Medically unexplained symptoms (MUS) treatment
Medically unexplained symptoms (MUS) is a diagnosis which is made when you have persistent physical problems such as headaches, dizziness or pain which don’t seem to match any recognised medical condition.
All medical disorders have both physical and psychological causes. Our state of mind has an important influence on how we experience physical illness. Symptoms of common physical disorders such as asthma, diabetes or arthritis, are strongly influenced by our mental state. Our state of mind has an impact on our immune system and on the levels of hormones such as cortisol in our bodies.
Being diagnosed with MUS is not uncommon, with around a quarter of people visiting GPs expressing symptoms which can’t immediately be diagnosed as a recognised medical condition. This doesn’t mean that your situation cannot be treated; it requires looking beyond a diagnosis of physical illness.
Priory’s nationwide network of hospitals and wellbeing centres offers flexible mental health treatment and support services including talking therapies that have been shown to reduce the intensity and frequency of physical complaints (in those with and without diagnosed physical disorders), and improve your ability to function daily without the associated symptoms of MUS.
We have an Early Detection of Medically Unexplained Symptoms Service, which is now available across 20 of Priory’s hospitals and wellbeing centres and provides access to expert therapists that are experienced in treating MUS.
The link between mental health and physical symptoms
Many people with MUS who report symptoms such as joint or muscle pain, fatigue or heart palpitations are often found to have mental health conditions such as anxiety or depression. Therefore, treating the associated symptoms of these mental health disorders can help to relieve the physical symptoms that you are experiencing.
Sometimes referred to as ‘functional symptoms’, MUS are physical complaints which last for more than a few weeks, and which have no link with a diagnosed physical problem. When you don’t understand the cause of your symptoms, this can lead to feelings of distress and uncertainty which can affect your ability to function in everyday life.
When usual diagnostic procedures such as blood tests, x-rays and scans have been inconclusive and the pain that you are experiencing doesn’t go away, it could mean that a psychological problem may be causing your physical discomfort.
Treatment for MUS
Physical symptoms without a diagnosed cause are very distressing. The pain experienced is as real and as distressing as pain from any other cause, as is the lethargy. These symptoms often result in secondary depression and anxiety, and saying that these symptoms are ‘all in your head’ is both incorrect and unhelpful.
Cognitive behavioural therapy (CBT)
CBT uses problem solving techniques to help you to understand and manage your symptoms, as well as working through how mental health conditions such as anxiety and depression could be causing your physical complaints. Through learning new methods of coping with distress and worry, it is possible that the physical pain that is associated with your diagnosis will begin to improve.
Mindfulness is accepted as an additional treatment to CBT for reducing the symptoms of MUS. This involves elements of CBT, with the addition of current psychological methods that can teach you to be present in the moment, as opposed to dwelling on what may or may not happen in the future.
Using breathing and meditation techniques, you will begin to learn how to clear your mind of negative thoughts which may be contributing to the preoccupation and health anxiety that is experienced if you have MUS.
Behavioural activation is a focused way of scheduling activities and creating positive routines each day. It is believed that a more positive frame of mind can improve your self-confidence and sense of wellbeing, thereby contributing to an improvement in symptoms and a proactive approach to facing life’s challenges.
Particularly if your symptoms of depression and anxiety are chronic, medication may be used alongside psychotherapy to help to improve MUS.
Selective serotonin reuptake inhibitors (SSRIs) can be used, as can other antidepressants and anxiolytics. These reduce both depression and anxiety.
This page was clinically reviewed by Dr Leon Rozewicz (MBBS, FRCPsych, MRCGP, MRCPsych) in August 2020.