통증을 표현하는 영어 어휘들

진료실 의학용어

미국에 와서 진료를 하며, 많은 언어적 장벽을 겪었는데요, 그중에 하나가 주관적인 통증의 호소입니다. 통증을 호소하는 방법이 나라마다, 민족마다, 또는 지역마다 크게 달라지는 부분이 있어요. 다민족인 사는 캘리포니아 지역은 특히나 혼란스럽다 보니, 그냥 sore 하다고 하는 경우가 많았던 듯합니다. 그러다 보니, 제가 더 구체적으로 여러 번 되물어야 이 사람이 어떤 통증양상(quality of pain)을 갖고 있는지 알 수 있더군요. 아래는 미국인들이 주로 사용하는 통증에 관한 어휘들입니다.

Aching: This term usually describes a continuous, dull pain that is often deep-seated. Aching is generally not sharp or stabbing but is more persistent and lingering. It's often associated with muscle pain, joint pain due to arthritis, or generalized bodily fatigue. The sensation of aching can be widespread or localized and is commonly reported in various conditions, from flu-like symptoms to chronic conditions like fibromyalgia. It is often associated with muscle pain or joint disorders such as arthritis.

"I feel a constant, dull ache in my lower back that just doesn't seem to go away. It's not sharp, but it's always there, making it hard to get comfortable."

Sore: Soreness typically refers to pain that is more surface-level and is often related to muscle pain that results from overexertion or strain. This type of pain is usually localized to specific muscles and is felt as tender and sometimes swollen areas. Muscle soreness is particularly common after unusual or intense physical activity and is a part of the body’s natural response to new or increased activity. The term "sore" can also imply a feeling of being raw or irritated, such as with a sore throat, where the pain is more acute and localized.

"My shoulders are really sore after that new workout routine. It feels like every muscle is tender to the touch, and it aches whenever I move."

Sharp: Sharp pain is described as a sudden, intense, and precise location of pain that can feel like a stabbing or cutting sensation. It is commonly reported in cases of acute injuries or infections.

Throbbing or Pulsating or Pounding: Throbbing pain is characterized by a pulsating sensation that often coincides with the heartbeat. It is frequently associated with migraine headaches or after an injury.

 "My head feels like it's being pounded with a hammer, throbbing with every heartbeat. It gets so intense that I can hardly focus on anything else."

Cramping: Cramp-like pain often involves involuntary muscle contractions and can be intense. It is commonly experienced in menstrual pain, gastrointestinal issues like irritable bowel syndrome or during muscular spasms.

Burning: This pain feels hot and as if the affected areas are on fire. Burning pain is typically associated with nerve damage,  such as that seen in neuropathies or conditions like shingles. Often used to describe epigastirc pain with burning sensation. (cf. Gnawing pain)

"Burning pain in the abdomen could have several causes, including gastroesophageal reflux disease (GERD) or stomach ulcers"

Gnawing pain: Gnawing pain is characterized as a persistent, often intense discomfort that feels as if something is eating away at the affected area. It is generally more specific and localized.

 "There's this gnawing pain in my stomach that feels like something is literally chewing on my insides. It gets worse if I haven't eaten for a while."

Electric or Shooting Pain

This type of pain is typically sharp, sudden, and intense, often resembling an electric shock. It travels along the path of a nerve and is usually a sign of nerve irritation or damage.

"It feels like an electric shock shooting down my leg, from my lower back all the way to my toes. It comes suddenly and is really intense, making it hard to stand or walk when it hits."

Radiating: Pain that starts at one point and spreads to other areas is described as radiating. This is often seen in sciatica, where pain begins in the lower back and travels down the leg.

Tingling or Pins and Needles: Often associated with paresthesia(para-esthe-sia), this sensation feels like pricking, tingling, or numbing and is usually due to nerve irritation or damage.

"Ever since I woke up this morning, I've been feeling this constant tingling sensation in my hands. It's like there are pins and needles poking me from the inside. It's not painful, but it's very uncomfortable and distracting. Whenever I try to hold something(puffy), it feels like my hands are partially asleep."

Pressure or Squeezing: This pain is often described as a feeling of something pressing internally, which can be intense and overwhelming. It is commonly reported in cardiac conditions and some types of headaches. cf. exploding

"There's a constant pressing pain behind my eyes, like someone is pushing their thumbs into them. It makes it really hard to concentrate, especially when looking at a screen."

Stiff: This quality of pain is often associated with a lack of flexibility or movement, commonly felt in and around the joints or after long periods of inactivity.

Heavy: Patients sometimes describe their pain as a heavy feeling, often in limbs or in the head, which can be associated with fatigue and various chronic conditions.

Wrenching Pain:  Wrenching pain is a severe, twisting or pulling sensation that is often sudden and intense. It can feel as if the body part is being physically twisted. This type of pain might occur with severe muscle spasms, joint dislocations, or injuries that involve tearing of ligaments or muscles.

