The language of chronic pain

Abstract

Objective Pain is a universal phenomenon, but is also inherently private and subjective – there’s no objective test for its existence. Sufferers rely on language to describe their pain experience. The McGill Pain Questionnaire paved the way for incorporating language into pain assessment and recent research has explored aspects of pain language such as metaphors and grammatical patterns. This study investigated how chronic pain sufferers use language to describe their pain experience. Design Three focus groups were conducted (N = 16, age 22–74 years, M = 46.6 years) with participants attending an outpatient chronic pain management program in Sydney, Australia. Participants were asked to describe aspects of their pain experience. Main outcome measure The language which participants utilized to talk about their pain experience. Results Thematic analysis identified five superordinate themes: Isolation, Physical Sensations of Pain, Pain Personified, Pain as Overwhelming, and Coping with Pain. Across themes, participants relied on metaphorical language, which reflects the complex, multidimensional aspects of pain as well as the desire to effectively communicate it to others. Conclusions This study underscores research indicating the complexity of pain experience and hence pain language, and suggests that single word adjectival measures are inadequate to completely capture its complexity. IMPLICATIONS FOR REHABILITATION Chronic pain is now considered a disease in and of itself, with patient’s pain language being an important study area due to the lack of objective tests for pain. In both assessment and rehabilitation, patients rely on metaphorical pain language in order to facilitate understanding and garner support from others. Pain metaphors may provide a useful target for interventions such as Acceptance and Commitment Therapy and Cognitive Behavioural Therapy, particularly when addressing catastrophic thinking patterns.