{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T16:05:24Z","timestamp":1768838724029,"version":"3.49.0"},"reference-count":54,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,12,9]],"date-time":"2013-12-09T00:00:00Z","timestamp":1386547200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Avances Neurol\u00ef\u00bf\u00bdgicos Sanitarios (ANS) S.A."},{"name":"Cardiva Centro S.L."},{"name":"Medtronic Ib\u00ef\u00bf\u00bdrica S.A."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Low back pain (<jats:styled-content style=\"fixed-case\">LBP<\/jats:styled-content>) symptoms and signs are nonspecific. If required, diagnostic blocks may find the source of pain, but indicators of suspect diagnosis must be defined to identify anatomical targets.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To reach a consensus from an expert panel on the indicators for the most common causes of <jats:styled-content style=\"fixed-case\">LBP<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>A 3\u2010round (2 telematic and 1 face\u2010to\u2010face) modified <jats:styled-content style=\"fixed-case\">Delphi<\/jats:styled-content> survey with a questionnaire on 78 evidence\u2010based indicators of 7 <jats:styled-content style=\"fixed-case\">LBP<\/jats:styled-content> etiologies was completed by 23 experts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>98.7% of the questionnaire was consensuated. The most accepted indicators were for zygapophysial joint pain, painful ipsilateral paravertebral palpation, worsening with trunk extension, paravertebral musculature spasm on the affected articulation, and referred pain above the knee, without radicular pattern. For sacroiliac joint pain, unilateral pain when seating, with at least 3 described provoking tests: Approximation; gapping; Patrick's; Gaenslen's; thigh thrust; Fortin finger; and Gillet's tests. For discogenic pain, midline pain that may be provoked by pressure on the spinal processes at the affected level; for quadratus lumborum muscle, painful palpation on both the L1 level paravertebral region, referred to iliac crest, and the iliac crest, referred to greater trochanter. For iliopsoas muscle, pain elicited by thigh flexion, referred to buttock, inguinal region, and anterior thigh. For pyramidal muscle, pain while sitting on the affected side and positive Freiberg's test. For radicular pain, paresthesias and positive Lass\u00e8gue's test at 60\u00b0.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Seventy\u2010seven diagnostic suspect indicators of <jats:styled-content style=\"fixed-case\">LBP<\/jats:styled-content> conditions were consensuated. These may facilitate conservative or interventional pain management decision\u2010making.<\/jats:p><\/jats:sec>","DOI":"10.1111\/papr.12135","type":"journal-article","created":{"date-parts":[[2013,12,9]],"date-time":"2013-12-09T09:03:01Z","timestamp":1386579781000},"page":"12-21","source":"Crossref","is-referenced-by-count":17,"title":["A Modified Delphi Survey on the Signs and Symptoms of Low Back Pain: Indicators for an Interventional Management Approach"],"prefix":"10.1111","volume":"15","author":[{"given":"Jos\u00e9","family":"Cid","sequence":"first","affiliation":[{"name":"Pain Unit Department of Anesthesiology and Reanimation \u201cVirgen de la Salud\u201d University Hospital Toledo Hospital Complex Toledo Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 L.","family":"De La Calle","sequence":"additional","affiliation":[{"name":"Pain Study and Treatment Unit \u201cRam\u00f3n y Cajal\u201d University Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"L\u00f3pez","sequence":"additional","affiliation":[{"name":"Pain Unit Department of Anesthesiology and Reanimation Gregorio Mara\u00f1\u00f3n University General Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Del Pozo","sequence":"additional","affiliation":[{"name":"Puerta de Hierro Majadahonda University Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfredo","family":"Perucho","sequence":"additional","affiliation":[{"name":"Pain Study and Treatment Unit \u201cRam\u00f3n y Cajal\u201d University Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Soledad","family":"Acedo","sequence":"additional","affiliation":[{"name":"Pain Unit 12 October University Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dolores","family":"Bedmar","sequence":"additional","affiliation":[{"name":"Pain Unit Department of Anesthesiology Fuenlabrada University Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Benito","sequence":"additional","affiliation":[{"name":"Pain Unit Department of Anesthesiology \u201cRuber Internacional\u201d Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"De Andr\u00e9s","sequence":"additional","affiliation":[{"name":"Pain Unit Department of Anesthesiology and Reanimation \u201cVirgen de la Salud\u201d University Hospital Toledo Hospital Complex Toledo Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susana","family":"D\u00edaz","sequence":"additional","affiliation":[{"name":"Pain Unit Department of Anesthesiology and Reanimation Gregorio Mara\u00f1\u00f3n University General Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Antonio","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Pain Unit Department of Anesthesiology and Reanimation \u201cInfanta Cristina\u201d University Hospital Parla Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leticia","family":"G\u00f3mez\u2010Caro","sequence":"additional","affiliation":[{"name":"Pain Unit Department of Anesthesiology and Reanimation \u201cVirgen de la Salud\u201d University Hospital Toledo Hospital Complex Toledo Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adolfo","family":"Gracia","sequence":"additional","affiliation":[{"name":"Pain Unit Jim\u00e9nez\u2010D\u00edaz Foundation University Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Mar\u00eda","family":"Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Pain Unit Madrid\u2010Montepr\u00edncipe University Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joaqu\u00edn","family":"Insausti","sequence":"additional","affiliation":[{"name":"Pain Unit Ciudad Real University Hospital Ciudad Real Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Madariaga","sequence":"additional","affiliation":[{"name":"Pain Unit Department of Anesthesiology and Reanimation \u201cInfanta Sof\u00eda\u201d University Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Mo\u00f1ino","sequence":"additional","affiliation":[{"name":"Pain Unit Department of Anesthesiology and Reanimation \u201cSan Carlos\u201d Cl\u00ednical Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"Ruiz","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Prince of Asturias University Hospital, Alcal\u00e1 de Henares Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Estrella","family":"Uriarte","sequence":"additional","affiliation":[{"name":"Pain Unit, Department of Anesthesiology and Reanimation \u201cSevero Ochoa\u201d University Hospital, Legan\u00e9s Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfonso","family":"Vidal","sequence":"additional","affiliation":[{"name":"Pain Unit, Department of Anesthesiology idcsalud Group Sur Hospital, Alcorc\u00f3n Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,12,9]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/eujp.2001.0310"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1157\/13092313"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181d952c2"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaceta.2011.10.012"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0014-2565(01)70913-7"},{"key":"e_1_2_7_7_1","first-page":"79","article-title":"Cervicalgias y lumbalgias mecanicodegenerativas. Tratamiento conservador. Actualizaci\u00f3n","volume":"8","author":"Cid J","year":"2001","journal-title":"Rev Soc Esp Dolor."