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Why are 'Waddell's signs' important to back injury victims?

Something called "Waddell's signs" may be the most important thing you've never heard of -- if you happen to be the victim of a low back injury and seeking workers' compensation benefits.

Back injuries tend to confound a lot of doctors. One patient may have X-rays that reveal major damage in the spine, including slipped and bulging discs, but very little pain and no limitations. Another patient may have almost nothing visible on his or her X-rays -- but still feel agonizing pain and suffer from tremendous limitations.

Because of this, doctors sometimes wonder if a patient with lower back pain is malingering. To tell you are faking or exaggerating your symptoms, a doctor may perform the following Waddell tests:

1. A tenderness test

One of the signs that a patient is exaggerating is widespread tenderness of the lower back when the doctor is barely touching the patient. Another is pain that is described as "deep" but not specific.

2. A false simulation

Doctors will sometimes indicate to a patient that they're looking for a pain reaction when they're really not. One test that shouldn't actually cause lower back pain involves pressing on the patient's head. Another involves rotating the patient's body, shoulders and hips together. Patients who are exaggerating their symptoms may complain of serious pain even though the lumbar spine isn't in use.

3. A distraction test

Sometimes doctors will try to distract a patient while performing what's known as a "straight leg" test. They'll raise the patient's leg while the patient is either laying flat or seated and tell the patient it is only meant to examine the knees. In reality, it should cause pain if the patient is actually suffering from a low back injury.

4. The body pain test

Pain follows the nerve endings in your body. If a doctor can elicit false exclamations of pain in areas of the body that are unrelated to the nerve bundles that are supposedly affected, that's a sign that a patient is malingering.

5. The over-reaction test

This is sometimes called the "over-acting" test. Doctors look for exaggerated limps, dramatic weaknesses and extreme expressions of pain that aren't characteristic of the damage they can see on X-rays or MRIs.

What's the best way to pass the Waddell test? Never exaggerate your symptoms. When dealing with a workers' compensation claim, let your injuries speak for themselves.

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