Detailed guides to painful problems, treatments & more

Don’t “push” for a diagnosis

 •  • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

Undiagnosable health problems are amazingly common. In the health care business, they are called “medically unexplained symptoms” (MUS), and chronic pain is probably the most common MUS subcategory. Many people with puzzling pain go see several healthcare professionals and get quite frustrated by the lack of clear answers. They often have high expectations of medical specialists as troubleshooters, at first, and are disappointed to discover that specialists seem reluctant to wear that hat. One common reaction is to push for a diagnosis, to get ornery, to demand diagnostic satisfaction.

Which usually backfires.

The problem is that specialists have great excuses and valid motives for passing the buck, and so they do, and they will do it all the quicker if you “push” them for help.

Every specialist is, by definition, an expert in the problems in their field that they can diagnose and treat, and they are very busy doing it too. When you present them with a problem that isn’t on that fairly short list, something they sincerely do not know how to diagnose and treat, they can honorably recuse themselves. It makes a lot of sense from their perspective: declaring that your odd problem is out of their scope of practice is far safer and easier than the risk and hassle of trying to figure you out. If you “push,” most specialists will quickly decide that they really want you to be someone else’s problem. They will pass the buck and sleep well that night.