“Why can I not find the cause of my patient’s pain?”

This is a question I hear a great deal from Family Medicine Doctors. For many doctors with patients like these, it's hugely frustrating. Imagine, then, how you and your patients would feel if you could find a way to provide better outcomes for them.

Written BY

Dr Angela Cooper

Head of Experiential Discovery

All author's posts

September 3, 2019

 …This is a question I hear a great deal from Family Medicine Doctors.


I’m Dr Ange Cooper, a clinical psychologist based at the Centre forEmotions and Health at Dalhousie University in Halifax, Nova Scotia, Canada.I’m also Head of Experiential Discovery at EmotiHealth in Birmingham, UK.

One of my areas of specialism is helping doctors and healthcare professionals to understand and master Medically Unexplained Symptoms (MUS).


During my recent role as a Psychologist for a Medically Unexplained Symptoms service, I supported Doctors across two family medicine clinics in Canada.

Unexplained conditions can be a source of sadness and frustration for physicians (and, of course, their patients) who have been, for the most part, trained to find medical problems when a patient comes to them with physical, bodily symptoms.  


In fact, statistics suggest that anywhere between fifteen to fifty per cent of patients attending primary care will present with symptoms that do not have a clear biological or medical origin (Dwamena, 2009; Haller et al., 2015;4 Weiland et al.,2015).

Even with the most modest statistics, that’s still a lot of people in pain… and a lot of physicians wondering what to do next. After all, these people will still come to you for help as they are wanting their symptoms and distress to reduce.  


For many doctors, unexplained conditions are hugely stressful. Imagine, then, how you and your patients would feel if you could find a different way to understand these symptoms and provide better outcomes.


If you would like to develop a wider understanding of what might be driving these symptoms, keep reading.

Over a series of posts I’ll be giving you a brief introduction to Medically Unexplained Symptoms. I’ll talk about common symptoms, what might be causing them, introducing you to the mind-body connection, exploring the link between adverse childhood events (ACEs) and physical symptoms, and how to recognise when a symptom might be a signal to look for a deeper emotional cause.  


So, what symptoms, despite physical investigations, might continue to be ‘medically unexplained’? This means that the root cause cannot be determined medically.


The most common include:

·      Chronic tension headaches and migraines

·      Chronic bodily pain, especially back pain, neck pain, chest pain and syndromes such as Fibromyalgia

·      Chronic abdominal or gynaecological pain or symptoms such as IBS, Vulvodynia, Dyspesia and Irritable bladder syndrome

·      Chronic insomnia

·      Persistent fatigue

·      Dizziness, blurry vision or unexplained neurological issues


It is important to note that ALL of these symptoms can have a medical basis. What we are referring to in this post are symptoms that have been medically investigated and these investigations draw a blank. In these cases, it might be that you have been looking in the wrong place. With a different understanding, you may be able to provide an explanation for these symptoms after all.


Read my next post to delve deeper into the mind-body connection. Let's see if, together, we can begin to explain the 'unexplainable'!

The Chronic Pain Cycle Explained (Infographic)


Click here to learn about the courses and workshops we run to help health care professionals master medically unexplained symptoms and achieve better outcomes for their patients.

Further Reading
Explaining chronic bodily symptoms (infographic)
What causes chronic symptoms when there's no obvious physical explanation, even after extensive medical investigations?
September 4, 2019
I'm a tug boat. Who knew!
Co-creating change and never giving up.
July 5, 2019