Preliminary evidence for the features of non-reducible discogenic low back pain: survey of an international physiotherapy expert panel with the Delphi technique

Objectives The lumbar intervertebral disc is a known source of low back pain (LBP). Various clinical features of discogenic pain have been proposed, but none have been validated. Several subgroups of discogenic pain have been hypothesised, with non-reducible discogenic pain (NRDP) proposed as a relevant clinical subgroup. The objectives of this study were to obtain consensus from an expert panel on the features of discogenic low back pain, the existence of subgroups of discogenic LBP, particularly NRDP, and the associated features of NRDP. Design Three-round Delphi survey. Participants Twenty-one international physiotherapists with expertise in LBP. Methods Panellists listed and ranked features that they believed to be indicative of discogenic pain and NRDP. On completion of Round 3, features with >= 50% agreement between panellists were deemed to have reached consensus. Results After three rounds, 10 features of discogenic LBP were identified. Nineteen of the panellists believed that NRDP was a subgroup of discogenic LBP, and nine features of NRDP were identified. Conclusion This study provides preliminary validation for the features associated with discogenic LBP. It also provides evidence supporting the existence and features of NRDP as a separate clinical subgroup of discogenic LBP. (C) 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.