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Gordon Waddell

BMJ 2017; 357 doi: (Published 23 June 2017) Cite this as: BMJ 2017;357:j2938
  1. Anne Gulland
  1. London
  1. annecgulland{at}

Orthopaedic surgeon who reformed the treatment of lower back pain

As an orthopaedic surgeon in the 1970s Gordon Waddell realised that the current model for treating back pain was not working. He identified three main problems: the standard advice of bed rest was incorrect, there was an over-reliance on surgery as a treatment, and the message that anything that causes pain must be avoided was wrong—“hurt does not mean harm” was his mantra.

Tackling back pain

Waddell was running a clinic in Glasgow and wondered why some patients were far more disabled by back pain than others. In what was a highly unusual move at the time, he formed a partnership with a young clinical psychology researcher, Chris Main, and together they investigated why some patients could barely walk while others were moving reasonably well, despite looking the same on physical examination.

Waddell was a conscientious data collector and, through careful observation and consideration of the evidence, he and Main realised that much of the medical assessment of back pain was unreliable. Waddell asked three doctors to examine the same patient and found that they came up with differing …

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