Are There Ways to Explain Medically Unexplained Symptoms?

Muscle pain, back pain, headaches, chronic tiredness, and stomach issues are just some of the discomforts people experience daily that you can find listed under “MUS” or medically unexplained symptoms. But what does “unexplained” really mean? Can’t we really know anything about them?

The term “medically unexplained symptoms” has been used in the medical setting for years to refer to a vast range of pains and discomforts that are, apparently, not linked to any physical injury or motif. The first thing you might think is, “Well, it must be some kind of Placebo effect (or nocebo). Something we believe in which becomes physical, even though it’s not really physical...” However, despite some truth belonging to this idea, symptoms categorised under this name might be more complex than this.

The right name and definition for MUS

In a 2015 study, participants were asked what kind of name could better fit the given symptoms. Although 25% of individuals admitted it wouldn’t make a big difference for them to hear one name or another, some different suggestions emerged. 20% of people thought Persistent Physical Symptoms better expressed the concept, and 17% of individuals described them as Functional Symptoms. Why is this important?

Medically unexplained symptoms are not signals that just “happen.” If you wake up one day with strong headaches, and physical tests and exams cannot fully detect the main cause of your headache, it doesn’t mean that “it’s all in your head” and that you should deal with it alone. It doesn’t either mean that you should just ignore the pain or neglect it and just hope for it to get better as time passes. Chances are, if your body is showing you signals, then it’s time you listen to them.

However, if we look at the medical definition of MUS, we quickly realise how much confusion still lingers around it. Terms like “functional,” “somatic,” and “dissociative” are often used, and some have suggested MUS should be considered a syndrome rather than a set of symptoms. After all, many symptoms classified under MUS might appear in clusters and might also range from mental to physical or belong to different medical specialities.

What should you do with these symptoms?

If we take a step back and then take a long, deep breath, we can look at this massive theme with a calm mind. Despite the fact that many medical names and conditions sound very complex, we can point out common denominators in most physical issues the body encounters.

For example, stress can worsen any negative condition. Inflammation is a common theme in most chronic conditions. Negative emotions, such as sadness, grief, or anger, can worsen the pain we might be already feeling. So, before getting lost in the rabbit hole, let’s review the basics.

• Common symptoms that are categorised in the healthcare setting under the term MUS include muscle and joint pain, back pain, headaches, tiredness, feeling faint, chest pain, heart palpitations, and experiencing stomach issues.

• Less common MUS include seizures, being out of breath even when not exercising, feeling extremely weak or having paralysis, feeling numb or having tingling sensations. 

• According to data, 25% of people who go to the doctor experience one or more of these symptoms.

• Often, people reporting such symptoms are also going through depression or have chronic anxiety. Some experience a set of symptoms, which are later labelled as chronic fatigue syndrome (CFS), irritable bowel syndrome (IBS), fibromyalgia, or functional neurological disorders (FDNs). 

• Although a visit to your doctor might not always help you solve the problem, it is important that you take this step first to rule out any path that strictly requires professional medical attention. But if your doctor has seen your case, and traditional medical care hasn’t yet helped you get better, then it’s time to move beyond common medical remedies.

Beyond medical care for MUS

As I mentioned earlier, sometimes the body is bothered by some physical issues and wants your attention so you can solve them. But, other times, it’s the mind that’s screaming for attention.

You’re at work, and that sharp headache won’t let you do what you truly need to do. So you take that painkiller. You go back home, and you’re finally done with the chores, and that headache is back on track, full speed. You truly don’t want your free time to be all about drama, so you take another pill. The next day, you wake up, have your coffee, and head back to work. Once again, the headache is on. “I truly don’t have time for this!” So, the cycle repeats. Whenever you are forced to take the time to notice, it’s never about wondering what’s going on but rather about getting angry about it, feeling frustrated, and resenting your body for not working properly. The headache then turns into stomach issues, so one pill gets to the next one, and the next one, and the next one… Until you wake up one day and decide you’ve got enough pills. But you don’t know what else to do about it. You’ve never looked at the issue in the face, as you’ve tried so hard to push it down because life happens quickly, and we never have enough time for minor inconveniences. 

