Long-term conditions and accompanied co-morbidities now affect about a quarter of the UK population. Enabling patients and caregivers to communicate their experience of illness, in their own words, is vital to developing a shared understanding of the condition and its impact on their life and delivering person-centred care to support them. Studies of patient language show how metaphors provide insight into the physical and emotional world of the patient, but such studies are often limited by their focus on a single illness. The authors undertook a secondary qualitative data analysis of 25 interviews, comparing the metaphors used by patients and parents of patients with five long-term conditions. The analysis shows how similar metaphors can be used in empowering and disempowering ways as patients strive to accept the illness in their daily lives, and how metaphor use depends on the manifestation, diagnosis, and treatment of individual conditions. There are implications for how metaphorical expressions are attended to by healthcare professionals as part of shared care planning.