 "I felt a wrenching pain in my knee when I twisted it during the game. It was like something inside was being wrung out, and it dropped me right to the ground."

Raw: Rawness usually affects the skin. When a patient describes their pain as "raw," they often convey a sense of irritation or inflammation that feels very tender and sensitive, almost as if the skin or tissue is exposed. Here's an example of how a patient might describe raw pain:

"The area around my surgical incision feels raw. It's like the skin is not just tender but almost exposed to the air. " 

"If you have raw-feeling pain, your skin may seem extremely sore or tender. Sharp"

자주 사용되는 순서를 보면 다음과 같습니다.

신경학적 통증: aching, penetrating, rqdiating, shooting, stabbing, spreading, tight, tingling, hot or cold

침해성 통증: cramping, crushing, beating, dull, hurting, pounding, pressing, pulling, sharp,throbbing

(Wilkie, Diana et al. (2010). Patient-Reported Outcomes: Descriptors of Nociceptive and Neuropathic Pain and Barriers to Effective Pain Management in Adult Outpatients With Sickle Cell Disease. Journal of the National Medical Association. 102. 18-27. )

아래는 American Pain Foundation의 환자용 브로셔에 수록된 픽토그램입니다.

한국어 통증 표현과 비교해 볼까요? 다음 한국의 표준 통증 표현 어휘와 픽토그램연구를 보시죠. (김수빈 and 이현주. (2021). 메타포를 활용한 통증 유형 픽토그램 디자인 연구. Archives of Design Research, 34(1), 157-171.)

통증 어휘의 적합성 평가의 평균은 3.13으로 평균 이상이 나온 어휘는 위와 같이 총 53개이다. 일반인 대상 통증 어휘의 적합성 평가에서 가장 높은 평균 점수는 ‘쑤시다’이며 평균 4.55로 나타났다. ‘만지면 (아프다)’도 평균 4.54로 비교적 높은 점수를 보였다. ‘끊어질 듯(4.46)’, ‘욱신욱신하다(4.39)’, ‘따갑다(4.30)’, ‘따끔하다(4.30)’, ‘쓰라리다(4.27)’, ‘쥐어짜는 듯(4.27)’, ‘화끈거리다(4.24)’, ‘뭉친다(4.22)’, ‘후벼 파는 듯(4.20)’, ‘도려내듯이(4.17)’, ‘쓰리다(4.17)’, ‘시리다(4.14)’, ‘당기다(4.11)’, ‘결리다(4.10)’, ‘깨질 듯이(4.07)’, ‘꼬집듯이(4.07)’, ‘찌릿하다 (4.04)’, ‘베듯이(4.03)’, ‘누르는 듯(4.00)’이 평균 4.00을 넘어 통증 어휘로서 적합도가 비교적 높게 나타났다. 이후, 전문가들의 검증을 통해 최종 추출된 어휘는 총 46개로 아래와 같다.

Figure 9 Expert verification result of pain vocabulary

통증의 양상(quality of pain)을 이해하는 것은 진단에 큰 단서를 줍니다. 특히 기본적인 통증의 원인을 이해하는데, 도움이 되는데요, 먼저 통증의 종류 2가지를 꼭 기억해 두시기 바랍니다.

통증의 종류

1. Nociceptive pain

Nociceptive pain is the most common type of pain. This type of pain you usually feel when you have any type of injury or inflammation. Nociceptive pain can be either acute or chronic. It can also be further classified as being either visceral or somatic.

Visceral pain

Visceral pain results from injuries or damage to your internal organs.

Visceral pain is often described as:

pressure aching squeezing cramping You may also notice other symptoms such as nausea or vomiting, as well as changes in body temperature, heart rate, or blood pressure.

Examples of things that cause visceral pain include:

gallstones, appendicitis, renal calculi

Somatic pain

Somatic pain results from stimulation of the pain receptors in your tissues, rather than your internal organs.

Somatic pain usually feels like a constant aching or gnawing sensation.

Examples of somatic pain include:

bone fractures, strained muscles ,connective tissue diseases, such as osteoporosis, cancer that affects the skin or bones, skin cuts, scrapes, and burns, joint pain, including arthritis pain

2. Neuropathic(Neurogenic) pain

Neuropathic pain results from damage to or dysfunction of your nervous system. You may also feel pain in response to things that aren’t usually painful, such as cold air or clothing against your skin.

Neuropathic pain is described as:

burning freezing numbness tingling shooting stabbing electric shocks. Diabetes is a common cause of neuropathic pain. Other sources of nerve injury or dysfunction that can lead to neuropathic pain include:

facial nerve problems, such as Bell’s palsy, spinal nerve inflammation or compression shingles , carpal tunnel syndrome