"Twisted knife in the wound" is a common metaphor used to describe emotional pain or discomfort. To express this sentiment in different ways, one could use synonyms such as "adding insult to injury," "salt in the wound," "rubbing it in," "making matters worse," or "deepening the cut." Each of these phrases conveys the idea of someone or something intensifying the pain or discomfort already being experienced. They are powerful images that evoke a visceral and uncomfortable response, helping to communicate the depth of emotional distress one feels when they are being hurt by someone or something. Whether used in writing or everyday conversation, these synonyms for "twisted knife in the wound" enable us to express our feelings effectively and vividly.