Measuring troublesomeness of chronic pain by location
Open accessAbstract
BACKGROUND: Current measures of pain assess the relative contribution of pain in different body regions to the overall impact of pain. We developed a series of questions to measure the relative 'troublesomeness' of pain in different body regions (the "troublesomeness grid"). The study aimed to determine whether the "troublesomeness grid" is an appropriate measure to assess the severity of pain in different body regions, allowing the comparative severity of pain in different body regions to be assessed. METHODS: We used data from a pilot for a population survey of pain (N = 205) and from the population survey itself (N = 2504) to assess the 'troublesomeness grid's performance. Specifically, its face and content validity using overall and item non-completion rates; its criterion related validity by exploring the relationship between troublesomeness and standard measures of pain, disability, distress and health utility for the five body regions most commonly affected by chronic pain; and its reliability and reproducibility in a test/re-test study. RESULTS: The troublesomeness grid appeared to have good face validity as it had good completion rates. It also appeared to have good content validity as the percentage agreement between the grid and the pain manikin was high (over 90%). In terms of criterion related validity, troublesomeness was most strongly correlated with pain intensity and health related quality of life, but less with disability and distress. The test-retest reliability was between 80% and 90% for the majority of body regions examined. CONCLUSION: The troublesomeness grid is well completed and appears to be an appropriate tool to assess the comparative severity of pain in different body regions.
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The authors will collect bodily pain data using a previously validated Troublesomeness Grid.
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Cites
(1988) · NFER-Nelson eBooks · Cited by 5,560 · see citing works
High agreement but low Kappa: I. the problems of two paradoxes
Feinstein, A. R., & Cicchetti, D. V. (1990) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(90)90158-l · Cited by 3,034 · see citing works
Grading the severity of chronic pain
Von Korff, M., Ormel, J., Keefe, F. J., & Dworkin, S. F. (1992) · Pain · doi:10.1016/0304-3959(92)90154-4 · Cited by 3,022 · see citing works
The Roland–Morris Disability Questionnaire and the Oswestry Disability Questionnaire
Roland, M. O., & Fairbank, J. C. T. (2000) · Spine · doi:10.1097/00007632-200012150-00006 · Cited by 1,913 · see citing works
Psychological Testing: Principles, Applications, and Issues
Kaplan, R. M. (1982) · Cited by 1,799 · see citing works
Zinkus, P. W. (1987) · Springer eBooks · doi:10.1007/978-1-4613-1797-5_8 · Cited by 1,519 · see citing works
Outcome Measures for Low Back Pain Research: A Proposal for Standardized Use
Deyo, R. A., Battie, M., Beurskens, A. J. H. M., Bombardier, C., Croft, P., Koes, B., Malmivaara, A., Roland, M., Von Korff, M., & Waddell, G. (1998) · Spine · doi:10.1097/00007632-199809150-00018 · Cited by 1,229 · see citing works
Psychological Testing: Principles and Applications
Murphy, K. R., & Davidshofer, C. O. (1988) · Cited by 1,174 · see citing works
Assessing health-related quality of life in patients with sciatica
Patrick, D. L., Deyo, R. A., Atlas, S. J., Singer, D. E., Chapin, A., & Keller, R. B. (1995) · Spine · doi:10.1097/00007632-199509000-00011 · Cited by 760 · see citing works
Coping or acceptance? What to do about chronic pain
McCracken, L. M., & Eccleston, C. (2003) · Pain · doi:10.1016/s0304-3959(03)00202-1 · Cited by 591 · see citing works
UK BEAM Trial Team (2004) · BMJ · doi:10.1136/bmj.38282.669225.ae · Cited by 517 · see citing works
The Chronic Pain Grade questionnaire: validation and reliability in postal research
Smith, B. H., Penny, K. I., Purves, A. M., Munro, C., Wilson, B. J., Grimshaw, J., Chambers, A. W., & Smith, C. W. (1997) · Pain · doi:10.1016/s0304-3959(97)03347-2 · Cited by 433 · see citing works
Dunn, K. M., & Croft, P. R. (2005) · Spine · doi:10.1097/01.brs.0000173900.46863.02 · Cited by 204 · see citing works
