“Hey doc, I have this pain in my back and I don’t know why?”

Chances are, your doctor may not know either.

One study (2011, 620 German primary-care patients,  Journal of Psychosomatics) estimates that up to two-thirds of patient pain complaints are unexplained.  Other reports seem to confirm this idea that pain can’t always be explained. In part, this may be due to patients having more serious psychiatric illness or somatic disorders (involve anxiety) that are not always front and center.

The most common symptoms of unexplained pain are headaches, back pain, fatigue, abdominal pain, and dizziness.  The goal in working with these symptoms isn’t necessarily to remit the pain, but help people live with it. We know that paying attention to symptoms can often make them feel worse.

And sometimes these symptoms are what we call “health seeking behavior” meaning something more psychological may be going on and needs to be treated. In fact, a 2006 study in the Journal of General Internal Medicine found that 60% of patients who averaged 13 visits to their doctor in a year had underlying major depression.

What helps is cognitive behavioral therapy and relaxation training. These can ease symptoms and improve a person’s mental health, as well as reduce the number of doctor visits. The goal in using these approaches is to help a person rethink his/her beliefs about pain and learn to distract from the pain.

In reality, most people live with unexplained pain and can still be in good health. So even though you can’t always explain away pain, you can still learn to reduce your anxiety over it, not ruminate over it and distract yourself from making the symptoms worse.