tHE ROAd tO PAin RECOnCEPtuAlisAtiOn : dO MEtAPHORs HElP OR HindER tHE JOuRnEy ?

The process of facilitating a meaningful reframing of persistent pain often involves metaphoric expression. In practice, this encompasses a variety of methods which attempt to find simplicity amid the cluttered complexities of a biopsychosocial pain management model. With this in mind, we must consider the impact that our metaphoric expressions have on our practice, and how they might influence our patients understanding of pain. A critical exploration of the literature surrounding metaphoric expression and pain reconceptualisation highlights several key debates regarding the application and value of metaphors when attempting to explain persistent pain. Whilst metaphors can promote a tangible advancement towards a meaningful reframing of persistent pain, they are also prone to oversimplification and misinterpretations. The evidence that clinicians and patients speak different metaphoric languages is compelling. This is compounded by our divergent vocabularies, assorted histories and our contextual dissimilarities. In order to reduce the risk of unintended misinterpretations, clinicians should seek collaborative metaphoric expression through dialogical co-construction. Such skills are essential when we consider the sociocultural implications of metaphoric pain reconceptualisation. If we are to further our understanding of metaphor application, future research must embrace a broad spectrum of methodologies, whilst creating a synthesis between pain research and linguistic analysis. When viewed with an appreciation of their constraints, metaphors can provide an outlet for new perspectives, whilst facilitating pain reconceptualisation. However, this review also highlights a need to investigate any subsequent impacts that metaphoric pain reconceptualisation has on pain and disability.