Test Question - Waddell's Sign

Specialties NP

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Anyone know the name of the maneuver used by HCP's to distinguish between real back pain and fake back pain?

Thanks!

P.S. This is not a quiz...I don't know the answer, but hope you do

Specializes in Education, FP, LNC, Forensics, ED, OB.

You must be referring to Waddell's Sign?

But, best not rely totally upon that. this is greatly associated with poor treatment outcomes and the inability to distinguish between organic and non-organic problems. Here is a link about Waddell's Sign:

https://neurosigns.org/wiki/Waddell_signs

Mankopf's Test is the theory that pain will increase the heart rate in the chronic back pain patient. Totally invalid.

Mcbride's Test is when you instruct the patient to stand on one leg and flex the other knee to the chest. Normally this does not cause pain and if it does, can often be a sign of malingering.

O'donoghue's Maneuver is patients in true pain, passive range of motion elicits greater pain. But, if active rom is greater, can be a behavioral problem.

Hoover's Test is performed while the patient is lying down. hold the patient's heels off the table, and ask him or her to raise one leg. If the patient can easily raise the leg the test is negative. Normally if a patient cannot raise the leg he/she will push down the other leg in order to assist the movement of the other leg. Therefore, lack of downward pressure from the opposite leg is a positive sign of malingering.

But, as the AMA states, "confirmation of malingering is extremely difficult and depends upon intentional or inadvertent surveillance".

Thank you Siri!

Your wisdom and kindness are so appreciated!

Specializes in Pain Management.

As mentioned above:

The famous Hoover's Test.

At least that's the one I remember.

Specializes in Education, FP, LNC, Forensics, ED, OB.

Axial loading is not the name of a test per se. Any activity that increases axial loading such as walking, standing, etc. can increase the px of the individual with "mechanical" back px.

Are you referring to pressing on the head to elicit px? (part of Waddells sign).

The answer this test maker was looking for was Waddel's sign, and this was the answer I chose.... Thanks again!

Specializes in Education, FP, LNC, Forensics, ED, OB.

Thanks for coming back with the answer, brownrice. I figured it was Waddell's sign, but I like clarification, too.;)

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