title: [Chronic muscular pain is not unexplainable].
abstract: BACKGROUND
  Patients with chronic muscular pain suffer from extensive symptoms although test results are normal. Symptoms considered as "unexplained" are not necessarily unexplainable. Recent research provides relevant frameworks for understanding the interaction of bodily and mental processes and life conditions. Such perspectives can be used as a point of departure for understanding and change of conditions shaping vulnerability and resistance.
  
  
  METHODS
  The article presents a summary of theoretical perspectives, empirical findings, and clinical experience, with a discussion of how this body of knowledge can be applied in clinical practice.
  
  
  RESULTS
  Distress can lead to dysregulation through spinal sensitization and sustained arousal. Psychoneuroimmunology describes how subjective experience, emotions, cognitive functions, the nervous system and physiological stress reactions interact to restore balance through complex signal systems. Responses are influenced by emotional and cognitive processes, dependent on individual vulnerability and strength. Phenomenology focuses on life circumstances, meaning, and interpretation of bodily signals. Through acknowledging patients' experiences doctors can shift the attention from shame to coping.
  
  
  CONCLUSIONS
  Chronic muscular pain can be explained by the interaction between body, mind and life circumstances. Searching for simple causalities and consistent findings will provide no benefit. Instead, we should encourage coping strategies with the capacity of breaking vicious circles that maintain symptoms.
authors.affiliation: Allmennmedisinsk forskningsenhet Bergen, Unifob Helse, Kalfarveien 31, 5018 Bergen, Norway. kirsti.malterud@isf.uib.no
authors.forename: Kirsti
authors.initials: K
authors.lastname: Malterud
mesh_terms: D002908:Chronic Disease; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D006801:Humans; D009140:Musculoskeletal Diseases / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D010146:Pain / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000209:etiology; D013001:Somatoform Disorders / Q000175:diagnosis / Q000209:etiology; D013315:Stress, Psychological / Q000150:complications