Mind your language


Often I hear people with ongoing pain talk about their ‘injury’.  Ouch!  This makes me feel worried – when pain persists, it’s no longer an ‘injury’ it’s pain! Pain itself is enough!!

The power of the language we use when we talk to people with pain is incredible, and often we forget that the words we use might mean something quite technical, but to people on the street the common meaning is the one they remember.

Let me give you some examples…

Injury: “I have a back injury” vs “I have a head injury” – “I have a back ache” vs “I have a head ache” – quite a different implication!

Instability: “You have back instability” vs “You use your muscles inefficiently” – instability means ‘Oh no, my back is going OUT!’   (where is your back going to??)

Desiccation: “You have desiccated discs” vs “Your discs are showing signs of getting older, they’re losing a bit of water” – desiccation means ‘My back is crumbling away like desiccated coconut leaving me with bone grinding on bone!’

Even psychological terms can have considerable impact

Maladaptive thinking: “Your thoughts are maladaptive” vs “Your thoughts are unhelpful”

Catastrophising: “You are catastrophising” vs “You think the worst – which isn’t helpful”

Coping: “It’s time to learn to cope” vs “It’s time to learn how to do things differently”  (surely if I’m still doing things, still alive I’m coping?)

Depressed: “You’ve got depression” vs “You are feeling demoralised and run out of hope”

Psychosomatic: “Your pain is psychosomatic” vs “I don’t know why your pain is carrying on, but it’s related to your whole body including your brain and mind” – ‘Psychosomatic? That means you think I’m imagining it!’

Inviting pain talk: “How are you today? What’s your pain like?” vs “What have you been up to? What have you been doing?”

So – think about what you say to people, use common language phrased in positive ways, and ask the person what they have heard.

Two articles (a little elderly but still interesting)

Schott, G. (2004). Communicating the experience of pain: The role of analogy. Pain Vol 108(3) Apr 2004, 209-212.

Stanford, E. A., Chambers, C. T., & Craig, K. D. (2005). A normative analysis of the development of pain-related vocabulary in children. Pain Vol 114(1-2) Mar 2005, 278-284.

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