Is it malingering, or is it 'real'? Eight signs that point to nonorganic back pain

Have you ever become frustrated while caring for patients who present with a confusing array of musculoskeletal complaints and other signs of illness? When routine evaluation does not suggest a diagnosis and you begin to suspect it's "all in their head," how do you identify the underlying cause? And what is the best tack to take when dealing with such patients? Thanks to research by Waddell and colleagues, there is a way to distinguish between physical and behavioral causes. Drs Kiester and Duke explain the eight Waddell signs for identifying nonorganic back pain and offer a practical approach to patient management.