BACKGROUND: Words can shape or reinforce a patient's coping strategies. We measured the emotional content of hand surgery words and some synonyms or alternatives in five categories (19 words total). METHODS: Healthy adult companions of 100 patients presenting to an orthopedic hand surgical practice were asked to score five hand surgery words and some synonyms and alternatives (19 total words) on three dimensions: affective/emotional (ranging from pleasant to unpleasant), arousal (ranging from calm to aroused), and dominance/control (ranging from dominated to feeling in control) using a validated methodology. Ratings were done using the self-assessment manikin-a validated graphic affective rating system. RESULTS: The emotional reaction to "discomfort" and "ache" was more positive than "pain." The words "tear" and "defect" were more positive than "rupture." The words "tight" and "stiff" were more positive than "locked" and "frozen." The word "faded" was more positive than "degenerated," "diminished," and "wasted". The words "overused" and "worn" were more positive than "cracked," "inflamed," and "broken." CONCLUSIONS: Some common hand surgery words have a relatively negative emotional content. Given that psychological distress is an important predictor of pain intensity and disability, additional research is merited to develop optimally positive language for describing musculoskeletal pathology.