Medically Unexplained Physical Symptoms

This short document will discuss Medically Unexplained Physical Symptoms (MUPS) and some of their effects on the afflicted. It is not a medical discourse. It will therefore employ a demotic language rather that specific iatric terminology.

The term Medically Unexplained Physical Symptoms is a reference made to symptoms that are experienced by
patients, without an overt display of ailment. Fibromyalgia, Multiple Chemical Sensitivity, and Gulf War Syndrome are examples of such ailments, which can affect a person without a clearly identifiable causation. The afflicted may suffer from diarrhoea, widespread pains, and irritable bowel symptoms (Wiki, 2012). These symptoms are real and affect the patient’s standard of living in a number of ways. They may also range from intermittent to very frequent in their occurrence. The severity of debility could also be graded according to how it confines the patient’s well-being and lifestyle. It can be inferred that a patient suffering from severe general pains and fatigue will be limited in the range of activities they may be able to undertake.

Severe symptoms can affect a patient’s life on a daily basis. A patient suffering from nausea would require a helper when showering to avoid falling over and hurting themselves. Such severe symptoms may also be a health and safety consideration, when occupational tasks are being considered. A fire-fighter with severe fatigue symptoms may be considered unsuitable to drive a large and heavy vehicle to an emergency. This is in contrast to driving their own vehicle, which gives them the flexibility to stop if so required.

Unlike most illnesses, MUPS show no overt signs like a broken limb. The most problematic issue for its sufferers is its lack of aetiology. In many cases, this can cause a problematic relationship between the patient and the health care professionals. Progress is being made, nevertheless, and international speakers are visiting the UK to help with research into the treatment of fibromyalgia (Fibromyalgia Association UK, n.d.). The condition is now being recognised and it is suggested that 1 in 25 people suffer from it (Arthritis Research UK, 1998-2011).

Patients also run the risk of not being understood by their colleagues and supervisors. Statements such as ‘I too feel like falling asleep’, may have a negative effect on the patient. It may also put undue mental pressure on them to believe that it all in the head. Fibromyalgia is a real debility. The NHS recognises it (NHS Choices, 2010) and gives advice about it.

MUPS patients can be susceptible to depression, which may spiral some of the physical symptoms. Cognitive Behaviour Therapy is a method employed and now favoured by the NHS to help patients focus on their thoughts, mental images, and behaviours (NHS Choices, 2010). It concentrates on the behaviours employed by the patient and looks at ways of evolving a positive and constructive way of dealing with situations that might be perceived as problematic. An example of this might be the avoidance of certain activities, when the opposite might be more constructive (Mind, 2012). CBT in most cases can be effective to help a patient take control of his thoughts, but it will not solve long-term physical ailments.

In conclusion, Medically Unexplained Physical Symptoms are real and often quite severe, affecting the patient’s quality of life in a number of ways, without being overtly visible. Their lack of aetiology can be problematic for the sufferer, who might look for medical answers. It might also affect their wider relationships if the sufferer is not treated with empathy. This includes consultations with their medical advisor. Research is being undertaken to understand treatment thereof and attitudes are changing. One way forward is CBT, which might empower the patient to develop solutions for depression affliction.

What are your views and experiences on this complicated and debilitating condition?


Fibromyalgia Association UK, Dr. Andrew Holman talks about Fibromyalgia,, accessed 29 June 2012.

NHS Choices, Cognitive behavioural therapy - How it works, last reviewed 07/07/2010– next review date 07/07/2012, , accessed 29 June 2012.

NHS Choices, Symptoms of fibromyalgia, last reviewed 31/03/2010 – next review date 31/03/2012,, accessed 29 June 2012.

Wikipedia, Fibromyalgia, last modified on 28 June 2012 at 18:44,, accessed 29 June 2012.

Wikipedia, Gulf War Syndrome, last modified on 23 June 2012 at 13:54,, accessed 29 June 2012.

Wikipedia, Medically Unexplained Physical Symptoms, last modified on 8 May 2012 at 11:07,, accessed 29 June 2012.

Wikipedia, Multiple Chemical Sensitivity, last modified on 26 June 2012 at 06:23,, accessed 29 June 2012.


  1. MUPS are situations that expose the fact that Western Scientific Medicine is not perfect, not omnipotent and does not possess all the tools or even the only box of tools with which to access explanation.

    And sometimes it is just the variable levels of knowledge individual practitioners have to call on when presented with the questions they fail to answer.

    For example, sometimes Irritable Bowel Syndrome is not that. It is Small Intestine Bacterial Overgrowth, baboom. Caused by digestive problems starting in the stomach - themselves caused by lots of different things affecting that goes on.

    1. I agree. There are no definitive answers, and maybe never will be any.


  2. I really loved the paragraph about depression. I don't think we talk about that enough. There is such a stigma in the U.S. When the DSM-V announced proposed changes to highlight the somatic affect patients were up in arms in part, I believe, it is because no one wants to be labeled with a mental illness. Especially in the case of fibromyalgia where we fight so hard to convince people it is real, the notion of somatization cannot even be discussed rationally, in my experience. However, many patients self-report somatic affects.

    There were things I think were a stretch especially people with nausea needing a helper to shower. But the example of the firefighter was spot-on perfect! Great analogy! Overall, it's a good article.

  3. I believe that an international conference was held in the UK last year to try and identify what causes FM/CFS/ME.

    A couple of weeks ago though, I heard that there was talk of classifying them as mental disorders. That would be a bleak day, if it were to happen. I believe we would be looking to 'blame' the patient rather than try to unearth the root of the issue.