When a person feels pain and doctors can’t figure out why, they often tell the person that their symptoms are psychological. A recently discovered biological cause could change the narrative.

woman experiencing neck pain seen from the back

People with heightened somatic awareness often experience pain in the neck and back.

Being told that one’s symptoms are a figment of one’s imagination can be a torment. But this is often the experience of people with one condition in particular.

Heightened somatic awareness has more than one name in the medical world. It is also known as bodily distress, functional disorders, or even “medically unexplained symptoms.”

Experts define it as pain that has no detectable physiological cause.

The most common symptoms of heightened somatic awareness tend to be headaches, fatigue, painful muscles and joints, and stomach trouble. Some people also report memory impairment, dizziness, and breathlessness.

People with heightened somatic awareness are twice as likely to experience chronic pain, and they often receive diagnoses of conditions such as irritable bowel syndrome, fibromyalgia, and rheumatoid arthritis. Some people may never get an accurate diagnosis, resulting in increased levels of distress.

The cause of heightened somatic awareness is unclear. Experts have named everything from hereditary factors and brain malfunctions to life stressors as potential causes.

Some healthcare professionals still see it as a psychological problem and recommend cognitive behavioral therapy, commonly called CBT, as an unmedicated treatment.

However, a team helmed by researchers at McGill University, in Montreal, Canada, has now found a potential biological cause of the condition. Their findings are published in the journal Annals of Neurology.

A biological cause

Samar Khoury, Ph.D., from McGill University’s Alan Edwards Centre for Research on Pain likens the findings to the tale of “The Princess and the Pea.”

“The princess in the story had extreme sensitivity, where she could feel a small pea through a pile of 20 mattresses,” says Khoury, who is the first author of the study.

“This is a good analogy of how someone with heightened somatic awareness might feel; they have discomforts caused by a tiny pea that doctors can’t seem to find or see, but which is very real.”

The results of the team’s study may provide proof that the pea exists — that symptoms of heightened somatic awareness aren’t imaginary.

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