Waddell Sign

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Purpose

Waddell's signs were developed to identify psychogenic, or nonorganic, manifestations of pain in patients that may have heightened emotional effects on their conditions. In order for these signs to be significantly correlated with disability, three of the five signs should be present.

Technique

1. Non-anatomical, widespread, referring tenderness in response to light touch.

2. Simulation tests

    a. Axial loading of the spine applying light pressure through the head

    b. With the patient in standing, passive hip and shoulder rotation

3. Distraction test - test a positive finding on a distracted patient

    example: If pain is found in testing hip flexion, observe the patient in tying his shoes

4. Regional disturbances – experiencing sensory or motor disturbances that are lacking in neurologic basis
5. Overreaction during examination (tension, grimacing, verbalization, tremors, etc.)

Evidence

Provide the evidence for this technique here

Resources

Waddell, G., McCulloch, J.A., Kummel, E., Venner, R.M. (1980). Nonorganic Physical Signs in Low-Back Pain. Spine, 5(2), 117-125.

References

Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc