I have always been very careful about which painful or noxious stimuli I use to elicit a patient response but I have seen some strange assessments.
Possibly the one that makes me maddest is the "nipple twist" oddly - most often attempted by young male MD's on female patients :angryfire
Mind you I use the word "attempted" wisely - the resident (intern) who stated he would use this assessment got told that "fair is fair - if you are going to start doing nipple twists on females we will start doing scrotal squeezes on males - starting with you." Funny he lost interest in doing this form of painful stimuli after that
and every other young resident who suggested painful stimuli tended to be very respectful and stand at the other side of the bed - guess word got around:chuckle
What do you use though?? Sternal pressure? Trapezius squeeze??? TMJ pressure??
Do you put pressure at the base of the nails or at the side of the fingers???