This psalm requires no translation of ideas. Sometimes, one wonders if commentators are too quick to interpret terms like those used here in their literal sense. Is a specific illness troubling the psalmist? Or is it perhaps a deeper ailment of the heart? In any case, the sense of sin weighs heavily; the relief can only come from the Lord. The tone of distress is remarkably comforting. We often assume that the sacred writers of Israel were pure and saintly, but behind these words lies an awareness of serious and repeated sin. If so, the lesson for us is more pointed: the greater the sin, the greater the need for confidence—not of course, in ourselves but in God.
This psalm has become the prayer of all sinners, as we see in 1 John 1:8-9. Many sick people and sinners have found God amid their sins or their suffering. When illness or adversity strikes, we start to reflect. We then realize that the greatest misfortune is to be a sinner.