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Information from Your Family Doctor
When You Have Chronic Unexplained Medical Problems
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Am Fam Physician. 2000 Mar 1;61(5):1431-1432.
See related article on somatizing patients.
People with chronic unexplained medical problems may have a condition that is called “somatization.” These people are usually more sensitive than the average person to changes in the way their body works. If you have this condition, you may have pain or other symptoms. Sometimes the symptoms last for years. This is a common problem, but people working in health care don't fully understand it yet.
We do know that chronic unexplained medical problems are not dangerous to you even though they cause you great discomfort. We also know that the problem is not “all in your head.” We know that your symptoms are real, and that they cause real problems in your life.
What causes chronic unexplained medical problems?
Some people are extra sensitive to changes in their body. Stressful life situations can make that sensitivity stronger. People who have been hurt, emotionally, physically or sexually, may get physical symptoms that can't be explained. The symptoms can get better when these people get help for their emotional pain.
What are some of the symptoms of this condition?
Many people with chronic unexplained medical problems have mild to severe pain or other problems in several areas of their body. You might have a combination of the symptoms in the box below.
Pain all over
Pain in your legs
Pain when you urinate
Stomach (or belly) pain
Bloating and excessive gas
Nervous system symptoms
Loss of voice
Double or blurred vision
Irregular menstrual cycles
Burning feeling in sexual organs
Pain during intercourse
(a syndrome is a collection of symptoms in one area)
TMJ pain (TMJ stands for temporomandibular joint, the place where the jaws come together)
Irritable bowel syndrome
Chronic fatigue syndrome
PMS (premenstrual syndrome)
Does depression cause this problem?
People with your condition may have depression or anxiety. Many people with other illnesses also feel depressed or anxious. If you are depressed or have anxiety, your doctor may want you to take medicine and get counseling.
How do I know I don't have a dangerous health problem?
Your doctor will see you regularly, to look you over and ask you questions about how you feel. If you keep seeing your doctor, new problems will be found right away. Tests are only needed sometimes. Too many tests may cause discomfort and more anxiety. They might even lead to allergic reactions or other problems.
Do I need an operation? Don't I need to see a specialist?
Your family doctor will know you well and will know if you need an operation or if you should see a specialist. Regular visits to a doctor who understands you and your problem can help you feel better.
Should I be taking medicine?
Sometimes medicine can help. Your doctor might suggest that you take an antidepressant. This kind of medicine might help your pain even if you aren't depressed.
Narcotic medicines will not cure your problem and can be addictive. These medicines also have side effects, like constipation, sleepiness and poor memory. These side effects might make you feel worse.
What else can I do to feel better?
Many people find that regular exercise makes them feel much better. Do some exercise you enjoy, like walking or swimming, at least three times a week, for at least 20 minutes each time.
Take time out for yourself, to do something that you enjoy. You may also want to try massage therapy, acupuncture or biofeedback.
Joining a support group and talking about your problems can also make you feel better.
If you try these things, your pain may not go away completely, but you should be able to get along better in your life. You have put up with this problem for a long time. It has taken a lot of strength. Maybe you did not know you had this much strength. You also have the strength to make your day-to-day life better. This will be easier to do if you keep seeing your doctor on a regular schedule.
This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
Copyright © 2000 by the American Academy of Family Physicians.
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