Saper

If they protest, "I say, 'If the drugs were working, you wouldn't be here,' " Dr. Saper says.

Doctors' Dilemma: How Real is that Pain? Melinda Beck 2011

Dr. Saper estimates that 15% to 20% of them are faking—or at least, aren't as incapacitated as they say.

Doctors' Dilemma: How Real is that Pain? Melinda Beck 2011

For example, "Many people tell us that they vomit yesterday's food," says Joel Saper , director of the Michigan Head-Pain and Neurological Institute in Ann Arbor.

Beware, a Big Headache Is Coming Melinda Beck 2011

"We don't have a pain-o-meter," says Joel Saper , director of the Michigan Head Pain and Neurological Institute in Ann Arbor, which draws about 10,000 patients a year, including some of the nation's toughest migraine cases.

Doctors' Dilemma: How Real is that Pain? Melinda Beck 2011

"For years, patients would say they got a migraine because they ate chocolate or pizza or a hot dog," says Dr. Saper.

Beware, a Big Headache Is Coming Melinda Beck 2011

"For years, patients would say they got a migraine because they ate chocolate or pizza or a hot dog," says Dr. Saper.

Beware, a Big Headache Is Coming Melinda Beck 2011

If they protest, "I say, 'If the drugs were working, you wouldn't be here,' " Dr. Saper says.

Doctors' Dilemma: How Real is that Pain? Melinda Beck 2011

"We don't have a pain-o-meter," says Joel Saper , director of the Michigan Head Pain and Neurological Institute in Ann Arbor, which draws about 10,000 patients a year, including some of the nation's toughest migraine cases.

Doctors' Dilemma: How Real is that Pain? Melinda Beck 2011

Dr. Saper estimates that 15% to 20% of them are faking—or at least, aren't as incapacitated as they say.

Doctors' Dilemma: How Real is that Pain? Melinda Beck 2011

For example, "Many people tell us that they vomit yesterday's food," says Joel Saper , director of the Michigan Head-Pain and Neurological Institute in Ann Arbor.

Beware, a Big Headache Is Coming Melinda Beck 2011