Pain is a subjective experience. It is difficult to comprehend other people’s experience of pain without having a way to somehow compare pain levels. So, back in 1971, Ronald Melzack and Warren Torgerson published a paper showing a way they’d devised to do just that. It was the McGill Pain Questionnaire, (named after McGill University which they attended in Montreal in Quebec, Canada).
The McGill Pain Index that resulted from the questionnaire is not just a number on a scale. Each number, representing the pain level of an injury or condition, is compiled from lots of data which includes numerical scores as well as descriptive words which patients have used to answer various questions about their pain experience. The various components have been assessed for additional aspects such as consistency. This scientific scale has been rigorously tested over the years and has withstood all tests into reliability.
So it’s a really useful tool to get our heads around pain which we may not have experienced personally, and for putting our own pain into some kind of perspective for others.
There are several versions of the scale diagram visible on the internet which show the placement of various injuries and conditions on the scale of 0-50. But with the copyright issues online it is difficult to know which ones we can share.
So, with that in mind I started creating my own diagram from the scientific information which is readily available. There is an extra addition to my diagram, however, as I found one research paper which had used the McGill scale to assess pain levels for their participants with fibromyalgia, and I feel that this is important to include as it is another variable pain condition which many people are not really aware of. The research paper found the fibro’ patients’ pain levels to be at 29 and 30.
Here’s hoping that the diagram can help to reassure some friends, families, employers, teachers and so on that their CRPS and fibromyalgia contacts really are living with a genuinely high level of pain.
I will also upload my diagram as a photo’ on the Facebook page, and I’ll even create some different background colours that you can choose from. 🙂
Here’s my little diagramatic piece of techy(ish!) artwork…
Although I have a copyright banner on this blog to protect my words and thoughts, and some personal pic’s, please be assured that if this diagram will help you then feel free to share it as that’s what I created it for.
Much love and best wishes from me,
x
References used:
Subspeciality Management, Anaesthesia for Obstetrics, (for widely available information in usual McGill diagrams) http://web.squ.edu.om/med-Lib/MED_CD/E_CDs/anesthesia/site/content/v04/040302r00.HTM
Cork, R.C., Wood, P., Ming, N.,et al (2004) ‘The effect of cranial electrotherapy stimulation (CES) on pain associated with fibromyalgia’ in The Internet Journal of Anaesthesiology http://www.ispub.com/journal/the-internet-journal-of-anesthesiology/volume-8-number-2/the-effect-of-cranial-electrotherapy-stimulation-ces-on-pain-associated-with-fibromyalgia.html NB: I’m only including this reference for where I found the fibromyalgia McGill Indexed data, I am not commenting on electrotherapy in any way
Melzack, R. & Torgerson, W.S. (1971) ‘On the language of pain’ in Anesthsiology, Vol. 34, pp 50-59
Elle and the Auto Gnome 
Excellent and very helpful. Thank you.
If you want to share your work but protect your right to it, one good way to do that is by Creative Commons licensure. It’s old enough and well-tested enough that every creative geek I know thinks of it first.
This page describes the different kinds of licensure they provide:
http://creativecommons.org/licenses/
I use the share-alike, attribution licensure. This lets anyone, anywhere, quote from or borrow my work freely, as long as they say who it came from. My goal is info-dispersal. Also, I don’t expect to make money, so I’m not holding out for it. Therefore, this makes sense for me; provides greater visibility and improves my name recognition, but doesn’t give me headaches. Also, if I find a publisher who will accept non-virginal work, I can still sell it!
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This is really handy for explaining just how painful fibro can be. Thanks for putting in the hard work!
No problem, I’m just glad I can be helpful, 🙂 x
the pain index is so helpful, as trying to describe the pain of crps or fybro to others that have never known it is impossible…at least this kinda gives it a rating from 1-10 even if they don’t get it. I have always been surprised that the McGill Index does not have Ankylosing Spondilitis on it. AS is a extremely painful, crippling, life altering disease and I’m pretty sure that it ranks up there with or above crps on the pain scale.
