I saw in my medical record the doctor recorded "Absence of Waddell signs; patient is a good candidate for spinal fusion." What are Waddell signs?

Gordon Waddell is a British doctor who has written a book called The Back Pain Revolution. This is a useful reference work for all clinicians treating patients with back pain. It gives the latest British and American guidelines for the management of non- specific low back pain.

Early on in his work, Dr. Waddell came up with some simple tests to look for emotional or psychologic basis for back pain. Doctors and physical therapists use these tests to help identify what kind of pain the patient is having.

The signs are meaningful only when found in groups of three or more. In other words, one positive Waddell sign doesn't mean much. The presence of these signs doesn't mean there isn't something wrong with the patient. They don't suggest the patient is faking. They are only signs that a psychologic component may be present.