ABSTRACT
The two terms that can cause the most damage to an honest patient when misapplied are symptom magnification and malingering. The skilled, knowledgeable clinician avoids the implications of symptom magnification by describing its clinical significance specific to the patient being examined. Increasing numbers of cases and reports are applying and misinterpreting Waddell’s and other nonorganic signs as being diagnostic of psychogenic pain or malingering, with devastating consequence to chronic pain patients. Chronic pain patients are apprehensive and may exhibit pain avoidance based on past examinations on or about trigger points or other soft tissue areas. Labeling or diagnosing a chronic pain patient as psychogenic, unsubstantiated by overwhelming evidence, will bring disaster, devastation, and potential irreversible damage to a patient’s life and family. Chronic pain patients will not open up and share their thoughts and concerns unless the examiner believes them. Belief is the foundation for restoring their lives; it is therapeutic.
