title: Posterior pelvic pain provocation test is negative in patients with lumbar herniated discs.
abstract: The classification of pelvic girdle pain can only be reached after lumbar causes have been excluded by a clinical examination. During clinical examination, the posterior pelvic pain provocation test is a well-established method for verifying pelvic girdle pain. However, a criticism of pelvic pain provocation tests is that they may have an effect on lumbar structures, thus yielding false-positive results. The posterior pelvic pain provocation test was performed with four groups of patients: patients with computed tomography-verified disc herniations (1) on the waiting list for surgery (14 women; 9 men); (2) 6 weeks after disc surgery (18 women, 12 men); (3) pregnant women seeking care for pelvic girdle pain (n = 25); and (4) women with persistent pelvic girdle pain after delivery (n = 32). The sensitivity of the posterior pelvic pain provocation test was 0.88 and the specificity was 0.89. The positive predictive value was 0.89 and the negative predictive value was 0.87. Analysis of only women showed similar results. In our study, the posterior pelvic pain provocation test was negative in patients with a well-defined lumbar diagnosis of lumbar disc herniation, both before and after disc surgery. Our results are an important step toward the more accurate classification of lumbopelvic pain.
authors.affiliation: Division of Physiotherapy, Department of Medicine and Health Sciences, Linköping University, Linköping, Sweden. annelie.gutke@liu.se
authors.forename: Annelie
authors.initials: A
authors.lastname: Gutke
authors.forename: Eva Roos
authors.initials: ER
authors.lastname: Hansson
authors.forename: Gunilla
authors.initials: G
authors.lastname: Zetherström
authors.forename: Hans Christian
authors.initials: HC
authors.lastname: Ostgaard
mesh_terms: D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000294:innervation / Q000473:pathology / Q000503:physiopathology; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D008159:Lumbar Vertebrae / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010147:Pain Measurement / Q000379:methods*; D017699:Pelvic Pain / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D010388:Pelvis / Q000473:pathology / Q000503:physiopathology*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012727:Sex Characteristics; D055815:Young Adult