The Nonverbal Expression Of Pain Through Posture
Christopher Philip

Much research has focused on the nonverbal expression of pain through facial expression. However, researchers Joseph Walsh, Christopher Eccleston and Edmund Keogh, Centre for Pain Research, University of Bath, UK, in their research, sought to develop an image set that would accurately represent pain through posture.

Toward this end, they had 16 actors perform their rendition of pain. Once complete, the images were presented to subjects and rated on various factor reflective of pain as well as their accuracy in demonstrating pain.

In the end, the researchers produced 144 images that had good reliability.

They found that pain can be communicated accurately through body posture and are accurately recognized with a high degree of specificity.

What goes into the nonverbal pain posture?

– Head averted
– Gaze downward
– Forward body lean
– Trunk averted
– Elbows bent
– Hands manipulate injury site (various sites on body depending on injury)
– Knees bent

The most salient nonverbal cues included particular hand movements toward specific body parts as well as knee bending.

The researchers note that bending the knees might serve to protect the body and reduce the overall profile, or be an additional communicative tool to appear less threatening.

Why do we express pain nonverbally? The authors present a few ideas including warning others of potential danger, requesting help, assistance or repair.

The researchers are clear with their conclusion:

“We demonstrate that pain behaviours serve a communicative function. Naive observers accurately recognized and categorised pain behaviours at rates that compare favourably to those for emotions. Pain was rated overall among the most unpleasant expressions, and was rated among the highest for arousal. This finding is consistent with previous research on facial expressions, and suggests that pain is afforded high significance in social perception.”


Walsh, Joseph; Christopher Eccleston and Edmund Keogh. Pain communication through body posture: The development and validation of a stimulus set. Pain. 2014. 155: 2282–2290.