Characteristics and frequency of malingering among patients with low back pain.

Information on the clinical characteristics and frequency of malingering among patients with low back pain was obtained in a survey mailed to orthopedic surgeons and neurosurgeons in 6 geographic regions of the United States. Working on the assumption that orthopedic surgeons and neurosurgeons are untapped historians of this clinical information, data from 105 respondents were analyzed to determine if a consensus of opinion underlies clinical judgment concerning malingering. The results indicated that agreement increases with clinical symptoms reflecting exaggeration and incongruous behavior. 70% or more of the physicians were in agreement on 6 symptoms fitting these 2 patterns. 60% of the surgeons were also in agreement that malingering is a relatively infrequent condition, occurring in 5% or less of patients with low back pain.