.,
Use a dolorimeter to test your pain threshold or tolerance.,
Get a functional MRI brain scan to objectify your pain.,
Use facial analysis to determine pain.

The MPQ (also called the McGill pain index), is a scale of rating pain developed at McGill University in Canada in 1971.It’s a written questionnaire that allows people in pain to give their doctors a good idea of the quality and intensity of pain they’re feeling / experiencing. Patients basically choose descriptive words from different categories that best describes their pain.

The MPQ is a well-validated measure of pain with extensive clinical research backing up it’s relative accuracy.
People can rate their pain in sensory terms (sharp or stabbing, for examples) and choose affective terms (sickening or fearful, for examples), so a doctor or therapist can review 15 total selected descriptors.Each selected descriptor is rated on a 4-point scale that ranges from none to severe, so the type and intensity of the pain can be better understood by health professionals.;
, The BPI is a questionnaire used to measure pain developed by the Pain Research Group of the WHO Collaborating Center for Symptom Evaluation in Cancer Care. The BPI comes in 2 formats: the short form, which is used for clinical trials; and the long form, which contains additional descriptive items that may be useful to a doctor in a clinical setting.The main purpose of the BPI questionnaire is to assess the severity of a person’s pain and the impact it has on their daily functions.

The BPI questionnaire is best for people with pain from chronic diseases, such as cancer, osteoarthritis or low back pain.
The BPI can also be used to assess acute pain, such as postoperative pain or pain from accidents and sports injuries.
The main areas of assessment for the BPI include: location of pain, severity of pain, impact of pain on daily activities and response of pain levels to medication.

, The ODI is a numbered index derived from the Oswestry Low Back Pain questionnaire developed in 1980 and used by health care professionals and researchers to quantify disability caused by low back pain.The questionnaire contains 10 topics concerning pain intensity, sexual function, social life, sleep quality and the abilities to lift, sit, walk, stand, travel and care for yourself.

The ODI is a 100-point scale derived from the questionnaire and considered the “gold standard” for measuring disability and estimating quality of life in people with lumbar spinal pain.
The severity scores from the questions (ranging from 0-5) are added up and multiplied by two to obtain the index, which ranges from 0-100. Zero is considered no disability, whereas 100 is the maximum disability possible.
ODI scores between 0-20 indicate minimal disability, whereas scores between 81-100 indicate either extreme disability (bed-bound) or exaggeration.
The questionnaire is more accurate for people with acute (sudden) low back pain than it is for those with chronic (long term) back pain.

, The TOPS is the longest and most comprehensive survey for patients with chronic pain.The survey is designed to measure quality of life and function for a variety of causes of pain. The TOPS actually contains items from the BPI and ODI questionnaires, as well as questions on coping styles, fear avoidance beliefs, potential substance abuse, satisfaction levels of treatment and demographic variables.

The full TOPS contains 120 items and is about as thorough of a questionnaire that measures pain that you’ll come across.
TOPS gives quantitative information on pain symptoms, functional limitations, perceived disability, objective disability, treatment satisfaction, fear avoidance, passive coping, solicitous responses, work limitations and life control.Because of the time it takes to fill out the TOPS, it may not be appropriate for people in severe pain.

, Unlike the multidimensional scales of pain determined by questionnaires, the VAS is considered a unidimensional measurement of pain because it just represents the pain’s intensity, or in other words, how much it hurts.When using a VAS tool, people specify their level of pain by indicating a spot along a continuous line between two end-points. Usually a VAS tool looks like a slide ruler that’s not numbered on the side the patient uses. It’s appropriate to use for pain caused by all conditions.

On the back of most VAS instruments (where the patients can’t see), there’s a numbered scale typically from 1-10 where the doctor or therapist can make note of in their charts.
The VAS is the quickest and probably the most sensitive single-item measure for pain levels, although it doesn’t indicate the type, duration or location of pain.
Many questionnaires use a VAS drawing to determine the perceived intensity of a person’s pain.

