what is it and how does it apply for chronic pain patients?
Pain is difficult to explain. Everyone has experienced that at some level. At the ER, the Medical Staff would ask you a very basic exercise to label your own pain: “From a scale to 1 to 10, who bad does it hurt?” Unfortunately, some type of diseases or conditions have pain as their core symptom, and a mere 1-10 scale is not enough to describe it. This is what brought two Canadian medical researchers to create what we now call “The McGill Pain Scale”.
Back in 1971, Dr Melzack and Dr. Torgerson started an experiment by involving different patients in their University Hospital, that eventually brought to a Questionnaire (MPQ) published in 1975. As Dr Melzack put it, “The quality of pain provides a key to diagnosis and may even suggest a course of therapy.” Following this motto, they drafted up a list of questions to help them classify the type of pain, and, as a consequence, the type of disease the patient was suffering from. Hence, they added a new step to the way Doctors all over the world would diagnose painful conditions such as Fibromyalgia [link to article] or CRPS.
The MPQ is divided into 3 areas. By answering the several questions of each area, the patient can describe their pain in a more detailed way: they would be asked to choose among some adjectives or definitions about how the pain feels in the present moment (sensory area), how it changes over time and how external factors would affect it (affective area), and how strong the pain feels (evaluative area). Once the questionnaire is completed, the doctor will be able to calculate the final score from a minimum of 0 (no pain at all) to a maximum of 50 (or 78 using the longer version of the MPQ).
Thanks to the McGill research, it has been made possible to define a range of different types of pain: all patients diagnosed with the same condition did answer the MPQ using very similar adjective and pain level scores. Dr Melzack and Dr. Torgerson could then draw an average Index, the “McGill Pain Index”, where they labeled the level of the most common painful conditions from a 13 level for a sprain, to average toothache (scoring at level 20), up to childbirth (34-36) and the amputation of a finger or toe (40).
Among the patient who participated to the original research were also patients who suffered from causalgia – another name for the disease now known as Complex Regional Pain Syndrome [link to article] – scoring it almost at the top of the Index with a 48 pain level, thus differentiating it from Fibromyalgia, which scores at 30 of the McGill Index.
As a consequence, chronic pain sufferers already have an instrument to their diagnosis, along with seeing their improvements in their condition after going through the Italian Protocol [link to neridronate + pt crps program] MTI offers to CRPS patients – as well as Fibromyalgia ones [link to fibro treatment – NB: in fase di stesura] – by retaking the MPQ monthly.