Findings suggesting nonorganic findings:
(1) tenderness to touch
(1a) widespread sensitivity to light touch
(1b) tenderness that is nonanatomic, extending over a large area
(2) simulation on axial loading or rotation
(2a) increase in low back pain with light touch on skull while standing (axial loading)
(2b) increase in low back with with passive rotation of shoulders and pelvis in the same plane while standing (rotation)
(3) distraction (inconsistent findings in sitting versus supine straight leg raising)
(4) regional neurologic disturbance
(4a) glove and stocking sensory complaints
(4b) nondermatomal loss of sensation
(4c) generalized giving way or cogwheeling resistance in manual muscle testing
(5) overreaction to the examination with disproportionate pain response during testing (exaggerated)
Interpretation:
• minimum number of findings present: 0
• maximum number of findings present: 5
• The presence of 3 or more items may indicate the presence nonorganic complaints which may be due to malingering behavior or a psychological problem.
Limitations:
• The findings should not be taken as confirmed evidence of malingering. They do help to identify patients who may require a more careful assessment.
