Medically unexplained symptoms
Medically unexplained symptoms are persistent physical symptoms, that do not appear to be linked to a medical condition. They can impact people’s ability to function and not understanding the cause can make them harder to deal with (NHS, 2023). This term is used as it the most widely recognised, although we acknowledge that patients may prefer other terminology (Marks & Hunter, 2015).
- More than a quarter of primary care patients in England have medically unexplained symptoms such as chronic pain, irritable bowel syndrome, or fatigue (Public Health England, 2019). In secondary and tertiary care, around 1 in 3 new neurological outpatients have symptoms thought by neurologists to be ‘not at all’ or only ‘somewhat’ explained by disease (Public Health England, 2019).
- Persistent physical medically unexplained symptoms are important as they are common, and without appropriate treatment, the outcomes for people with these symptoms are poor (Public Health England, 2019). Patients with medically unexplained symptoms often have poor experiences of healthcare and poor quality of life, benefitting less from treatment and incurring high healthcare costs (Hartman et al., 2017).
Treatment for medically unexplained symptoms
People experiencing medically unexplained symptoms are often referred for multiple assessments and investigation, which can cause harm to individuals (Naylor et al., 2016) and is estimated to cost the NHS £3 billion, around 10% of total NHS expenditure on services for the working-age population (Public Health England, 2019). The needs of people with these symptoms vary substantially (Naylor et al., 2016).
- Persistent physical medically unexplained symptoms are generally managed with limited psychological support (Public Health England, 2019). Without appropriate treatment, outcomes for many patients are poor (Public Health England, 2019).
- The King’s Fund highlights that GPs can play an important role in supporting people experiencing persistent medically unexplained symptoms, by exploring relevant psychosocial factors and acknowledging the impacts of physical symptoms (Naylor et al., 2016).
- People with more complex symptoms may require multi-disciplinary support (Public Health England, 2019). This will enable people to access the services most appropriate for their problems, resulting in improved outcomes for patients and substantial cost-savings for the healthcare system (Public Health England, 2019).
Additional resources
References
Full list of references is included at the end of this chapter.