The reliability of selected pain provocation tests for sacroiliac joint pathology

Spine (Phila Pa 1976). 1994 Jun 1;19(11):1243-9. doi: 10.1097/00007632-199405310-00009.


Objective: To assess the inter-rater reliability of seven pain provocation tests for pain of sacroiliac origin in low back pain patients.

Summary of background data: Previous studies on the reliability of such tests have produced inconclusive and conflicting results.

Methods: Fifty-one patients with low back pain, with or without radiation into the lower limb, were assessed by one examiner and another drawn from a pool of five. Percent agreement and the Kappa statistic were used to evaluate the reliability of the seven tests.

Results: Percent agreement and the Kappa statistic ranged in value from 78% and 0.52 (P < 0.001) to 94% and 0.88 (P < 0.001), respectively, when results for all examiner pairs were pooled. However, two tests demonstrated only marginal reliability when performed by one pair of assessors that examined 43% of the patients.

Conclusions: Five of seven tests employed in this study were reliable, the other two were potentially reliable. These tests may be used to detect a sacroiliac source of low back pain, although sensitivity and specificity studies are needed to determine their diagnostic power.

MeSH terms

  • Adult
  • Female
  • Humans
  • Low Back Pain / diagnosis*
  • Low Back Pain / physiopathology
  • Male
  • Observer Variation
  • Pain Measurement / methods*
  • Pain Measurement / statistics & numerical data
  • Pain Threshold
  • Reproducibility of Results
  • Sacroiliac Joint / physiopathology*