Waddell Sign

Excerpt

Professor Gordon Waddell first described a group of eight clinical physical signs in 1980 known as Waddell signs. As an orthopedic surgeon, Waddell initially developed these signs as a method to identify patients with low back pain who were likely to experience a poor surgical outcome from lower back surgery. More recently, clinicians have utilized Waddell signs to detect psychogenic, sometimes inappropriately labeled “non-organic,” manifestations of low back pain in patients. This practice has expanded to identify malingering in patients, such as discrediting the legitimacy of motor vehicle accident claims as well as identifying psychogenic components in other non-lumbar pain syndromes.

In 1998, Main and Waddell stated that these physical signs have been misinterpreted and misused both clinically and medico-legally. In their article, they emphasize the importance of viewing back pain within a psychosocial context. They state that behavioral signs may be a response affected by fear from injury and development of chronic incapacity, and are not a test of credibility. They conclude that patients displaying Waddell signs may require both physical management of their physical pathology as well as careful therapy for the psychosocial and behavioral aspects of their illness.