Medically Unexplained Physical Symptoms (MUPS)

Definition:

Medically unexplained physical symptoms (MUPS), or medically unexplained symptoms (MUS), is a term sometimes used in health care to describe a situation where an individual suffers from multiple physical symptoms for which the physician or other healthcare provider has found no physical cause. Up to 30% of all primary care consultations are patients with medically unexplained symptoms.[1] The term is commonly used to refer to Gulf War illness and more occasionally to other symptom-based diagnoses such as fibromyalgia, chronic fatigue syndrome, and multiple chemical sensitivity.[2] The term does not necessarily imply that a physical cause does not exist, and as more becomes known about a disorder (as is the case with chronic fatigue syndrome) it may be applied less often.

Mr Stefan Chmelik on Medically Unexplained Physical Symptoms (MUPS)

This term is now gaining increasing recognition and usage to describe people with groups of specific symptoms. Being diagnosed with MUPS tends to mean two things: it is a recognition that your problem is real, and not just in your head; you are unlikely to be suffering from a life threatening disease (but certainly from a quality of life threatening one).

You may well have had a previous diagnosis such as Chronic Fatigue Syndrome (CFS), Fibromyalgia Syndrome (FMS), Multiple Chemical Sensitivity (MCS) or one of several other acronyms.

The common factor is that people with all these conditions suffer distressing symptoms and consume large amounts of NHS resources in their search for explanation and support. They receive a poor response from the NHS, and are often bounced from one hospital speciality to another at great expense and without any benefit.

Compared to the general population and people with other chronic conditions, those with MUPS are affected more significantly by their health conditions and report higher degrees of discrimination due to health problems.

New Medicine Group has significant experience of supporting and assisting people who have been unfortunate enough to fall into this category. If you would like to know how we can be of service, we would be very happy to hear from you.

Dr Brian Kaplan on Medically unexplained physical symptoms:

The beauty of an holistic approach in medicine is that a medical diagnosis, while highly desirable, is not essential. Nevertheless, because I spend an hour on the first visit and 30-60 minutes on all other visits, I do have time to consider medical diagnoses that may have not yet been picked up. However, no diagnosis does not mean no treatment!

Homeopathy:

A medical diagnosis is not necessary for the prescription of a homeopathic remedy which is based on the totality of your symptoms. In other words, the remedy is chosen to suit your subjective experience of your illness. That is why homeopaths always ask patients about their feelings, moods, changes in tastes in foods, diet etc.

Autogenic Training:

Doctors agree that a huge amount of illnesses are caused or aggravated by stress. We don’t have to have a specific diagnosis to know if stress is a major component in a person’s life. If it is, a course in this powerful relaxation technique can have a major effect on your health – whether there is a medical explanation for your symptoms or not.

Nutrition:

Food and drink are both fuel and building blocks for the body. An improved diet can therefore initiate a much healthier person. Symptoms (explained or not) can disappear as mysteriously as they arrived when people start eating healthier.

Mr Bevis Nathan on Medically unexplained physical symptoms

If we look at a list of medically unexplained symptoms, they tend to fall into three categories. One, disorders which modern medicine does not recognise. Two, so-called psychosomatic illness. Three, post-traumatic disorders. Very often, symptoms fall into two or all of these categories!

If you have problems which:

• are difficult to explain in ordinary medical terms, or
• seem resistant to treatment, or
• for which there seems not to be a suitable treatment, or
• get better and then are mysteriously replaced with other symptom somewhere else in the body,

... then the most likely explanation is that you have some kind of after-effect of trauma ? category three.

But some symptoms are actually far more straight-forward, and are simply missed by ordinary examination techniques ? category One. For example, I recently was asked to see a man who has had face pain and face tingling across his cheeks and nose for five years. At first it was assumed he had chronic sinusitis. He?d had his skull x-rayed, CT-scanned, MRI-scanned, he?d been blood-tested - the lot. No evidence of anything wrong with sinuses, skull bones or facial nerves. But when I examined the top of his neck very carefully I found an obvious disturbance of function that, when tested for mobility, reproduced the symptoms. When I gently prised apart the impacted joint, the symptoms lifted. He remembered a neck injury that had caused temporary headaches several years ago. It had caused a semi-permanent neck problem that he simply hadn?t felt, because the other neck joints worked perfectly. It?s not widely understood that pain and other sensations can be ?referred? to the face by problems in the neck. No-one had ever looked at his neck. There is a saying that the last physician on the scene is always the cleverest! But that?s because (s)he looks at the things other doctors haven?t yet.

And then there?s category two. It could be that the unexplained symptoms are caused by the effects of stress, anxiety, depression, unrecognized extreme long-term tiredness, or even un-resolved relationship problems that leave a kind of stuck emotional state. This category is a very important cause of persistent unexplained symptoms. It works this way: the part of the brain that organizes emotional states and how we feel, and how we deal with these feelings, also runs the quality of nerve activity in glands and muscles (and other tissues) throughout the entire body. The whole point of emotions is to alter our behaviour. So emotional responses affect most if not all body processes. The brain expresses itself through the body. It?s kind of obvious. But many people need permission to have a physical symptom caused by an emotional process, because they might feel it?s not a proper illness. But it is. Many of the most debilitating problems are in this category. Or partly in this category.

I would say that my expertise lies in the diagnosis of problems in these three categories. If I think I have the right skills to help, I?ll use a combination of Somatic Experiencing and Osteopathy. If not, I?ll refer you to one of my colleagues at the New Medicine Group who I?m sure has the skills to help you.