Communication about a patient’s pain experience is a fundamental component of rehabilitation, but often requires the use of metaphoric expressions. However, whilst the meaning of some metaphors is clear, for others it can be obscure. This article will allow the reader to understand the influence that metaphors have on rehabilitation and how they can be used for pain reconceptualisation and behavioural change. It will also allow the development of strategies that enable better communication. There is also an audio recording of this article.