Medically unexplained symptoms (MUS) is a term
commonly used for persistent bodily complaints for which adequate
examination and investigations do not reveal an underlying
pathology. That is, they are troublesome physical sensations that
do not have an explanation in current disease models.
Although a contentious term, MUS is one that is understood by
most physicians. We will use it here to include functional somatic
syndromes (FSS) and other newer descriptors, such as somatic
symptom disorder (SSD) and health anxiety, which will be explained
In practice, despite having a strong suspicion that there is no
serious medical problem, physicians are trained to investigate
symptoms and some can see this as their only role in these cases.
However, as well as the desire to provide the best possible care,
physicians may be driven by a worry about missing something serious
or may not feel skilled at 'explaining the unexplained'
satisfactorily to patients. Either way, they may be left with a
sense of dissatisfaction about their management.
Patients with so-called MUS often report feeling unsupported and
confused. These dynamics can often lead to extensive, unproductive
and expensive investigations, with patients feeling no better and
clinicians feeling frustrated.
The aim of this module is to enhance physicians' knowledge and
confidence in dealing with patients with MUS. Skills required
in interviewing patients who do not appear to have organic
pathology are outlined, and information on managing patients
presenting with these symptoms is discussed towards the end of