},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198304000-00009"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199006000-00004"},{"key":"e_1_2_7_10_1","first-page":"181","article-title":"The tissue origin of low back pain and sciatica: a report of pain response to tissue stimulation during operations on the lumbar spine using local anesthesia","volume":"22","author":"Kuslich SD","year":"1991","journal-title":"Ortho Clin North Am."},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199404000-00013"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199501000-00007"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2010.01045.x"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-197909000-00009"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(89)90173-5"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199809150-00011"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199608150-00012"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2005.01.003"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2005.09.023"},{"key":"e_1_2_7_20_1","first-page":"33","article-title":"Does the location of low back pain predict its source?","volume":"3","author":"Palma MJ","year":"2011","journal-title":"PMR."},{"key":"e_1_2_7_21_1","doi-asserted-by":"crossref","first-page":"E71","DOI":"10.36076\/ppj.2009\/12\/E121","article-title":"Comprehensive review of neurophysiologic basis and diagnostic interventions in managing chronic spinal pain","volume":"12","author":"Manchikanti L","year":"2009","journal-title":"Pain Physician."},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004150050480"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20060329"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2007.12.003"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200005010-00016"},{"key":"e_1_2_7_26_1","first-page":"CD007431","article-title":"Physical examination for lumbar radiculopathy due to disc herniation in patients with low\u2010back pain","volume":"17","author":"Van der Windt DA","year":"2010","journal-title":"Cochrane Database Syst Rev."},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2009\/12\/699"},{"key":"e_1_2_7_28_1","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/B978-0-7216-2872-1.50021-2","volume-title":"Interventional Spine: An Algorithmic Approach","author":"Bogduk N","year":"2008"},{"key":"e_1_2_7_29_1","doi-asserted-by":"crossref","first-page":"E141","DOI":"10.36076\/ppj.2010\/13\/E141","article-title":"Critical review of the american pain society clinical practice guidelines for interventional techniques: part 1. diagnostic interventions","volume":"13","author":"Manchikanti L","year":"2010","journal-title":"Pain Physician."},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.3410\/M2\u201057"},{"key":"e_1_2_7_31_1","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1093\/ptj\/85.9.895","article-title":"Identifiers suggestive of clinical cervical spine instability: a Delphi study of physical therapists","volume":"85","author":"Cook C","year":"2005","journal-title":"Phys Ther."},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(03)00211-7"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta2030"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2007.02.003"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2011.04.017"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes147"},{"key":"e_1_2_7_37_1","volume-title":"Foundations of Clinical Research: Applications to Practice","author":"Portney L","year":"1993"},{"key":"e_1_2_7_38_1","volume-title":"The Delphi Method: Techniques and Applications","author":"Linstone H","year":"1975"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1080\/713680259"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1108\/14777260310469319"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1134-8046(10)70017-3"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/NCC.0b013e318210e3a2"},{"key":"e_1_2_7_43_1","volume-title":"The Rand\/UCLA Appropriateness Method User's Manual","author":"Fitch K","year":"2001"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(00)90080-7"},{"key":"e_1_2_7_45_1","first-page":"96","article-title":"Tratamiento del S\u00edndrome de Dolor Miofascial con Toxina Botul\u00ednica tipo A","volume":"2","author":"Castro M","year":"2006","journal-title":"Rev Soc Esp Dolor."},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000166523.84016.4b"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2012.03.013"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2012.03.003"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2012.03.002"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1080\/16501970600632768"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1002\/msc.126"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-010-1671-8"},{"key":"e_1_2_7_53_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-011-2057-2"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.1177\/1742395312451280"},{"key":"e_1_2_7_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1134-8046(09)73097-6"}],"container-title":["Pain Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fpapr.12135","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/papr.12135","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T21:37:17Z","timestamp":1696282637000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/papr.12135"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,12,9]]},"references-count":54,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2015,1]]}},"alternative-id":["10.1111\/papr.12135"],"URL":"https:\/\/doi.org\/10.1111\/papr.12135","archive":["Portico"],"relation":{},"ISSN":["1530-7085","1533-2500"],"issn-type":[{"value":"1530-7085","type":"print"},{"value":"1533-2500","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,12,9]]}}}