Medically unexplained physical symptoms, misunderstood and wrongly treated? A semiotic perspective on chronic pain

Area of Science:

• Integrative medicine
• Philosophy of medicine
• Biosemiotics

Background:

• Medically unexplained physical symptoms (MUPS) are increasingly prevalent in Western societies.
• Chronic pain is a significant component of MUPS, challenging traditional biomedical explanations.
• Current biomedical models have limitations in addressing the complexity of MUPS and chronic pain.

Purpose of the Study:

• To explore the utility of semiotics, an anti-dualistic meta-theory, for understanding MUPS and chronic pain.
• To propose an expanded framework for viewing the body and symptoms by integrating natural science and humanities.
• To enhance clinical encounters for patients experiencing unexplained chronic pain.

Main Methods:

• Conceptual analysis applying semiotic principles to the understanding of body and symptom.
• Examination of self-referential signs as internal bodily communication and warnings.
• Integration of evolutionary and existential perspectives on the human body.

Main Results:

• Semiotics bridges the gap between natural science and humanities, offering an integrated view of subjective and measurable aspects.
• Self-referential signs can signal when an individual's actions conflict with their physiological or psychological needs.
• Existential conditions can activate bodily defense systems, reframing unexplained pain as a functional warning sign.

Conclusions:

• A semiotic perspective provides a more comprehensive understanding of MUPS and unexplained chronic pain.
• This approach facilitates the integration of biological and experiential dimensions of symptoms.
• Semiotics offers valuable insights for physiotherapists, potentially improving patient care and clinical interactions.