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Complaints and pain with no apparent physical cause in children

Some children suffer from long-lasting discomforts, such as headaches, fatigue, muscle aches, dizziness, or abdominal discomfort, without the pediatrician being able to assign a physical cause. Complaints that last more than a few weeks and that cannot be explained, you can know exactly what it is and what you can do about them here.

What is SIEP?

Somatically Inadequately Explained Physical Complaints. These are persistent physical discomforts that limit your child’s daily life and cause many problems, but in which no medical diagnosis of a disease or disorder has been found after a medical examination. It can involve all sorts of ailments, from abdominal and headache pains to chronic fatigue. These are symptoms that persist for at least a few weeks continuously or for periods.

Ailments for which no physical cause is found are also called functional ailments (because a function of the body is disturbed) or psychosomatic (physical ailments that are related to psychological ailments). The term psychosomatic complaints do not mean that complaints are made up. Sure enough, there are real complaints (of pain). It is important that complaints are acknowledged and taken seriously. But having pain and/or discomfort does not necessarily mean that there is tissue damage or disease.

Chronic pain has more to do with how the brain and nervous system continue to “transmit” pain. Several factors can influence its appearance. Fortunately, this ailment can be treated in different ways.

Complaints in children and adolescents

Anyone can develop this ailment at any age, but it usually begins in childhood or adolescence. The most common complaints in children and adolescents are chronic stomach pain, chronic headache, chronic joint or muscle pain (back, neck, arms or legs) and chronic fatigue. Sometimes a child has only one complaint, but sometimes it is a combination of complaints. In boys, it is equally common in boys and girls, but from puberty, it is diagnosed more often in girls.

Consequences on children

If a child or adolescent suffers from symptoms for an extended period, this can have a significant impact on their daily lives. For example, children with this ailment may stop going to school, meeting friends, or playing their hobbies or sports because of their symptoms. As a result of avoiding activities, the child’s overall health deteriorates further and he loses confidence in his body. This can create a negative spiral.

Sometimes children with this problem encounter a lack of understanding on the part of their parents or arguments arises within the family. Therefore, it can lead to social isolation, anxiety and/or depression in the child. This, in turn, can worsen physical symptoms, as if a child feels bad mentally and emotionally, this can also affect their body.

Recognize your child’s symptoms

We can’t talk about the “symptoms.” One child may have chronic neck pain, while another may suffer from nausea, vomiting, and fatigue. The following symptoms are the most common in children and adolescents:

  • Chronic headaches
  • Chronic stomach pain
  • Prolonged muscle or joint pain
  • Back pain
  • Neck pain
  • Nausea
  • Vomiting
  • Symptoms of paralysis
  • Dizziness
  • Chronic fatigue
  • Digestion problems
  • Memory or concentration problems
  • Deafness
  • Vision problems
  • Trouble speaking or swallowing
  • Sometimes it is also a combination of the above symptoms.
  • Thus, although there are no clear symptoms, there are a number of characteristics that apply to all cases:
  • All symptoms are long-term (or recurrent) symptoms that do not go away.
  • Your child is limited in his daily life by those symptoms.
  • For all these ailments, no clear medical explanation can be found after the examination.


There is no single cause for these ailments. It is often a combination of factors that can lead to physical ailments. The factors listed below may play a role in the development of these symptoms:

  • Stress or tension
  • A traumatic event
  • An illness, accident, or injury previously suffered
  • Genetic factors
  • Learned behaviour
  • Personality traits
  • Family features
  • Overprotection or excessive attention to pain symptoms

A psychological disorder (between one-third and one-half of children with SOLK also have a psychiatric disorder, such as depression, anxiety disorder, ADHD, ADD, autism, or eating disorder)

There are also factors that can maintain or worsen, such as psychological complaints (depression, anxiety), social isolation, an altered sleep pattern or stress at school, to have more information about it, I leave you the link to another of our articles where we talk about stress in childhood. In addition, your child may begin to think about doom and become convinced that their symptoms will never go away, which can reinforce or maintain the symptoms.


If your child suffers from certain physical symptoms for a long time, you should take him to the GP. First, the doctor will talk to you about the symptoms and do a physical exam to find the cause. After all, these are complaints that may have a medical cause.

If a medical cause is not immediately found, additional testing will be necessary. Blood tests may be required or your child may need to keep a diary or “pain calendar” to better understand his or her symptoms. Your GP may also refer you to a specialist. Only if, after these additional examinations, no medical explanation is found, is their talk of insufficiently explained physical symptoms.

That’s why sometimes a physical cause can be found to explain the symptoms, but it’s not clear why the symptoms last so long or are so intense in your child. For example, if you initially felt nauseous due to food poisoning, but then nausea never goes away or keeps popping up, even though the food poisoning is over.


Different treatments are available, depending on your child’s symptoms and what may be causing them. Your GP or pediatrician will explain the options and recommend a method of treatment. For example, you may be referred to a psychosomatic physical therapist, a pediatric physical therapist, a rehabilitation center, or a special outpatient consultation in the hospital. Treatment is tailored to your child’s personal situation. A treatment plan, for example, may consist of a combination of physical therapy and sessions with a psychologist.

Possible treatments are:

  • Psychosomatic physiotherapy
  • Exercise therapy
  • Relaxation exercises
  • Consultations with a psychologist
  • Family Therapy
  • Cognitive-behavioural therapy
  • Hypnotherapy
  • EMDR (eye movement-based therapy)
  • Possible use of medications for anxiety or depression

In addition, a regular lifestyle (eating and sleeping well, exercising) helps in treatment.

The role of parents

This can also lead to difficult situations for parents. First of all, it is difficult to recognize this kind of ailment. If your child has vague, recurring symptoms with no apparent cause, he may think he’s doing his own. Children sometimes have a hard time naming what bothers them. But if you regularly have physical discomfort, it is advisable that you go to the doctor in any case.

If, after several medical examinations, no cause is found and the diagnosis of this ailment is made, this can be quite difficult to accept. You may feel that they are not taken seriously, your child has obvious physical discomfort, so there must be a cause. You’ve probably already gone through a long medical process and may have your own suspicions about another cause. You can always express these doubts and suspicions to the doctor. Maintain good communication with each other, but take the diagnosis and advice of medical specialists seriously. After all, prompt treatment increases the chances of recovery, so it is advisable not to delay treatment.

In addition, it is important for the treatment that you, as a mother, also trust him and strive to make the treatment a success. You can discuss your child’s different treatment options with the doctor so that together they can come up with an appropriate approach.

Is there a cure?

Most children with these symptoms heal over time. Sometimes symptoms go away on their own after a few weeks or months, but other times they need treatment. A small number of children are never really spared their symptoms and continue to suffer from them even as adults. The chances of a good recovery depend mostly on a quick approach, so always take your child to the doctor if he or she has prolonged or recurrent symptoms without a clear cause. The sooner your child can be treated, the more likely he or she is to recover quickly.


All the information we give you in this article is indicative as each child and each family is different and unique.



Carolina González Ramos

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