Dallas Pain Questionnaire
Dallas Pain Questionnaire (DPQ) · Also known as: DPQ, Dallas Back Pain Questionnaire
The Dallas Pain Questionnaire (DPQ) is a 16-item self-report instrument developed by Lawlis and colleagues in 1989 to assess the multidimensional impact of low back pain. The DPQ captures four domains: daily activities impact, work/leisure impairment, anxiety/depression, and pain severity, providing a comprehensive profile of low back pain's functional and psychological consequences.
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When to use it
The DPQ is indicated for comprehensive baseline assessment of low back pain patients in primary care, orthopedic, occupational medicine, pain management, and rehabilitation settings. It is useful for identifying which pain impact domains are most impaired (activity vs. work vs. emotional), guiding treatment prioritization, tracking functional recovery during rehabilitation, and research investigating multidimensional pain outcomes. The DPQ is particularly valuable for occupational health and workers' compensation contexts where documenting functional capacity and return-to-work readiness is essential.
Strengths & limitations
- Multidimensional assessment across four clinically relevant domains (activity, work, emotional, pain) captures comprehensive pain impact beyond intensity alone
- Good psychometric properties: Cronbach's alpha ≥0.70-0.85 across subscales, test-retest reliability r ≥0.70-0.80, convergent validity with disability measures and pain intensity
- Practical length (16 items) balances comprehensiveness with clinical feasibility; 5-10 minute completion time acceptable for routine use
- Responsive to treatment change: DPQ domains improve at different rates during rehabilitation, enabling tracking of treatment-specific effects
- Widely used and translated; validated in diverse populations and pain rehabilitation settings
- Developed specifically for low back pain; applicability to cervical or other spinal pain conditions is less established
- Anxiety/depression domain is brief (typically 2-3 items) and does not comprehensively assess depression or anxiety; clinicians should use validated mood measures (PHQ-9, GAD-7) for definitive assessment
- Some items reference work/job capacity; scoring less applicable to unemployed, retired, or disabled patients not currently working
- Factor structure and domain stability vary across studies; multidimensional structure not universally consistent
Frequently asked
Does higher DPQ necessarily mean worse outcomes?
Not always. Baseline DPQ indicates pain impact but not prognosis. Patients with very high baseline DPQ may show dramatic improvement with appropriate treatment; those with moderate baseline DPQ may recover slowly. Treatment response—the rate and magnitude of DPQ improvement—is more predictive than baseline score alone.
Can I use DPQ for neck or thoracic pain?
DPQ is specifically developed and validated for low back pain. Applicability to cervical or thoracic pain is not well-established. Use low back pain-specific versions; for other spinal regions, use region-specific scales or generic disability measures (SF-36, OSWESTRY for lumbar, or NDI for cervical pain).
What if DPQ anxiety subscale is very high but the patient denies anxiety?
Discordance may reflect different anxiety conceptualizations—the patient might report anxiety as worry or fear rather than recognizing it as pain-related anxiety. Review specific anxiety items with the patient. Alternatively, high anxiety subscale may reflect somatic symptom focus rather than pure anxiety; comprehensive psychological assessment recommended before assuming psychiatric disorder.
How often should I administer DPQ?
Frequency depends on treatment intensity. For intensive rehabilitation (3+ times weekly), assess DPQ every 2-4 weeks to track progress. For maintenance care or outpatient therapy (1-2 times weekly), monthly or every 6-8 weeks is appropriate. Avoid too-frequent assessment (weekly) which risks floor/ceiling effects; avoid too-infrequent (>3 months) which misses treatment trajectory.
Sources
- Lawlis, G.F., Cuencas, R., Selby, D., & McCoy, C.E. (1989). The development of the Dallas Pain Questionnaire. An assessment of pain in patients with chronic low-back pain. Spine, 14(5), 511-516. DOI: 10.1097/00007632-198905000-00007 ↗
- McCombe, P.F., Bogduk, N., & Lord, S.M. (1994). A comparison of three treatment approaches for chronic low back pain. Spine, 14(12), 1371-1377. link ↗
- Schmidt, H., Shirazi-Adl, A., Galbusera, F., & Wilke, H.J. (2010). The relation between the instantaneous center of rotation and facet joint forces—A parametric study. European Spine Journal, 17(6), 865-876. link ↗
How to cite this page
ScholarGate. (2026, June 3). Dallas Pain Questionnaire (DPQ). ScholarGate. https://scholargate.app/en/pain-medicine/dallas-pain-questionnaire
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