Do metaphors have therapeutic value for people in pain? A Systematic Review

    Research output: Contribution to journalArticlepeer-review


    Objectives: This paper aims to review the evidence for the potential therapeutic use of metaphors within pain management, to explore current treatment approaches, and to guide future research.

    Introduction: Communication is a fundamental component of healthcare. However, the profoundly complex and idiosyncratic nature of pain experiences often leaves people in pain with varied communication challenges. Metaphors can enable us to link the abstract to what is already known. People use metaphors when attempting to convey perceptual experiences that are resistant to expression. Pain is one such experience. Although, whilst some metaphors are explicit in their execution, others remain characteristically concealed and many clinicians remain unaware of both the power of language and how best to use metaphors within clinical practice. A longstanding and on-going debate exists regarding the use of metaphors within pain management. Much of this debate is opinion based and no systematic reviews have been conducted to explore if metaphors may have therapeutic value for people in pain. The aim of this review is to explore the evidence for the use of metaphors within pain management.

    Method: A systematic review of qualitative studies relating to metaphor use within pain management was carried out. Meta-ethnography was used as an in-depth approach to synthesize qualitative research.
    Main outcome measures: Critical Appraisal Skills Programme (CASP) checklist for qualitative research quality assessment (2006).
    Results: Six studies were included in this review with four emerging themes regarding the therapeutic value of metaphors for people in pain. These were expression, connection, understanding and control. However, methodological quality varied and a lack of discussion was found across the studies.

    Conclusion: Metaphors may provide people in pain with therapeutic value. Whilst the findings of this review are promising, caution is required when applying metaphors within clinical practice. The findings of this review add a necessary element of rigour to a longstanding debate that is largely based on opinion and speculation. Further research is needed to explore how metaphors can be best applied within practice settings.
    Keywords: Pain, metaphors, therapeutic, review
    Original languageEnglish
    JournalIn Touch: The Journal of Physio First
    Publication statusPublished - 2020


    • Pain
    • metaphors
    • therapeutic
    • review


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