The core idea: each word draws the rhythm of the pain
These words belong to the family of giongo and gitaigo, sound and manner words; pain words are gitaigo, pictures of a feeling rather than copies of a noise, and they work like tiny drawings. The doubled shape, two identical halves, is the key. Doubling means the feeling repeats or continues, so zukizuki is not one throb but throb after throb. The sound of each half carries the texture. The voiced z and g of zukizuki and gangan feel heavy and deep; the lighter k, sh, ch and h of kirikiri, shikushiku, chikuchiku and hirihiri feel sharper, fainter or closer to the surface.
Once you see them as rhythms, choosing one becomes a matter of asking what the pain is doing. Is it keeping time with your pulse, hitting like a hammer, winding tighter, dragging on, pricking in many small points, or burning across the surface? The diagram draws each answer as a line over time.
The seven words side by side
Each word has a verb it prefers. Most take itamu, to ache, or itai, painful, directly after them, and all of them can take suru. The last row is the odd one out: mukamuka is not a pain at all, so it only takes suru.
| Word | Reading | Rhythm it pictures | Usual verb | Typical places |
|---|---|---|---|---|
| ズキズキ | zukizuki | A pulse: throb, pause, throb | itamu, itai, suru | Head, teeth, a cut or burn |
| ガンガン | gangan | Heavy hammer blows | suru, sometimes itai | Head only: hangover, fever |
| キリキリ | kirikiri | Tight winding, sharp and piercing | itamu, suru | Stomach, often with stress |
| シクシク | shikushiku | A low ache that drags on | itamu, itai | Stomach, belly, sometimes teeth |
| チクチク | chikuchiku | Many small needle pricks | suru, itamu | Skin, eyes, chest |
| ヒリヒリ | hirihiri | An even burning sting on the surface | suru, itai | Sunburn, grazes, throat, tongue |
| ムカムカ | mukamuka | Churning nausea, not pain | suru only | Stomach, chest |
Where each word usually lives
The words are not locked to body parts, but each has a home. Gangan belongs to the head. Kirikiri and shikushiku belong to the stomach and belly. Hirihiri and chikuchiku live on surfaces: skin, eyes, throat, tongue. Using a word away from its home is not wrong; it simply tells the listener that this pain has an unusual rhythm for that place.
The same word can also turn up in two places with the same rhythm. Hirihiri is the sting of sunburn and of a raw throat; zukizuki is a headache and a toothache. A colleague asks how you are, and you answer like this.
| Japanese | Romaji | Meaning |
|---|---|---|
| 歯がズキズキして、眠れませんでした。 | Ha ga zukizuki shite, nemuremasen deshita. | My tooth was throbbing and I couldn't sleep. |
| 会議の前は、胃がキリキリします。 | Kaigi no mae wa, i ga kirikiri shimasu. | Before meetings, I get a sharp pain in my stomach. |
| のどがヒリヒリします。 | Nodo ga hirihiri shimasu. | My throat feels raw and stings. |
| 辛いものを食べて、舌がヒリヒリします。 | Karai mono o tabete, shita ga hirihiri shimasu. | I ate something spicy and my tongue is burning. |
| 目にまつげが入って、チクチクします。 | Me ni matsuge ga haitte, chikuchiku shimasu. | An eyelash got in my eye and it prickles. |
Building the full sentence: when, where, what kind
A complete description has four slots in a fixed order: when it started, where, what kind, and the verb. Kinō kara, since yesterday, comes first. The body part follows with ga. The pain word sits directly before the verb, with no particle. Then comes itamimasu, itai desu or shimasu. Adding n desu, as in itai n desu, turns the sentence into an explanation, which is exactly what you are doing when a doctor asks what brings you in.
Zutsū (頭痛), literally head pain, and fukutsū, literally belly pain, appear on forms and medicine boxes; in conversation, the full sentence is what people more often say.
| Japanese | Romaji | Meaning |
|---|---|---|
| 昨日から頭がズキズキ痛みます。 | Kinō kara atama ga zukizuki itamimasu. | I've had a throbbing headache since yesterday. |
| 今朝から胃がキリキリ痛みます。 | Kesa kara i ga kirikiri itamimasu. | Since this morning I've had a sharp pain in my stomach. |
| 三日前から、おなかがシクシク痛いんです。 | Mikka mae kara, onaka ga shikushiku itai n desu. | My belly has had a dull ache for three days. |
| 飲みすぎて、頭がガンガンします。 | Nomisugite, atama ga gangan shimasu. | I drank too much and my head is pounding. |
| 日焼けしたところがヒリヒリします。 | Hiyake shita tokoro ga hirihiri shimasu. | The sunburnt part stings. |
| 新しいセーターを着ると、首がチクチクします。 | Atarashii sētā o kiru to, kubi ga chikuchiku shimasu. | When I wear my new jumper, my neck prickles. |
| 朝から胸がムカムカします。 | Asa kara mune ga mukamuka shimasu. | I've felt sick since this morning. |
Pairs that are easy to mix up
Most confusion comes in pairs, and in each pair one feature separates the words: rhythm, sharpness, or whether the feeling is a pain at all.
| Pair | Reading | The difference |
|---|---|---|
| ズキズキ / ガンガン | zukizuki / gangan | A rhythmic throb with gaps / heavy pounding that fills the whole head |
| キリキリ / シクシク | kirikiri / shikushiku | Sharp and tight, hard to ignore / dull and lingering, in the background |
| チクチク / ヒリヒリ | chikuchiku / hirihiri | Separate pinpricks / an even burning sting across an area |
| ムカムカする / ムカつく | mukamuka suru / mukatsuku | Nausea, or quiet anger / in everyday speech, mainly being annoyed |
| 痛みます / 痛いです | itamimasu / itai desu | The verb, a little more formal and descriptive / the adjective, everyday |
Shikushiku has a second life outside medicine: shikushiku naku is to cry quietly, sniffling. The rhythm is the same, low and continuing, which is a good way to remember the pain meaning too.
