Screening for psychological factors in patients with low back problems: Waddell's nonorganic signs.

The role of Waddell's nonorganic signs test as a screening tool for psychological factors in the examination of patients with low back problems has been described. The presence of nonorganic signs should alert the physical therapist to the need for additional psychological tests and should not necessarily be considered an indicator of malingering. Nonorganic signs may coexist with organic findings. An illness behavior role of the nonorganic signs is suggested, as they have been related with disability in addition to physical impairments. Physical therapy management for these patients should focus on treatment of illness behavior and on combating disability.