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Waddell signs: distributional properties and correlates
D M Novy1, H S Collins, D V Nelson
1Department of Anesthesiology, University of Texas-Houston Health Science Center, 77030, USA.
Archives of Physical Medicine and Rehabilitation
|July 31, 1998
Summary
Most chronic back pain patients lack Waddell signs, but their presence correlates with depression and functional issues. These factors may hinder treatment success, highlighting the need for comprehensive patient assessment.
Area of Science:
- Pain Management
- Psychosomatic Medicine
- Clinical Psychology
Background:
- Waddell signs are nonorganic behavioral indicators used in assessing low back pain.
- Their prevalence and correlation with various patient factors are not fully understood.
- Understanding these relationships is crucial for effective pain management strategies.
Purpose of the Study:
- To determine the percentage of patients without Waddell signs.
- To examine the relationship between Waddell signs and somatic complaints, functional performance, treatment attitudes, physical pathology, depression, anxiety, and MMPI-2 validity scales.
- To identify factors influencing treatment outcomes in chronic back pain.
Main Methods:
- Case series survey design.
- Involved 75 consecutive chronic back pain patients at a multidisciplinary pain center.
- Utilized medical evaluations and self-report inventories to assess Waddell signs, physical pathology, pain intensity, functional performance, and psychological symptoms.
Main Results:
- 64% of patients exhibited no Waddell signs.
- A higher number of Waddell signs significantly correlated with depression, disturbed functional performance, somatic complaints, and pain intensity.
- Waddell signs were not significantly correlated with generalized anxiety, negative treatment attitudes, physical pathology, age, pain duration, gender, lumbar surgeries, or MMPI-2 validity scales.
Conclusions:
- Multiple Waddell signs and their associated factors can impede optimal treatment response.
- Comprehensive assessment considering behavioral and psychological elements is vital for chronic back pain management.
- Further research may elucidate the complex interplay between Waddell signs and treatment outcomes.