Behavioral Responses to Examination, A Reappraisal of the Interpretation of “Nonorganic Signs.” Main CJ, Waddell G (Spine, 1998;23, 2367-2371).
In 1980, orthopedist Gordon Waddell described physical examination signs that should alert physicians to the potential presence of “nonorganic” factors. Eighteen years later, the present article offers an update on how these signs have come to be used, both appropriately and inappropriately, in assessing individuals with lumbar spine complaints. It also reviews the process by which the 8 “Waddell—s Signs” were first identified and examines subsequent studies on their reliability and validity. The authors remind the reader:
With 18 years of additional experience, Main and Waddell note that Waddell—s Signs can be present due to patient fear the physical examination may be painful, based on discomfort experienced during prior exams. The authors point out that observations of inappropriate pain...
