Desencajado

[aleCcowaN]

I couldn't find a proper word in English matching desencajado in the phrase "rostro desencajado de dolor".

It's a physical thing, when a person's facial expression looks tense and distorted, a grimace, caused by experiencing a great deal of pain, short of fainting for that cause, during a long period.

Considering the great degree it implies, what English adjective could replace desencajado in this context? Should I use "a grimace of pain" as a substitute for the whole sentence instead?

[Rusty]

I think "racked with pain" would fit the bill.

[aleCcowaN]

Thank you, Rusty!

I wonder if there's a way to link that expression to the "contorted" face of the person experiencing the pain.

[Rusty]

His face was unhinged (out of joint, out of place, and thus contorted), but we don't usually couple that description "with pain." Although, if I had a face out of joint, I'd be in a lot of pain. So, "racked with pain" explains why someone's face could look contorted/twisted.

[aleCcowaN]

So, I might say

his face was racked with pain = tenía el rostro desencajado de dolor

and there's no reason for us to rack our brain(s) looking for a better match = y no hay razón para que nos rompamos el coco buscando una mejor alternativa

Thank you again, Rusty!

[poli]

He grimaced with pain or he cringed with pain when they removed to bullet.
Her face cringed with pain when she heard the singer at the karaoke bar.

[aleCcowaN]

Thank you, poli!