For the word “suffering”, many scholars prefer to keep the original Sanskrit word, duhkha, because they often feel the English does not really carry the whole meaning of the Sanskrit. Some translators try to use ‘unsatisfactoriness’ or ‘dissatisfaction’ instead because it has a wider and deeper meaning than suffering.

In Buddhism, when we talk about suffering or duhkha as in the Noble Truth of Suffering, it has a deep meaning. This is not really everyday suffering. Of course, everyday suffering is there – pain, difficulties, illness, discomfort, all those sufferings – but here the deeper meaning is more to do with psychological suffering, that sense of dissatisfaction which is very deep-rooted in our psyche. Because that kind of suffering is at the core of the first Noble Truth, I think these scholars feel the English word “suffering” is not really exact enough.

Walpola Rahula in his book, What the Buddha Taught, writes: “It is true that the Pali word dukka (or Sanskrit duhkha) in ordinary usage means ‘suffering’, ‘pain’, ‘sorrow’, or ‘misery’, as opposed to the word sukka meaning ‘happiness’, ‘comfort’, or ‘ease’.  

But the term duhkha as the first Noble Truth, which represents the Buddha’s view of life and the world, has a deeper philosophical meaning and connotes enormously wider senses. It is admitted that the term duhkha in the first Noble Truth contains, quite obviously, the ordinary meaning of ‘suffering’, but in addition it also includes deeper ideas such as ‘imperfection’, ‘impermanence’, ’emptiness’, ‘insubstantiality’.” 

Source: Adapted from Geshe Tashi Tsering, The Four Noble Truths: The Foundation of Buddhist Thought, Vol. 1, with a foreword by Lama Zopa Rinpoche, ed. Gordon McDougall (Somerville, MA: Wisdom Publications, 2005), 29-38.