Introduction

Medically unexplained physical symptoms (MUPS) are when someone suffers from physical symptoms for which no underlying physical cause can be found.

About one in 10 children and adolescents suffer from this condition. Common symptoms are headaches, stomach aches, joint pains and tiredness. Less commonly, young people can have significant unexplained physical symptoms, including muscle weakness, collapses, 'fit-like' episodes, and severe and chronic pain.

What are the causes?

Physical illness or injury may be a factor at the beginning, but when no obvious physical explanation can be found, emotional or psychological factors need to be thought about.

These problems are more common in children and young people who:

• Are feeling stressed, for instance about moving schools, friendship problems or not managing school work
• Are very sensitive to physical symptoms and pain
• Are very sensitive to others
• Have low self-esteem
• Tend to be fussy or perfectionist
• Are very anxious and worry more than most
• Worry continuously about the symptoms and their effects on everyday activities – this can cause the symptoms to continue, and even get worse.

Unexplained physical symptoms may also be part of another psychiatric condition, such as depression or anxiety. There may also be a family history of unexplained physical symptoms.

How is it treated?

A planned approach to treat the symptoms is important. The aim of the treatment is to help your child to recover gradually by creating more effective ways of coping with the symptoms, and getting back to a normal daily routine.

Everyone needs to work together as a team towards the same goals: you, your child, the paediatrician, psychiatrist, general practitioner and school may all need to get involved.

It can be helpful for everyone involved in helping the child to meet and review their progress from time to time. This allows ideas to be shared about the best ways forward – physical, psychological and educational.

Caring for a young person with unexplained physical symptoms can be very stressful. Family life can become dominated by your child’s difficulties. Parents will need to be caring, but also determined and positive even when things seem bleak and uncertain.

Treatment is best done with active participation from the family. It will involve:

• Finding ways of paying less attention to the symptoms
• A small, but steady, increase in everyday and social activities
• The young person will be encouraged to do more for themselves and to regain their confidence and independence
• Asking teachers to help with looking at ways of overcoming any school or education problems.