Applicability of the McGill pain questionnaire to the differentiation of ‘toothache’ pain

The McGill Pain Questionnaire (MPQ) was administered to 102 ‘toothache’ patients to determine whether it was sufficiently sensitive to distinguish between dental patients whose pain was clinically diagnosed as originating from a reversibly inflamed tooth pulp (group I) and those whose pain was diagnosed as originating from an irreversibly inflamed or necrotic pulp (group II). Scores for Total Pain Rank Index (PRI(T)), Sensory Pain Rank Index (PRI(S)), Evaluative Pain Rank Index (PRI(E)), Miscellaneous Pain Rank Index (PRI(M)), and Number of Words Chosen (NWC) were significantly higher (P< 0.05) for group II patients. The PRI differences between both groups were attributed mainly to the more frequent selection by group II patients of 8 of the 20 subclasses of words and/or of words with higher rank values within the 8 subclasses. A significantly greater degree of sleep disturbance, nausea, headache, drowsiness and/or dizziness was also found in group II patients. Discriminant analysis using the 20 subclasses and 4 supplementary questions related to sleep disturbance, changes in food intake or activity levels, and accompanying symptoms, indicated that the MPQ, when used alone, correctly predicted diagnosis and treatment outcome in 73% of patients. Therefore, our findings indicate that the MPQ can distinguish between the two types of toothache and suggest that, especially when used along with other standard diagnostic tests, it may be a useful clinical adjunct in the diagnosis of dental pain.     

McGill疼痛问卷在三叉神经痛诊断和治疗中的应用

目的:通过采用McGill疼痛问卷(McGill pain questionnaire,MPQ)鉴别三叉神经痛,并观察射频热凝术的疗效,研究MPQ在面痛诊断上的重要性。方法:本研究共观察159例三叉神经痛患者,其中136例患有典型三叉神经痛(CTN),23例患有混合型三叉神经痛(MTN)。采用MPQ评估患者的疼痛,并观察其中124例术后患者疼痛的缓解情况。结果:CTN组的平均现有疼痛强度(PPI)值为4.20±0.34,MTN组的平均PPI值为3.50±0.57,明显低于CTN组(P0.001);与MTN患者相比,CTN患者在疼痛分级指数(PRI)-感觉项上报告了更高的强度(P0.001);两组间PRI-情感和PRI-评价项上有明显区别,CTN组的得分更高(P0.001);RFT术后CTN患者显示了高的立即疼痛缓解率,达到93.6%。MTN患者的结果没有CTN组的好,只有58.8%的患者疼痛明显缓解。结论:MPQ可以很好鉴别不同类型的三叉神经痛,鉴于射频热凝治疗两种三叉神经痛疗效的差异,使用MPQ在面痛诊断中有重要意义。     

Endurance training of the trunk extensor muscles in people with subacute low back pain.

BACKGROUND AND PURPOSE: Clinicians treating patients with low back pain often use exercise to reduce pain and improve function. The aim of this study was to evaluate the effectiveness of trunk extensor endurance training in reducing pain and decreasing disability in subjects with subacute low back pain (ie, onset of back pain within 7 days to 7 weeks). SUBJECTS AND METHODS: Patients were randomly assigned to either an experimental group or a control group. A visual analog scale and the pain rating index (PRI) of the McGill Pain Questionnaire (MPQ) were used to obtain baseline measurements of pain. The Roland Morris Disability Questionnaire (RMDQ) was used to measure disability, and the Sorensen Test was used to measure trunk extensor endurance. Subjects in the experimental group attended exercise sessions 3 times a week for 6 weeks. Subjects in the control group did not do exercises. Both groups were given back care advice and hot packs for 15 minutes, 3 to 5 times per week. Reassessments were carried out at 3 and 6 weeks. RESULTS: There were differences between the 2 groups at 3 weeks in regard to pain intensity during the evaluation session and pain experienced over the preceding 24 hours, the total MPQ PRI, the sensory component of the MPQ PRI, and the RMDQ. At 6 weeks, no differences were found for pain measurements, disability scores, and holding time on the Sorensen Test. CONCLUSION AND DISCUSSION: Trunk extensor endurance training reduced pain and improved function at 3 weeks but resulted in no improvement at 6 weeks when compared with the control group. Endurance exercise is considered to expedite the recovery process for patients with an acute episode of low back pain.     

Sensitivity of the McGill pain questionnaire to intensity and quality of laboratory pain

Subjects completed a modified McGill Pain Questionnaire (MPQ) to describe one of two laboratory stressors (cold pressor or electrical tooth pulp stimulation) at one of two subjective intensities (pain threshold or pain tolerance). Differences in MPQ-derived scores were associated with both type of stressor and intensity level, as were patterns of frequently chosen word groups and specific words. These data support the validity of interpretations drawn from MPQ differences in clinical practice and research. In addition, the fact that the MPQ can be used in both clinical and laboratory settings suggests one way in which relevant dimensions of similarity and difference among “types” of pain may be clarified in later research.     

McGill Pain Questionnaire Scores Do Not Predict Outcomes of Outpatient Therapy for Patients with Low-Back Pain

Abstract

The purpose of this study was to determine the value of the McGill Pain Questionnaire (MPQ) as a predictor of two outcomes in patients receiving outpatient physical therapy services. The outcomes of interest were the patients' final Oswestry Low-Back Pain Questionnaire (OLBPQ) score and the change between the patients' initial and final OLBPQ scores. Predictive validity of the MPQ was examined in the context of other potentially informative variables. Data from 23 patients with low-back pain were analyzed. Data obtained at enrollment included initial MPQ and OLBPQ scores, demographics, compensation status, time since onset, injury type, employment type, and worker class. MPQ scores predicted neither outcome. Initial OLBPQ scores and compensation status, however, predicted outcomes. Together these variables explained 59.1 percent of the variance in the final OLBPQ score and 46.3 percent of the variance in the change (improvement) in the OLBPQ score. Results of this study do not support use of the MPQ as a predictor of functional outcome in outpatients with low-back pain.