Abstract

and E. Louis REDER, M.D.a Psychogenic disability the backis very ofcommon and it will come as no surprise that it has fairly definite features and fairly standard patterns. This paper will describe the orthopedic findings of the various types of psychogenic back disability and there will be a discussion of the psychic mechanisms in volved. It is the combined effort of an ortho pedist and a psychiatrist. There are three major types of psychogenic back disability and two lesser types. The major types dominate every activity of the patient and will be discussed in detail. The lesser types offer no diagnostic difficulty and are obvious to almost any physician. One of the lesser types is a backache in an overworked female or asthenic male. The symptoms combine psychogenic and organic factors. Characteristically, the work load (multiple children, long hours, additional employment) is excessive, but the symptoms are not due only to the work load. There are often situational difficulties which add to the problem. The symptoms are approxi mately the same as are found in unstable low back due to disc damage (morning stiffness, some relief with mild activity, relief in flexion, increase of pain in extension, relief