However, most of the time, what we resist… Persists.

I have a lot of patients who came to my studio after having tried plenty of traditional paths to healing. It’s not easy to slow down. It’s not easy to get back to our roots. We are wired to seek efficiency, but the world of today has driven our minds to levels of speed we cannot sustain. Life moves so quickly, and the brain is exposed to so many inputs. We’re online 24/7, and most of us go through life with the constant thought of “being late” or “not having enough time” to do all we should do. You know all the shoulds. You know the work shoulds, including all the meetings, deadlines, tasks, chats with clients, sales, goals, and expectations you should meet. You know the family shoulds, including calling those you haven’t met in a while, being there for the elders, supporting the youngest of the family, and being a good partner, wife, mother, daughter, and so on. What about the society shoulds? Those might be losing weight, looking good, showing off stuff on social media, buying a new car, having trendy clothes, being nice every time you step out of the door, contributing somehow, paying the bills, paying the taxes, and doing something meaningful. Not to mention all the shoulds in your head, maybe just linked to the person you think you should be or feel like you should be in order to fit in or please someone. Isn’t this list alone just stressing you out?

Sometimes, MUS might simply be there to tell you “Hey, we got too many shoulds in here. Please, make some space for some wants or feel likes.”

When was the last time you did something just for you? Not because it was on your shoulds list but because your roots were calling for you to get back to them?

The Feldenkrais method for MUS

At MindfulBody, our goal is to help you unlearn your pain, reconnect with your body, and discover - or rediscover - the freedom of pain-free movement. We do this by combining mind-body re-education, somatic bodywork - like the Feldenkrais Method - and a range of pain therapy techniques, including PRT and EAET.

For patients experiencing medically unexplained symptoms, some paths can lead to incredible outcomes. Feldenkrais Awareness Through Movement classes are great if you’re just starting with some inner work and wish to explore ways to turn your attention inward, connect with your body, and lower your stress, potentially letting go of symptoms that might be linked to neuroplastic pain and chronic stress. On the other hand, if you truly want to dig into your case in-depth, then individual work is more likely the better choice for you. This is Feldenkrais applied to the individual setting, where a practitioner moves your body in search of movement patterns that are inefficient and can be improved. In my Feldenkrais practice, it always fascinates me how it can help people switch from fight or flight to inner connection and deep calmness, sometimes for the first time in years. Reconnecting with our bodies through slow movement and awareness is just as simple as effective for changing our state. The everyday life might leave little space for natural emotional regulation and stress management, but we can choose to make time for it. 

What else do we use for these cases of medically unexplained symptoms?

If the Feldenkrais Method stands as the base for the house, then the building blocks of the mansion involve work on past traumas, negative beliefs, thought patterns, emotional blocks, and mind-body connection. No single tool or method can be as effective as multiple solutions applied together.

In fact, as many of the symptoms we have seen earlier don’t really appear alone, the solution must be sought in a carefully blended formula of mental and physical aids.

How we can help

Medically unexplained symptoms might come with plenty of questions, but don’t come with no explanations. When the body stays in a state of stress for too long, its fundamental functionalities start crumbling down. If we ignore the body’s cries for help for months and years, then we end up with more severe conditions that are, apparently, untreatable.

At MindfulBody, we believe in the power and wisdom of the body itself. When the nervous system is calm and the body is in a state of homeostasis, then things start going back to their place, one after the other. The challenge is not to seek the secret code to fixing the machine, but much rather to go back to the instructions paper and take some time, and love, to understand what the machine needs to function properly, day and night.

If you want to reconnect with yourself, break your pain cycle, and find ease and freedom in your movement, I’m here to help you. To explore the ways in which I could support you on your healing journey, feel free to drop me a message at iryna@mindfulbody.lu