Beyond the basics: one twinge, zukitto and chikutto
Take one half of a doubled word, add a small tsu or n, and the rhythm collapses to a single moment. Zukizuki is throbbing; zukitto or zukin is one sudden stab of it. Chikuchiku is prickling; chikutto is one prick. These single forms need to after them: zukitto suru, chikutto suru. The doubled forms can go without it.
You will hear the single form from staff as a warning. Before an injection, a nurse almost always says sukoshi chikutto shimasu yo, and dentists use it too. Patients use it for pain that comes with a movement.
| Japanese | Romaji | Meaning |
|---|---|---|
| 少しチクッとしますよ。 | Sukoshi chikutto shimasu yo. | You'll feel a little prick. |
| 立ち上がるとき、腰がズキッとします。 | Tachiagaru toki, koshi ga zukitto shimasu. | When I stand up, I get a sharp twinge in my lower back. |
| 押すと、ズキンと痛みます。 | Osu to, zukin to itamimasu. | When I press it, it gives a stab of pain. |
| かき氷を食べたら、頭がキーンとしました。 | Kakigōri o tabetara, atama ga kīn to shimashita. | I ate shaved ice and got brain freeze. |
Beyond the basics: neighbours that are not quite pain
A few words sit next to the pain words and describe discomfort instead. They follow the same frame and always take suru. Samuke, the chills, is literally cold feeling, and zokuzoku is the shiver that goes with it. The scene here is a phone call to your manager on a morning you feel unwell.
| Japanese | Romaji | Meaning |
|---|---|---|
| 朝から寒気がして、ゾクゾクします。 | Asa kara samuke ga shite, zokuzoku shimasu. | I've had chills since this morning and keep shivering. |
| 頭がクラクラします。 | Atama ga kurakura shimasu. | I feel dizzy. |
| のどがイガイガします。 | Nodo ga igaiga shimasu. | My throat feels scratchy. |
| おなかがゴロゴロしています。 | Onaka ga gorogoro shite imasu. | My stomach is rumbling and upset. |
| ぶつけたところがジンジンします。 | Butsuketa tokoro ga jinjin shimasu. | The place I knocked is tingling and throbbing. |
What the doctor asks, and how to answer
Doctors ask about the rhythm directly, then about what makes it worse. The key contrast is zutto, all the time, against tokidoki, sometimes, and the pattern verb plus to, when, for triggers: osu to, when pressed; ugoku to, when I move. Some doctors also ask you to rate it from one to ten. A general guide to sound words, and a list of illness and symptom vocabulary, are covered in separate posts; this exchange is where pain words do their work.
| Japanese | Romaji | Meaning |
|---|---|---|
| どんな痛みですか。 | Donna itami desu ka. | What kind of pain is it? |
| ずっと痛いですか。それとも、時々ですか。 | Zutto itai desu ka. Soretomo, tokidoki desu ka. | Does it hurt all the time, or only sometimes? |
| 押すと痛いですか。 | Osu to itai desu ka. | Does it hurt when I press here? |
| 十段階で言うと、どのくらいですか。 | Jū-dankai de iu to, dono kurai desu ka. | On a scale of one to ten, how bad is it? |
| ずっとシクシクしています。 | Zutto shikushiku shite imasu. | It has been aching dully the whole time. |
| 時々、キリキリ痛みます。 | Tokidoki, kirikiri itamimasu. | Now and then I get a sharp pain. |
| 食べた後に、ひどくなります。 | Tabeta ato ni, hidoku narimasu. | It gets worse after I eat. |
| 七ぐらいです。 | Nana gurai desu. | About a seven. |
Common mistakes with pain words
Mukamuka itai. The cause is treating every body word as a pain word. Mukamuka is nausea, so say mukamuka shimasu, or hakike ga shimasu; hakike is literally a vomiting feeling.
Using mukatsuku for feeling sick. Dictionaries list nausea, but in everyday speech most people hear I am annoyed. Keep mukatsuku out of the clinic and use mukamuka suru or kimochi ga warui.
Dropping to after a single form: zukitto suru, not zukit suru. The cause is copying the doubled words, which can go without to.
Onaka ga gangan suru. The cause is reading gangan as very strong in general. It is a head word; for a severe stomach pain say sugoku itai, or kirikiri if it is sharp.
Forcing a word you are not sure of. The cause is wanting to sound fluent. A wrong word gives the doctor wrong information, so if unsure, say surudoi itami, a sharp pain, or nibui itami, a dull pain, and let the doctor ask more.