Complexities of Medically Unexplained Symptoms

By Kenneth H. ReinhardFebruary 3, 2014

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(Photo Credit: U.S. Army) VIEW ORIGINAL

Fort Leonard Wood, Mo. -- Imagine the frustration of going to your primary care provider with a medical issue that is deeply troublesome to you, and after being thoroughly examined, the doctor is unable to tell you what's wrong.

This is called Medically Unexplained Symptoms (MUS) or Medically Unexplained Physical Symptoms (MUPS).

The cause of these symptoms can be either physiological or psychological; often it is a combination of both, but have not been specifically determined…yet.

The MUS/MUPS can put a strain on the provider and patient relationship as they attempt an array of tests and treatments to include physicals, blood work-ups, imaging, medications and counseling.

An example of MUS/MUPS may involve someone who sustained concussion recently or in the remote past. They may believe that many of the unexplained symptoms they are experiencing are likely to result from the concussive event since these symptoms appeared to begin following the concussion.

However, if doctors find that all concussion tests yield results within acceptable ranges, the patient suffers the anguish of not having something to take to get better, or know what's wrong with them.

It may be surprising to learn that MUS/MUPS is not that uncommon.

According to www.pdhealth.mil, studies show that doctors can find no specific cause for about one-third of their patient's symptoms.

Headaches, sleep disturbances, sensitivity to light, short-term memory loss, loss of mental focus, and irritability can be caused by, and associated with, multiple factors. Personal or family concerns, financial or work-related stressors, anxiety, depressed mood, or traumatic experience from the past, are some of these concerns.

The good news is that MUS/MUPS requires a "normal work-up" which will at least inform the patient whether they are likely to have a life-threatening disease.

Doctors are very good at detecting severe, life-threatening diseases that traditionally begin with rapid decline.

Often times unknown, unpredictable, or incontrollable nature of the MUS/MUPS can be as big a factor to the patient as the symptoms themselves, according to Dr. Dongwook Lee, Traumatic Brain Injury program director at General Leonard Wood Army Community Hospital.

Lee says it's important to consider multiple factors when dealing with MUS/MUPS and to stay upbeat and positive.

Also, he emphasized that the patient needs to build a strong, trusting relationship with their provider, openly and honestly discuss any health concerns they may be experiencing, and not overly focus on a cause or diagnosis.

Some patients prefer an alternative to traditional medicine. The holistic side of healing explores the mind, body and spirit connection, according to Dr. Debbie Love a psychologist at the Behavioral Health Division at General Leonard Wood Army Community Hospital.

Through the use of cognitive behavioral therapy, herbal supplements, nutrition changes, aromatherapies, acupuncture, spiritual healing, or a combination of these treatments, many come to the understanding that healing is a multifaceted process, said Love.

Patients seeking less conventional therapies to assist with their personal unexplained symptoms may choose to do so before, after, or coupled with other more traditional procedures, said Love.

The mind is a powerful tool in the process of healing, explained Love.

Correcting global, negative and often inaccurate thoughts are an important part of Cognitive Behavioral Therapy.

CBT focuses on examining the relationships between thoughts, feelings and behaviors. People who seek CBT can expect their counselor to be problem-focused, and goal-directed in addressing the challenging symptoms of many illnesses.

It is also very important for patients not to self medicate any symptoms they're experiencing through use of alcohol in conjunction with prescribed medications or take any prescription medications that belong to another patient. If a therapy seems to be unsafe, check with your physician.

While the internet also has an abundance of information, remember the plan you make with your provider is the best source for additional information or questions you may have in regard to your MUS/MUPS and how best to treat them.

(Editor's Note: Kenneth H. Reinhard is the TBI Program Liaison at General Leonard Wood Army Community Hospital)