A new sign of inappropriate lower back pain.

The treatment of lower back pain constitutes a major problem for orthopaedic surgeons. Identifying the patients who have a non-organic component to their lower back pain is often difficult. Waddell et al. (Waddell G, McCulloch HA, Kummel E, Venner RM. Non-organic physical signs in low-back pain. Spine 1980; 5: 117-25) devised a set of five physical signs to assist in determining this. These signs are time consuming and can be difficult to interpret. We have developed a sign that is simple, quick and easy to perform. In a set of 94 patients, we have compared our sign with Waddell's signs. Our sign has a highly significant correlation with Waddell's signs (chi2 = 55.093, P < 0.001), and thus we would suggest it as an accurate alternative to Waddell's signs.