Unclear physical complaints (functional physical complaints)

It is not always possible to find a medical cause for physical complaints. For example, many people have pain, digestive problems, or circulatory problems for which the cause is unclear. If the complaints persist, it is important to reconsider how you deal with stresses and conflicts.

At a glance

  • Some people have persistent physical complaints for which doctors cannot find a cause.
  • Complaints of unknown cause can be disconcerting – but they often disappear on their own after a few weeks.
  • If no physical cause is found, this does not mean that the complaints have no cause.
  • It is estimated that around 10 percent of the population have complaints whose causes cannot be clearly determined.
  • Severe psychological strain and stress can be the result if such complaints persist permanently.

Note: The information in this article cannot and is not intended to replace a doctor's visit and should not be used for self-diagnosis or self-treatment.


Unclear physical complaints (functional physical complaints)


What are functional body complaints?

Many people are familiar with complaints such as headaches, diarrhea or dizziness. While they can be uncomfortable, they usually go away after a while. There is often a specific reason for complaints that persist. Nevertheless, doctors are sometimes unable to identify a clear physical cause, such as inflammation or injury. These are referred to as functional body complaints.

It can be unsettling to have complaints whose cause is unknown. Often, however, the symptoms disappear again within a few weeks or they can be alleviated. Those who are affected by functional body complaints should try to remain active in everyday life and look for ways to cope with the complaints.

If functional body complaints last for a long time and are very stressful, those affected may be able to seek further help – such as support from a psychotherapist.

If at all, medications are of very limited help in the long run. For those affected, it can be very frustrating when doctors cannot find a cause for the persistent complaints. But it does not mean that the complaints are just imagination or that nothing can be done.

What are the symptoms of functional body complaints?


Unclear physical complaints (functional physical complaints)


There are many different functional body complaints. Common are:

  • Pain: especially headache, abdominal pain, back pain and muscle pain
  • Stomach and intestinal problems such as nausea, vomiting, flatulence, diarrhea and constipation
  • Circulatory disorders: They manifest themselves as drowsiness, palpitations and feelings of anxiety, among other things
  • Exhaustion, fatigue and lack of concentration
  • Dizziness
  • Shortness of breath or panic-like attacks in which breathing accelerates and deepens (hyperventilation)
  • Cramps and muscle tension
  • Sensory disturbances such as itching, tingling and numbness
  • Bladder complaints: such as a strong urge to urinate or painful urination

Physical symptoms may be accompanied by anxiety and depressive feelings. Some people with functional body complaints also feel foreign bodies inside them or feel something supposedly abnormal on their body.

Diseases such as fibromyalgia or irritable bowel syndrome can cause symptoms that are distressing but are initially difficult to explain. In such disorders there are therefore many similarities to functional body complaints.

What are causes of functional body complaints?

If no physical cause is found, this does not mean that there is no reason for the complaints. Often physical factors and psychological influences probably come together. This includes, among other things, excessive demands, previous illnesses, a family predisposition, difficult life circumstances or interpersonal conflicts.

People experience physical complaints with different intensity and deal with them differently. Some sufferers find them very severe and restrictive, others pay little attention to them. The extent to which functional body complaints affect life also depends on how the person affected deals with them.

Functional body complaints are also referred to because an organ may be healthy but still not function properly. For example, the intestines may be neither injured nor inflamed, but digestion still causes problems. The bowel may not function normally due to stress. Diarrhea, flatulence or constipation can then be the result.

How often functional body complaints occur?

It is estimated that around 10 percent of the population have complaints for which no clear cause can be found. Women are affected twice as often as men. One possible reason is that the perception of pain can depend on hormones, among other things. Social and cultural factors can also play a role – such as different role expectations and life experiences. Women are also more likely to seek medical help than men.

How functional body complaints develop?

As a rule, functional body complaints are harmless. They are often mild and temporary. In some cases, however, they are also very stressful and last for a long time. Functional body complaints can affect those affected both physically and psychologically. They can also restrict family and working life – or even make it impossible to carry out one's previous profession.

Many people with persistent physical complaints find it difficult to remain active. Often they also believe that they have to take it easy because of their complaints. This can lead to a vicious circle: Because certain problems often become even worse by taking it easy. This is the case, for example, with muscle and joint pain.

Severe psychological strain and stress can also result from permanent functional body complaints. Around half of all sufferers develop depressive symptoms or anxiety disorders.

However, many sufferers also manage to remain calm despite their complaints. It can be helpful to pay attention to the fact that the complaints change and are sometimes stronger and sometimes weaker. Optimism and confidence that the symptoms will subside can also help sufferers.

People with functional body complaints sometimes feel that doctors do not take them seriously and leave them alone. This may be one reason why sufferers seek medical advice frequently and often change doctors' practices.