Development of a symptom based outcome measure for asthma
Steen, N., Hutchinson, A., McColl, E., Eccles, M. P., Hewison, J., Meadows, K., Blades, S., & Fowler, P. (1994) · BMJ · doi:10.1136/bmj.309.6961.1065 · Cited by 89 · see citing works
Studies of the Modified Somatic Perceptions Questionnaire (MSPQ) in Patients with Back Pain
Deyo, R. A., Walsh, N. E., Schoenfeld, L. S., & Ramamurthy, S. (1989) · Spine · doi:10.1097/00007632-198905000-00006 · Cited by 53 · see citing works
International association for the study of pain
&NA;, &. (1986) · Pain · doi:10.1016/0304-3959(86)90069-2 · Cited by 35 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Bolton JE Fish RG Responsiveness of the Revised Oswestry Disability Questionnaire European Journal of Chiropractic 1997 45 9 14
Cited by
Sorted by citations
Parsons, S., Breen, A. C., Foster, N. E., Letley, L. H., Pincus, T., Vogel, S. K., & Underwood, M. R. (2007) · Family Practice · doi:10.1093/fampra/cmm027 · Cited by 165 · see citing works
Exercises to improve function of the rheumatoid hand (SARAH): a randomised controlled trial
Lamb, S. E., Williamson, E. M., Heine, P., Adams, J., Dosanjh, S., Dritsaki, M., Glover, M. J., Lord, J. L., McConkey, C. C., Nichols, V. P., et al. (2014) · The Lancet · doi:10.1016/s0140-6736(14)60998-3 · Cited by 160 · see citing works
Deere, K. C., Clinch, J., Holliday, K., McBeth, J., Crawley, E. M., Sayers, A., Palmer, S., Doerner, R., Clark, E. M., & Tobias, J. H. (2012) · Pain · doi:10.1016/j.pain.2012.06.006 · Cited by 136 · see citing works
Underwood, M. R., Ashby, D., Cross, P. L., Hennessy, E., Letley, L. H., Martin, J., Mt‐Isa, S., Parsons, S., Vickers, M. R., & Whyte, K. (2007) · BMJ · doi:10.1136/bmj.39399.656331.25 · Cited by 114 · see citing works
Williams, M. A., Williamson, E. M., Heine, P., Nichols, V. P., Glover, M. J., Dritsaki, M., Adams, J., Dosanjh, S., Underwood, M. R., Rahman, A., et al. (2015) · Health Technology Assessment · doi:10.3310/hta19190 · Cited by 84 · see citing works
Harrison, L., Wilson, S. J., & Munafo, M. R. (2014) · Pain Research and Management · doi:10.1155/2014/615203 · Cited by 80 · see citing works
Dritsaki, M., Petrou, S., Williams, M. A., & Lamb, S. E. (2017) · Health and Quality of Life Outcomes · doi:10.1186/s12955-016-0584-6 · Cited by 65 · see citing works
Topical or oral ibuprofen for chronic knee pain in older people. The TOIB study
Underwood, M. R., Ashby, D., Carnes, D., Castelnuovo, E., Cross, P. L., Harding, G., Hennessy, E., Letley, L. H., Martin, J., Mt‐Isa, S., et al. (2008) · Health Technology Assessment · doi:10.3310/hta12220 · Cited by 60 · see citing works
Makino, S., Jensen, M. P., 有村, 達., 小幡, 哲., Anno, K., Iwaki, R., Kubo, C., Sudo, N., & Hosoi, M. (2012) · Clinical Journal of Pain · doi:10.1097/ajp.0b013e3182579c63 · Cited by 43 · see citing works
Rusu, A. C., Pincus, T., & Morley, S. (2012) · Pain · doi:10.1016/j.pain.2012.05.034 · Cited by 34 · see citing works
Williamson, E. M., McConkey, C. C., Heine, P., Dosanjh, S., Williams, M. A., & Lamb, S. E. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-013121 · Cited by 33 · see citing works
Australian chiropractic sports medicine: half way there or living on a prayer?
Pollard, H. P., Hoskins, W. T., McHardy, A., Bonello, R., Garbutt, P., Swain, M., Dragasevic, G., Pribicevic, M., & Vitiello, A. L. (2007) · Chiropractic & Manual Therapies · doi:10.1186/1746-1340-15-14 · Cited by 29 · see citing works
Supportive Self-Management Program for People With Chronic Headaches and Migraine
Underwood, M. R., Achana, F. A., Carnes, D., Eldridge, S. M., Ellard, D. R., Griffiths, F. E., Haywood, K. L., Hee, S. W., Higgins, H. B., Mistry, D., et al. (2022) · Neurology · doi:10.1212/wnl.0000000000201518 · Cited by 29 · see citing works
Patel, S., Achana, F., Carnes, D., Eldridge, S., Ellard, D. R., Griffiths, F., Haywood, K., Hee, S. W., Mistry, D., Mistry, H., et al. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-033520 · Cited by 24 · see citing works
“42 At baseline we also collect data on age, gender, ethnic group, age at leaving full-time education and current work status.”
