Development of a Modern Standard Arabic version of the pain disability index: translation, cross-cultural adaptation, psychometric, and validity data

The assessment and treatment of chronic pain rely heavily on patient self-report, making linguistically and culturally appropriate tools essential. However, no well-validated Arabic language measures of pain-related disability are widely available. The objective of this study was to create and validate a Modern Standard Arabic (MSA) version of the Pain Disability Index (PDI). This prospective cross-sectional study was conducted in a pain management clinic in a tertiary care center in the United Arab Emirates (UAE). The MSA PDI was developed using a forward-backward translation protocol by a team of native Arabic speakers from diverse backgrounds, reviewed by a professional translation company, and pilot-tested with a small sample of patients. Participants completed the MSA PDI along with measures of depression (PHQ-8), anxiety (GAD-7), and current pain severity. A total of 423 Arabic-speaking adults participated (54.84%) women, mean age of 43.71 ± 13.53, most of whom were UAE nationals (88.41%). The mean PDI score was 31.29 (±17.64), indicating moderate pain-related disability. Over half of the sample met screening thresholds for moderate to severe pain (50.83%), depression (57.21%), or anxiety (38.77%). Factor analysis of the MSA PDI supported a unidimensional structure. The MSA PDI also demonstrated excellent internal consistency (α = .91). Construct validity was supported through a tiered multi-method approach (correlation, regression, and structural equation modeling), which showed moderate positive associations between pain severity, depression, anxiety, and pain-related disability. Overall, the MSA PDI showed strong psychometric properties and provides a reliable, standardized tool for assessing pain-related disability in Arabic-speaking populations.