The Power of Words – How Scary Imaging Language Impacts Perceptions of Pain

September 27, 2023

Words have a big influence on how we may be impacted by pain. This idea is particularly present in the realm of healthcare, where the language used by medical professionals can shape our understanding of conditions and affect our experience of pain. In recent years, research has shown that the use of scary imaging language can significantly impact perceptions of pain. Specifically, we are looking at imaging surrounding age-related changes, such as arthritis and other changes, not serious medical issues, such as fractures, tumors, etc. This article explores the connection between language, pain perception, and the importance of using clear and reassuring communication in healthcare.

The Influence of Scary Imaging Language

When patients are presented with medical information, especially related to diagnostic imaging, the words used by healthcare providers can sometimes evoke fear and anxiety. This is particularly true when discussing conditions like arthritis, herniated discs, or even common wear and tear on joints. For instance, instead of using neutral terms like “degeneration,” phrases like “bone-on-bone” may be employed, conjuring vivid and frightening mental images which can lead to:

  1. Heightened Anxiety: Words that evoke fear and hopelessness can trigger a stress response in the body, making patients more sensitive to pain and discomfort. This can, in turn, contribute to a negative feedback loop, where increased anxiety exacerbates the perception of pain.
  2. Catastrophizing: The use of frightening language can contribute to pain catastrophizing, a cognitive distortion where individuals interpret their pain as being far more severe or disabling than it actually is. This can trigger a vicious cycle of increased pain perception, avoidance of physical activity, and a decline in overall well-being.
  3. Avoidance Behavior: Patients may be more likely to avoid recommended treatments or physical therapy due to their heightened fear. This can lead to delayed recovery and further deterioration of their condition.
  4. Reduced Pain Tolerance: Studies have shown that individuals exposed to negative and fear-inducing language tend to have reduced pain tolerance. They become more sensitive to pain, which can affect their overall quality of life and ability to function.

What this Means To You, The Patient

The impact of language on pain perception highlights the need for healthcare professionals to communicate clearly and reassuringly with their patients. Until more health care providers understand this important communication point, it also highlights how patients can be empowered to take control over their own health and condition, in spite of what imaging may say.

Often imaging is used to rule out serious situations that may require immediate medical or surgical intervention. However, outside of ruling those items out, it is often not nearly as helpful in identifying what hurts or WHY you hurt. This has been evident in many studies that have shown results highlighting individuals with high levels of pain having no remarkable findings on imaging in corresponding areas; and vice versa; individuals with no pain having a variety of “bone-on-bone” and “slipped, bulging discs” present in their pictures.

Your x-ray or other image (or the potentially harmful words used to describe it) does not indicate your prognosis and should not dictate your course of care. As a patient, first and foremost be aware of this and pause when receiving your results. Find a medical professional who understands the power of words to help you decipher results and use caution before getting upset or jumping to invasive conclusions. It is important to explore your options and keep an open mind for conservative treatments that can allow you a natural option without medication, injections, or surgery.

Ultimately prior to making decisions to perform joint replacements or other surgeries, only the patient can determine if they are ready and at the point where they feel they need the surgery. An image or picture alone should not determine when a surgery is needed. A combination of imaging, plus your specific situation and current functional abilities should all be taken into consideration before making decisions.


The impact of language on pain perception is a reminder of the profound connection between mind and body in healthcare. Scary imaging language can significantly affect patients’ experiences and outcomes, leading to increased anxiety, pain catastrophizing, and avoidance behavior. Healthcare providers have a responsibility to communicate clearly and reassuringly, empowering patients to understand and manage their conditions effectively. If you have a healthcare provider who is using these negative terms to describe age-related changes, be aware of it and ultimately advocate for your options and trust how you are feeling and functioning; not solely what a picture is telling you.