Medically Unexplained Symptoms and how we can help

What are medically unexplained symptoms?

Medically unexplained symptoms describe physical feelings that are as of yet not explained by a diagnosed medical condition. An important point to be made is that this does not mean that the symptoms are ‘all in your head’, these symptoms are real and can impair your ability to do daily tasks.

To understand medically unexplained symptoms we have to look at how the body and mind work together. Whilst the lack of answers regarding why you feel a certain way can be incredibly frustrating, medically unexplained symptoms can still be treated.

Actions that can help

1. Go and see your GP. They will work with you to eliminate all possible causes of your symptoms.
2. Tell your doctor what your symptoms are like, when they started and what makes them better or worse.
3. Tell your doctor what you think or fear is the cause of your symptoms and your expectations of how tests and treatments might help.
4. Tell your doctor how your symptoms affect what you can do and what they stop you doing.
5. Tell your doctor if these symptoms are distressing for you.

Symptoms

Medically unexplained symptoms can come in a variety of forms. You may have a diagnosed condition but are experiencing an additional symptom that is not fully explained by that illness, or you may be considered completely healthy aside from this (or these) symptoms.

Some of the most common medically unexplained symptoms include:

• Muscular/joint pain
• Back pain
• Tiredness
• Headaches
• Feeling faint
• Chest pain
• Stomach problems - pain, feeling bloated, diarrhoea and constipation
• Heart palpitations
• Collapsing
• Numbness

This list is by no means exhaustive. Any recurring and persistent symptom that you have which a doctor cannot associate to a certain condition can be considered a medically unexplained symptom.

Treatment

Talking therapies

Talking therapies can be a very effective way of recognising what exacerbates your symptoms and manage their severity in the best way you can. Therapeutic options used to treat medically unexplained symptoms are described below.

Cognitive behavioural therapy (CBT) CBT can help you to identify unhelpful patterns of thinking and behaving which can make symptoms worse. For example, stress and depression can lower your pain threshold, making symptoms more difficult to bear. By taking steps to address these factors, you can significantly cut down the impact of the unexplained symptoms.

Psychodynamic therapy

‍Psychodynamic therapy helps people to explore past experiences and relationships, and think about how they may impact on current difficulties. Therapy may help you to understand how and why symptoms may have first occurred, as well as developing ways of coping.

Problem-solving therapy and solution-focused therapy

‍Problem-solving therapy and solution-focused therapy help you identify and tackle specific problems in your life that seem to be making the symptoms worse.

Medication

Antidepressants can help to treat a range of medically unexplained symptoms, even when someone is not depressed. Science does not yet fully understand exactly how they do this, but the evidence shows that they do work.

• Sometimes, symptoms may occur as part of anxiety or depression. In which case, they will improve if the depression or anxiety is successfully treated with antidepressants.
• Depression lowers your pain threshold, which can therefore create a vicious circle in which the more depressed you feel, the more pain you are in. Antidepressants can help break this circle and both the depression and the symptoms may improve.

Before you start an antidepressant, you should discuss possible side-effects with your doctor. People with medically unexplained symptoms may notice more side-effects than others, partly because they may be more attuned to changes in bodily symptoms than others.

Knowing what to expect in advance may help you to cope with any side-effects. It is worth trying antidepressant treatment for 2 to 3 months before deciding if it has or hasn’t worked.

Medically Unexplained Symptoms - Five facts

1. Medically unexplained symptoms account for 45% of GP appointments in the UK.
2. Regular exercise has been shown to be effective in coping with medically unexplained symptoms.
3. Medically unexplained symptoms are more common in women, young people, those who have experience with anxiety and depression and those that have recently had an illness/medical problem.
4. Even without treatment, there is a good chance your symptoms will significantly improve over time. The human body has a remarkable ability to recover.
5. Taking time to do things you find relaxing (yoga, swimming, walking, meditation) have also shown to be helpful.

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