Hi Gerri, I’ve done a quick search for you and found a few research papers which may potentially mention a McGill pain score for AS but unfortunately I do not have access to the journals at the moment so I’m behind the paywall again. I’ll ask my contacts if they can find out for me as the only score I can currently access is from a case study (the score was 24), and as it’s just a sample of one person it doesn’t help us at all. If I can find out I’ll let you know, x
Okay, I have some info’ now…
I’ve found two papers already which include the McGill Pain Scale for AS: overall 47 patients rated AS pain as 28-32.
I’ll write a new post and add in the score to the diagram for you, x
thank you
Thanks so much, that would be great. I do think you are right though about only a sampling of 1 person, 24 is definitely low. I guess it really depends on the day, time of day, what stage the disease is at, and/or if they are in a form of remission somewhat or not, are if they have managed to afford the few treatments that are out there..ex: enbrol etc.So many variables. I personally know two people with AS (Ankylosing Spondilitis) and the pain alone is crippling, never mind the physical ravages of the disease. Again though, it dos affect everyone a bit differently, both of these people have different episodes, or conditions at different times, all related to how the disease is progressing.
Absolutely, the larger the sample group the better the average pain score for the condition, but at the end of the day it’s still an average however reliable an average it is.
I’ll post the link here once I get the new blog post completed, x
Hi Gerri, after a few WordPress hiccups where my references kept not getting saved I now have the info’ posted with a new diagram including the ball-park AS result I found in some research. Here’s the link hon, x
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This is crap! I have rheumatoid and psoriatic arthritis and what an understatement this scale is and therefore can be disregard as a duplicitous and ficticious scale. I have arthritis in my facet joints and in my sacroiliac joints (spondyloathrpy) and the worst pain comes from my feet, toes, knees, hips, fingers, wrists and shoulders. I’ll give credit to spondyloathrpy locking up my back and hips at night causing me to wake screaming in pain but considering I have many days I can’t walk on my own or stand up or sit down without help or screaming I’m calling pure BS on this chart!
Crikey, hello Chrissy! It’s okay – this is not my placement of arthritis, it’s the official medical research placement on the scale which is available in many places online.
The only ones I’ve added (for two conditions, by request, and posted in later articles on this weblog) I have specified as ‘ballpark’ figures only. So everything you see here in this post is exactly what is readily available online as official ratings.
So… the figures on the scale for all of the conditions listed in this post are nothing to do with me, I am simply sharing what already officially exists for those who could find it helpful.
You can shoot the messenger if you like, but as I like to help my fellow pain patients whenever I can it’d be a bit counter productive if you did! 😉 x
And yes, I also thought it was strange that ‘arthritis’ is all lumped under one heading. As it’s the official rating it’s not something that I can change but it would be interesting to do some journal searches to see if we can gain some clearer info’ for fellow patients.
Wonderful chart. Thank you for sharing. Where would a kidney stone and rheumatoid arthritis fall on this scale?
I WOULD LIKE TO KNOW WHERE TRIGEMINAL NEURALGIA WOULD RANK ON THIS PAIN SCALE. MY FIBROMYALGIA IS ALMOST UNBEARABLE, BUT STILL PALES IN COMPARISON TO MY TRIGEMINAL NEURALGIA PAIN.
Nice but where are some of the common highly painfull illnesses like passing a kidney stone.
It depends what has been medically measured and is available to us members of the public I’m afraid. I’ve been asked a few times where certain conditions would show on the McGill scale (like the Fibro’ included above) and I’ve had to resort to trawling research papers to find a ballpark figure. So it’s not conditions which I’ve chosen, it’s dependent on which information is readily available online. The descriptions were very medical though so I wanted to translate the information into more accessible terminology. I’m hoping that this can be of help to some fellow patients and their families out there, x
where would cluster headache come on this taxonomy of pain?
It’s worth noting, for the sake of completeness, that “finger amputation” actually refers to traumatic amputation, that is, having a finger hacked or ripped off by accident (or torture.) It doesn’t refer to having one surgically removed, which wouldn’t be nearly as bad!
Very helpfull and just to read that someone totally understand my pain and day to day life,many thanks.x