Pain-related and Psychological Symptoms in Adolescents With Musculoskeletal and Sleep Problems
Harrison, L., Wilson, S. J., & Munafo, M. R. (2015) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000000252 · Cited by 26 · see citing works
Williamson, E. M., Ward, L., Vadher, K., Dutton, S., Parker, B., Petrou, S., Hutchinson, C. E., Gagen, R., Arden, N., Barker, K. L., et al. (2018) · BMJ Open · doi:10.1136/bmjopen-2018-022205 · Cited by 25 · see citing works
Langworthy, J. M., & Breen, A. C. (2007) · Chiropractic & Manual Therapies · doi:10.1186/1746-1340-15-5 · Cited by 24 · see citing works
Underwood, M., Mistry, D., Lall, R., & Lamb, S. (2011) · Arthritis Care & Research · doi:10.1002/acr.20518 · Cited by 23 · see citing works
Self-citationWilliamson, E. M., Sanchez-Santos, M. T., Morris, A., Garrett, A., Conway, O., Boniface, G., Fairbank, J. C. T., & Lamb, S. E. (2020) · Spine · doi:10.1097/brs.0000000000003719 · Cited by 23 · see citing works
Chronic Fatigue Syndrome and Chronic Widespread Pain in Adolescence: Population Birth Cohort Study
Norris, T., Deere, K. C., Tobias, J. H., & Crawley, E. M. (2016) · Journal of Pain · doi:10.1016/j.jpain.2016.10.016 · Cited by 22 · see citing works
the Back Skills Training Trial (BeST) Team, Lamb, S. E., Lall, R., Hansen, Z., Withers, E. J., Griffiths, F. E., Szczepura, A. K., Barlow, J. H., & Underwood, M. R. (2007) · BMC Musculoskeletal Disorders · doi:10.1186/1471-2474-8-14 · Cited by 21 · see citing works
Sarah Trial Team, Adams, J., Bridle, C., Dosanjh, S., Heine, P., Lamb, S. E., Lord, J. L., McConkey, C. C., Nichols, V. P., Toyé, F., et al. (2012) · BMC Musculoskeletal Disorders · doi:10.1186/1471-2474-13-230 · Cited by 17 · see citing works
Ellard, D. R., Underwood, M. R., Achana, F. A., Antrobus, J. H. L., Balasubramanian, S., Brown, S., Cairns, M. C., Griffin, J. M., Griffiths, F. E., Haywood, K. L., et al. (2017) · Health Technology Assessment · doi:10.3310/hta21300 · Cited by 16 · see citing works
Moßhammer, D., Lorenz, G., Meznaric, S., Schwarz, J., Muche, R., & Mörike, K. (2009) · Family Practice · doi:10.1093/fampra/cmp006 · Cited by 16 · see citing works
Patterns of chronic pain in the population
Carnes, D. (2011) · International journal of osteopathic medicine · doi:10.1016/j.ijosm.2011.07.004 · Cited by 14 · see citing works
Chronic pain patients' perceptions of their future: a verbal fluency task
Rusu, A. C., & Pincus, T. (2016) · Pain · doi:10.1097/j.pain.0000000000000740 · Cited by 14 · see citing works
Typology of Chronic Pain Among Overweight Mexican Americans
Zettel‐Watson, L., Rutledge, D. N., Aquino, J. K., Cantero, P. J., Espinoza, A., Leal, F., & Jones, C. J. (2011) · Journal of Health Care for the Poor and Underserved · doi:10.1353/hpu.2011.0092 · Cited by 12 · see citing works
Underwood, M. R., Achana, F. A., Carnes, D., Eldridge, S. M., Ellard, D. R., Griffiths, F. E., Haywood, K. L., Hee, S. W., Higgins, H. B., Mistry, D., et al. (2023) · Programme Grants for Applied Research · doi:10.3310/pljl1440 · Cited by 10 · see citing works
Hee, S. W., Dritsaki, M., Willis, A., Underwood, M. R., & Patel, S. (2016) · European Journal of Pain · doi:10.1002/ejp.984 · Cited by 8 · see citing works
Group exercise and self-management for older adults with osteoarthritis: a feasibility study
Patel, S., Heine, P., Ellard, D. R., & Underwood, M. R. (2015) · Primary Health Care Research & Development · doi:10.1017/s1463423615000389 · Cited by 8 · see citing works
Iannazzo, S., Santoni, L., Saleri, C., Puma, E., Vestri, G., Giuliani, L., Canonico, P. L., & Centonze, D. (2016) · Farmeconomia Health economics and therapeutic pathways · doi:10.7175/fe.v17i2s.1230 · Cited by 7 · see citing works
Sandhu, H. K., Ellard, D. R., Achana, F. A., Antrobus, J. H. L., Balasubramanian, S., Brown, S., Cairns, M. C., Griffiths, F. E., Haywood, K. L., Hutchinson, C. E., et al. (2015) · Trials · doi:10.1186/s13063-015-1117-z · Cited by 7 · see citing works
(2011) · Clinical Governance An International Journal · doi:10.1108/cgij.2011.24816aaf.002 · Cited by 5 · see citing works
