Understanding Medical Unclassified Symptoms (MUS), Does Mental Health Play A Role? – Guest Blog Post By Rosie Allden
Have you ever suffered lower back pain or pain in general that you can’t explain? An enduring headache that aspirin or ibuprofen won’t kick? A change in your inner works?
Then a few days, a week, a year later it resolves itself? Or maybe its ongoing and your doctor is stuck of how to help? You may have had or have what is termed a medically unclassified symptom.
Physical complaints without being explained by a sports injury or biological cause can be classified as medically unclassified symptoms (MUS). MUS are any physical complaint without any found organic cause or pathology and account for 1 in 5 general practitioner consults in the United Kingdom.
MUS has its own thesaurus of names explaining the same phenomena: somatisation; functional somatisation; psychosomatic and functional symptoms.
Further classified into a number of disorders: somatic symptoms disorder; somatoform disorder; functional somatic syndrome; bodily distress syndrome; functional disorders; and conversion disorder, all disorders denoting physical symptoms with no identifiable cause and un-diagnosable by any medical test.
Then a spanner in the works with functional neurological disorder (FND), that poses physical symptoms to be caused by the nervous system, rather than physical or neurological disorders.
All the disorders are arguably contested illnesses, illnesses not taken seriously in medicine due to no pathological explanatory basis, despite its impact on individuals functioning.
A number of symptoms fall under this bumbershoot; muscular, joint and back pain, the chronic of which is increasingly termed fibromyalgia, a condition of enduring pain; headaches; heart palpitations and chest pains; irritable bowel syndrome; faintness; and tiredness, associated and in chronic cases diagnosable as chronic fatigue syndrome (CFS) also known as myalgia encephalometric (ME), extreme fatigue.
A proposed 1.5 to 2 million people in the U.K have fibromyalgia and 260,000 individuals have CFS with a trend of incidences between the two and further co-morbidities with other health difficulties.
A number of theories pose to explain these difficult disorders and include traumatic injury, arthritis, autoimmune and, or nervous system abnormalities, although remain inconclusive.
This blog will emit fibromyalgia and CFS, as they are independently recognised disorders and will focus on other MUS symptomology that remain an enigma in the biomedical texts.
The surge of unidentifiable symptoms has been recognised in Germany with the division of mental health care into psychiatric and psychosomatic, the U.K in comparison operates from the dual model of physical, with various specialities and mental (psychiatric) health.
Interestingly individuals with psychological distress will present with unexplainable physical symptoms and similarly, those suffering stress will demonstrate similar physical complaints with chronic stress acting as a catalyst in a number of illnesses.
We have all undoubtedly heard of the brain-gut axis, the communication of brain to gut and gut to the brain; gut microbes attributable to our mental health and counter to this mental health associated with irritable bowel syndrome.
Then there are the less common brain-uterus, for both sexes, there is the hypothalamic-pituitary-gonadal axis, which keeps our reproductive centres and immune systems in check.
We as a species are a mind-field of axes in the conjunction of physical and psychological health and is levelled-up or levelled-down as a result of our endocrine system, our perfume centres spritzing out hormones.
When stressed cortisol prepares our innate autonomic nervous response of either fight, flight or (a less effective survival instinct if you’re not a possum) freeze, either to conserve the energy to at some point leg it or conjure the energy to fight.
Unfortunately, in this stone-age, we can’t fight it out with other humans (it’s not an accepted practice) nor can we set fire to our workload, walk away from our desks and be done with it.
This primal response is synched with the tenth cranial nerve (vagus nerve) (known as the polyvagal theory), this nerve sends messages from your brain to your heart, lungs and digestive tract.
Picture this, you are about to do a speech to a large group of people, before stepping out your heart beat increases (circulating the blood to all extremities, including feet, essential for the flight component), your breath might quicken and shorten and your tummy knots (the expression ‘bricking it,’ is literal).
Congratulations your nervous systems are working, and after the speech, your cortisol will ease up on the ninja grip and you will go back to an equilibrium.
In the potentiation of stress may mean this equilibrium isn’t restored and remains on full volume (this is the case in PTSD), whilst one night of not sleep fretting about the presentation tomorrow, a week, a month of not sleeping impacts individuals’ health.
Stress has been linked to not just insomnia but asthma; brain shrinkage and memory loss, a catalyst in the development of Alzheimer’s; circulatory problems; gastrointestinal disorders; hypertension; cardiovascular diseases, to name a few, let alone depression, anxiety and headaches from the stress of it all.
The use of stress management mediates our heightened responses into the awareness that it is unlikely that the audience you are presenting to is going to go after you with pitchforks and this can be aided with the likes of cognitive behavioural therapy (CBT).
Generally, if we are stressed we are somewhat psychological distressed and if we are psychologically distressed we will be stressed. An example of a nervous breakdown whilst donating a psychological state is a result of a number of stressors, neither is exclusive.
The therapeutic techniques of CBT and similar, are psychological techniques found effective in the management and mediation of pain and in the symptoms associated with MUS.
The enigmatic circumstance of MUS may well be the mysterious soup of our body’s response to psychological distress and stress with the endocrine and nervous systems responding appropriately or not, affecting our physical health.
This blog touches on only one of our motion centred room odourise going off (cortisol), we have a collective of 50 different hormones simultaneously operating all at the same time… Giving rise to potential toxic chloroform to our body’s regular functioning.
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