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The Pelvic Pain Impact Questionnaire (PPIQ)

A 10-item tool for women to assess the impact of their pelvic pain on daily life and function.

Provided by EVAL Foundation
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Instructions
  • Answer each question based on your experience over the past month..
  • The last two questions (9 & 10) are optional.
  • A total score will be calculated from the first 8 questions to show the overall impact of your pain.
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Purpose

Developed by Dr. Kristy Chalmers and colleagues (2017), the Pelvic Pain Impact Questionnaire (PPIQ) is a brief, validated self-report tool designed to measure the broad impact of pelvic pain on a woman's life. Developed to be simple and quick to complete, it helps both patients and clinicians understand how pelvic pain affects daily function, activities, relationships, and emotional well-being, moving beyond a simple pain intensity score.

 

Development and Validation

The PPIQ was developed through rigorous research involving interviews with women experiencing pelvic pain and expert clinicians. The final 8-item scored questionnaire was validated and demonstrated excellent psychometric properties. According to the primary research, it has high internal consistency (Cronbach α = 0.91) and good test-retest reliability (intraclass correlation coefficient = 0.88). The questionnaire exhibits a unidimensional factor structure, meaning it consistently measures a single underlying construct: the life impact of pelvic pain. Its validity is further supported by strong correlations with other established measures for pain, disability, catastrophizing, anxiety, and depression.

 

Scoring and Interpretation

The questionnaire consists of 10 items. The first 8 items are scored on a 5-point Likert scale, from 0 ('Not at all') to 4 ('A great deal'). The total score is calculated by summing the responses to these 8 items, resulting in a score between 0 and 32. A higher score signifies a greater negative impact of pelvic pain on the individual's life. The final two questions are optional and not part of the score.

 

Result Interpretation

To get your result, you sum the points from items 1 through 8.

  • Range: 0 to 32
  • Higher Score = Higher Impact: A score of 0 means the pain has no impact on these life domains, while a 32 represents the maximum possible disruption to daily life.
  • Clinical Significance: While there is no "pass/fail" mark, clinicians look for scores above 15–20 as an indicator that the pain is significantly interfering with the patient's quality of life and may require a multidisciplinary approach (e.g., physical therapy, counseling, and medical management).

 

Clinical Application

In a clinical setting, the PPIQ is a valuable tool for initial assessment and for tracking the effectiveness of treatment over time. It provides a comprehensive snapshot of the patient's experience, facilitating better communication and helping to tailor a multi-faceted, biopsychosocial treatment approach.

 

Why the Results Matter

Clinicians use the PPIQ results in three specific ways:

  • Prioritizing Treatment: If you score a "4" (A great deal) on Sitting but a "1" on Sleep, your therapist will focus immediately on nerve-gliding and seating adjustments rather than sleep hygiene.
  • Tracking Progress: Because it is a "Rasch-validated" scale, it is very sensitive to change. If your score drops from 25 to 12 over three months of treatment, it is a scientifically valid sign that the treatment is working, even if your pain level (NRS) hasn't changed much yet.
  • Opening Difficult Conversations: By making the "Intimacy" and "Tampon" questions optional and supplemental, the tool allows you to flag these issues for your doctor without feeling pressured to "score" your sex life.

 

Reference

Chalmers, K. Janea; Catley, Mark J.; Evans, Susan F.; Moseley, G. Lorimer. Clinical assessment of the impact of pelvic pain on women. PAIN 158(3):p 498-504, March 2017. | DOI: 10.1097/j.pain.0000000000000789

All questions & possible results

PPIQTitle not visible
1. In the past month, how much has your pelvic pain affected your ENERGY LEVELS?

Select one option:

  • Not at all
  • A little bit
  • Somewhat
  • Quite a bit
  • A great deal
2. In the past month, how much has your pelvic pain affected your MOOD?

Select one option:

  • Not at all
  • A little bit
  • Somewhat
  • Quite a bit
  • A great deal
3. In the past month, how much has your pelvic pain affected your SLEEP?

Select one option:

  • Not at all
  • A little bit
  • Somewhat
  • Quite a bit
  • A great deal
4. In the past month, how much has your pelvic pain affected your STOMACH & INTESTINAL FUNCTION?

Select one option:

  • Not at all
  • A little bit
  • Somewhat
  • Quite a bit
  • A great deal
5. In the past month, how much has your pelvic pain affected your ABILITY TO SIT FOR LONGER THAN 20 MINUTES?

Select one option:

  • Not at all
  • A little bit
  • Somewhat
  • Quite a bit
  • A great deal
6. In the past month, how much has your pelvic pain affected your ABILITY TO PERFORM & FUNCTION NORMALLY AT HOME / WORK / SCHOOL / UNIVERSITY?

Select one option:

  • Not at all
  • A little bit
  • Somewhat
  • Quite a bit
  • A great deal
7. In the past month, how much has your pelvic pain affected your ABILITY TO TAKE PART IN PHYSICAL ACTIVITY? (E.G. JOGGING, YOGA, BICYCLING)

Select one option:

  • Not at all
  • A little bit
  • Somewhat
  • Quite a bit
  • A great deal
8. In the past month, how much has your pelvic pain affected your ABILITY TO WEAR CERTAIN CLOTHES? (E.G. UNDERWEAR, TIGHT FITTING CLOTHES)

Select one option:

  • Not at all
  • A little bit
  • Somewhat
  • Quite a bit
  • A great deal
9. During your last period, how much did your pelvic pain affect your ability to use tampons?

If the question applies to you, please answer. If not, please leave blank. This question will not be added to your summed score.

Select one option:

  • Not at all
  • A little bit
  • Somewhat
  • Quite a bit
  • A great deal
10. In the last month, how much has your pelvic pain affected your levels of intimacy or sexual relationships? (e.g. having sex, masturbating)

If the question applies to you, please answer. If not, please leave blank. This question will not be added to your summed score.

Select one option:

  • Not at all
  • A little bit
  • Somewhat
  • Quite a bit
  • A great deal
Possible results
PPIQ Total Score

This tool is not meant to diagnose or treat a medical condition. See your medical practitioner for thorough evaluation and a treatment plan.

  • The higher the score, the higher the impact or maxium possible disruption to daily life.
  • A score above 15-20 points may be an indicator that the pain is significantly interfering with quality of life and may require a multidisciplinary approach (e.g., physical therapy, counseling, and medical management).
  • The answers may help prioritize treatment and track progress with your medical professionals.

Citation

Chalmers, K. Janea; Catley, Mark J.; Evans, Susan F.; Moseley, G. Lorimer. Clinical assessment of the impact of pelvic pain on women. PAIN 158(3):p 498-504, March 2017. | DOI: 10.1097/j.pain.0000000000000789

Literature

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