Patients with disability that is not fully accounted for by known pathology commonly consult within health care systems, and their diagnosis and management present challenges. This editorial puts the phenomenon in a historical context, and then discusses three such challenges: explanation, labelling and management. It suggests that the World Health Organization (WHO) ICIDH-2 model of illness would predict the existence of illness without pathology and consequently it suggests that a new name, sinepathy (i.e. without disease), would be appropriate. It also suggests that a standard rehabilitation approach with a focus on cognitive behavioural therapy might be the best management for patients with sinepathic disability.
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