On bad days, Barbara Deatherage, 44, is mired so deep in pain that she cannot find any words to explain how she feels.
"Fibro fog days are where you just can't do too much. It's hard when you know these words," Deatherage said, trailing off. "See, I'm losing words here."
Though the language of pain is rich, full of words such as "searing" and "taut" and "agonizing," at the same time it is barren and Deatherage's dilemma is shared by many people. As communicative as humans are, when it comes to pain, they are often at a loss for words.
"At that moment when you're in pain, the felt experience of it just obliterates [everything]," said Elaine Scarry, an English professor at Harvard University and author of "The Body in Pain." "If you had a whiting out of everything except the sheer fact of pain, you're not going to have anything to express in language."
But pain is an important health indicator and, according to the Joint Commission on Accreditation of Healthcare Organizations, it is considered a vital sign. Beyond blood tests or heart rate, medical personnel rely on descriptions of pain to understand what the patient's body is experiencing.
"The reason why we turn to language is because pain is a private experience," said Ephrem Fernandez, a professor of clinical health psychology at the University of Texas at San Antonio. "You invariably rely on a person's self-report to communicate what is really a nonobservable experience."
Without an accurate description, a doctor might lose the opportunity to administer the most effective treatment. But these descriptions can be difficult to offer because pain can vary from ailment to ailment, from person to person and even from day to day.
"They're all different kinds of pain. I guess it's hard to put an adjective to," said Deatherage, who suffers from fibromyalgia, a syndrome characterized by chronic pain and sensitivity, and hepatitis C. While she said she wants to be accurate for her doctors, explaining how her migraines hurt leaves out her pain from irritable bowel syndrome and neither of those address her fatigue.
"I guess I would be confused what to say. To try to tell the doctors is hard," Deatherage said.
Scarry believes pain has the power to actively destroy language.
For example, smashing the hand with a hammer might cause someone to scream or curse.
"It's almost watching language backing up to the kind of sounds we make before we learned language, when we could just yelp," Scarry said.
But people in pain may find they are robbed of words because of other people's attitudes.
"When you have a chronic illness, you tend to stop saying things because you feel the people around you don't want to hear it anymore," Deatherage said.
A network of people going through the same thing can help share the burden of finding accurate descriptors for ailments.
"It's kind of like playing charades sometimes, when you're trying to find a way to get to that word," said Deatherage, who runs a fibromyalgia and chronic fatigue support group in Hanson, Mass.
There are some clinical tools that are commonly used to help people describe their pain in a concrete way. Zero-to-10 pain scales let patients rate how much pain they are in, zero indicating no pain and 10 indicating terrible pain. Pictures of faces ranging from smiling to frowning may help patients show doctors how they feel about their pain.