Williamson, E. M., Sanchez-Santos, M. T., Fairbank, J. C. T., Wood, L., & Lamb, S. E. (2024) · BMC Geriatrics · doi:10.1186/s12877-024-05504-1 · Cited by 3 · see citing works
Williamson, E. M., Sanchez-Santos, M. T., Marian, I. R., Maredza, M., Srikesavan, C. S., Garrett, A., Morris, A., Boniface, G., Dutton, S., Griffiths, F. E., et al. (2023) · Programme Grants for Applied Research · doi:10.3310/lkwx3424 · Cited by 3 · see citing works
The Convergent Validity of Pain Drawings and Anatomic Checklists in Individuals With Chronic Pain
Fung, J., Evans, D. W., Falla, D., & Barbero, M. (2025) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000001290 · Cited by 2 · see citing works
Carnes, D., Ashby, D., Parsons, S., & Underwood, M. R. (2008) · Family Practice · doi:10.1093/fampra/cmn027 · Cited by 2 · see citing works
Centonze, D., Iannazzo, S., Santoni, L., Saleri, C., Puma, E., Giuliani, L., & Canonico, P. L. (2017) · Multiple Sclerosis and Demyelinating Disorders · doi:10.1186/s40893-017-0030-6 · Cited by 2 · see citing works
Rusu, A. C., & Hallner, D. (2018) · Scandinavian Journal of Pain · doi:10.1515/sjpain-2018-0059 · Cited by 2 · see citing works
Marian, I. R., Williamson, E. M., Garrett, A., Lamb, S. E., & Dutton, S. (2020) · Trials · doi:10.1186/s13063-020-04590-x · Cited by 2 · see citing works
Dima, A.-L. (2010) · ERA · Cited by 2 · see citing works
Houweling, T. A. W. (2013) · OpenGrey (Institut de l'Information Scientifique et Technique) · Cited by 1 · see citing works
Okyay, L. (2010) · Unitec Research Bank (Unitec Institute of Technology) · Cited by 1 · see citing works
Tests mit mehr als 2 Merkmalsausprägungen: Überprüfung der Objektivität
Mangold, S. (2011) · Springer eBooks · doi:10.1007/978-3-642-17202-1_15
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O’Brien, C. (2010) · Unitec Research Bank (Unitec Institute of Technology)
Ferguson, W. (2016) · Unitec Research Bank (Unitec Institute of Technology)
Tests mit mehr als 2 Merkmalsausprägungen: Überprüfung der Validität
Mangold, S. (2011) · Springer eBooks · doi:10.1007/978-3-642-17202-1_16
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Mangold, S. (2013) · Springer eBooks · doi:10.1007/978-3-642-40636-2_16
- Authors
- Parsons, S., Carnes, D., Pincus, T., Foster, N., Breen, A., Vogel, S., & Underwood, M.
- Affiliations
- Queen Mary University of London (GB)
- University of London (GB)
- Keele University (GB)
- Health Sciences University (GB)
- University College of Osteopathy (GB)
- Corresponding author
- Parsons, Suzanne
- ORCID
- Venue
- BMC Musculoskeletal Disorders
- Published
- 2006-04-05
- Volume
- 7
- Issue
- 1
- Pages
- 34-34
- ISSN
- 1471-2474 (ISSN-L)
- PMC
- PMC1459155
- OpenAlex
- W1776840375
- Cited by
- 48
- References
- 17
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 1 · 2020: 3 · 2018: 2 · 2017: 4 · 2016: 5 · 2015: 4 · 2014: 2 · 2013: 2 · 2012: 4
- FWCI
- 1.67
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Musculoskeletal Disorders (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
- Bournemouth University Research Online (Bournemouth University) (submittedVersion)
- Keele Research Repository (Keele University) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Royal Holloway Digital Repository (Royal Holloway University of London) (submittedVersion, cc-by)
- Royal Holloway Digital Repository (Royal Holloway University of London) (submittedVersion)
- Funders
- National Institute for Health and Care Research (PC6/CSA04/03)
- Medical Research Council
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Keywords
- chronic pain, pain localization, face validity, content validity, criterion validity, test-retest reliability, health-related quality of life, pain intensity, disability, distress
- MeSH terms
- Chronic Disease, Cross-Sectional Studies, Follow-Up Studies, Health Surveys, Humans, Musculoskeletal Diseases, Pain, Pain Measurement, Pilot Projects
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