Chronic Pain and Understanding the Interplay between Orthopedic and Psychological Aspects: A Case Study

Submit Manuscript | http://medcraveonline.com suggest one of three possible evidential opinions: evidence of significant organic/anatomical structural damage where pain is obvious in its organic/medical origin and is not controversial; evidence of mild/minor organicity where pain is expected but not significant; or lack of evidence of organicity where ongoing pain is unexpected, unexplained and pesistent. In all three cases, the orthopaedic surgeon will be sensitive to unusual physical signs (Waddel tests) indicative of ‘non-organic factors’. These Waddel’s signs [1,2] include: vocalisation, axial pressure on the head; simulated versus true spinal rotation; different straight leg raise when lying versus sitting; a light touch on the back perceived as painful; pain diagrams illustrating pain outside the body, widespread and different types of pain waddle found these corelated with poor physical outcomes. This may be described by the orthopaedic expert as an indicative of magnification (conscious or not) and an opinion of ‘Psychological Overlay’ with a recommended referral to a psychologist for an assessment of possible psychological factors.