Although functional body complaints can significantly impair the quality of life, they do not usually affect life expectancy. On average, those affected live just as long as people without functional body complaints.

How are functional body complaints diagnosed?

To diagnose the condition, the doctor first talks to the patient. A physical examination follows to determine the complaints more precisely. A blood test or ultrasound examination may follow. Afterwards, the doctor can often better assess whether a clear cause is likely and whether treatment is necessary. The first step in the examination is to look for common causes of the symptoms. The doctor also looks for indications of serious illnesses.

Whether further examinations or a referral to a specialist practice is necessary depends on several factors – for example, how severe the complaints are and how they develop. Since functional complaints often improve again after a few weeks, doctors may not immediately perform all the examinations that would be possible. Further examinations are often only made if the complaints last longer or worsen. It is rare for organic causes or a disease to be detected later.

Important to know: Not every possible investigation is useful. One reason: some examinations are associated with health risks. In addition, the risk of false suspicious findings increases with the number of examinations. In the case of false suspicions, an apparent cause is discovered, but it later turns out not to be true or harmless. The affected person can be unnecessarily worried by such findings. In addition, this can lead to unnecessary further examinations.

In case of persistent functional body complaints, it is important to stay in discussion with the doctor. Even if no clear cause is found, it is possible to discuss together what could be contributing to or aggravating the complaints. It can also be discussed what might help to alleviate the discomfort. The discussion with the doctor aims, among other things, to find a preliminary explanation for the complaints – but also to find treatment options and ways to deal with them better. These approaches can be reviewed and adjusted, if necessary, during further medical visits. This procedure also allows other explanations or courses of action to be considered. To look for explanations and sensible measures together with the doctor is often the best way in case of functional body complaints.

If the functional body complaints persist for a longer period of time and are very stressful, it may be useful to seek advice from a psychosomatic or psychotherapeutic practice or clinic. Psychosomatic facilities are usually specialized in the treatment of functional body complaints.

How are functional body complaints treated?

Complaints without a clear cause often improve within a few weeks, even without treatment. Doctors are therefore initially reluctant to provide treatment. If the complaints are minor, they often only give tips on how to deal with them better in everyday life.

Doctors often recommend a dental treatment for functional body complaints:

  • to be physically active.
  • to continue participating in social life, meeting friends and cultivating hobbies.
  • Recognizing and, if possible, avoiding overwork.
  • to clarify conflicts and to rethink the handling of burdens.
  • To observe what relieves the discomfort.
  • to pay attention to a healthy lifestyle and to sleep enough.

In certain cases, medication can also be a treatment option. They can be used, for example, for pain or gastrointestinal complaints – but usually only for a short time.

In some patients, the symptoms persist for a longer period of time or affect several organs. If they become a heavy burden, psychotherapeutic support may be useful. In certain cases, other approaches such as physiotherapy, nutritional counseling and occupational therapy are also possible. In addition, relaxation methods or mindfulness training can be tried out in order to cope better with the stresses and strains.

Important to know: For people with functional body complaints, it is more helpful to become active themselves than to passively rely on measures from the outside. Such measures include, for example, massages. If at all, they are only recommended as a temporary and supplementary measure. It makes more sense to look for activities that have a lasting effect: for example, more exercise and better stress management. Some sufferers first have to find their way through the process and be patient. Often they get used to it quickly and feel better. Sports activities should not be too demanding, but above all fun and positive experiences.

Those affected by persistent and severe functional body complaints usually need patience. Therefore, it is often useful to set small goals for yourself. It may also be advisable to work primarily towards leading an active life – despite the discomfort: in other words, to stay active, distract oneself, and initially just expect the discomfort to subside somewhat.

The main point of contact for functional body complaints are family physicians.

Many of them have the additional qualification "basic psychosomatic care". They are then trained specifically for this topic. If necessary, the doctor will coordinate the treatment with specialist practices or clinics.

For more in-depth information on issues with Functional Body Complaints and what can help, visit gesundheitsinformation.de.

Does rehabilitation make sense?

Few people with functional ailments need rehabilitation. However, it can be useful in case of incapacity for work, for example. Then rehab can help the individual return to work. But a rehab can have other goals, such as:

  • prevent the symptoms from worsening.
  • to encourage those affected to participate in social life.
  • to maintain the ability to work.

The focus of rehab can vary from case to case. Every rehab includes both physical and psychological measures.

Depending on the type and severity of health problems, outpatient or inpatient treatment may be appropriate. The German Pension Insurance is primarily responsible for medical rehabilitation. Sometimes, however, the health insurance or the statutory accident insurance are also the right places to turn to.

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