, In a busy health clinic, time is often precious, so another quick and easy tool to use to measure pain is called the numerical rating scale. The NRS is similar to a VAS, except the scale is numbered, sometimes from 0-10 or occasionally 0-100, which is a little more specific.Zero represents no pain, whereas the highest number on the scale represents the worst pain imaginable.

The NRS can look like a slide-rule tool or it can be a printed scale on a piece of paper. The person with pain chooses the number that best represents their pain level.
Like all visual or numbered scales, the NRS measurement is subjective and based on the person’s perceptions.
The NRS is useful for health care practitioners who want to gauge their patient’s response to treatment by measuring pain levels at specific time intervals (like every week, for example). The NRS is also used in the hospital for acute pain, and to gauge a patient’s response to a specific intervention, such as administration of pain medication.
Unlike the VAS, the NRS has the advantage of being administered verbally, so the patient doesn’t have to move, read or write anything.

, The PGIC scale is helpful for describing your improvement (in terms of pain) over time or as a result of some sort of therapy.The PGIC asks you to rate your current status based on 7 choices: very much improved, much improved, minimally improved, no change, minimally worse, much worse, or very much worse. The PGIC is helpful for practitioners to understand how their patients are responding to treatment.

The PGIC can be used for a wide variety of conditions and treatments, but it lacks more descriptive language to describe pain.
The PGIC is often used in conjunction with other scales or questionnaires because it provides information on changing pain levels over time, but lacks pain intensity and pain quality measurements.

, The Wong-Baker scale is especially useful for children and adults who might have trouble rating pain with other scales. The Wong-Baker scale uses a series of six faces to help patients identify what level of pain they feel. The scale gives patients options ranging from “no pain” to “the worst pain.”The first face is smiling and a patient might point to that face to indicate that she is having no pain at all, while the last face is frowning and crying and a patient might point to that face to indicate that she is in severe pain.

, Dolorimetry is the measurement of pain sensitivity or pain intensity by instruments that can apply heat, pressure or electrical stimulation to some part of your body. The concept was developed in 1940 in order to test how well pain medication worked, although the devices used to cause pain and have advanced quite a bit over the decades.Lasers and various electrical devices are now used to test your tolerance to pain — but not measure pre-existing pain from some disease or injury.
Dolorimeters are calibrated to determine how much stimulation (from heat, pressure or electrical impulses) you can take before you describe it as painful. For example, most people express painful sensations when their skin is heated to 113 °F.
In general, women have higher pain thresholds than men, although men have greater abilities to work through high levels of pain.

, New technology and breakthroughs are allowing doctors and researchers to evaluate pain levels from fMRI brain scans, which might eventually replace the dependency on self-reporting (via questionnaires and visual scales) to measure the presence or absence of pain.The new tool (an fMRI given in real time) documents patterns of brain activity to give an objective assessment of whether someone is in pain or not.

Using functional MRI scans of the brain and advanced computer algorithms, researchers claim that they can detect pain 81% of the time in patients.
Because the sensation of pain causes certain identifiable brain patterns, this new MRI tool can substantiate a person’s pain and also expose someone who may be faking it.
Although the technology can detect pain within people, it cannot yet determine the extent (intensity) of the pain.

, We all know the common facial expressions that signify a person is in pain, such as wincing, grimacing and frowning. The problem is that facial expressions are easy to fake, or sometimes they are misinterpreted due to cultural reasons. However, advanced facial recognition software allows doctors and researchers to determine if a person is truly in pain and, to a lesser extent, the degree of pain they feel.Patients are typically videoed while being physically examined or doing an activity that’s meant to elicit pain, such as bending over of a person claims they have low back pain.
The facial recognition software analyses various points on the face for typical painful expressions and correlates the timing to an activity or exam — such as a practitioner putting pressure on a reportedly painful body part.
Facial recognition software if expensive and not meant for people to describe or measure their own pain, but rather for doctors / practitioners to prove or disprove the presence of pain.

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