I noticed this. In Brazil, for instance, the most common “ouch” expression is AI. Ayeee. (and its variants.). In english speaking countries it seems that “ouch” is more common. I even say on japanese tv shows people in pain saying something like TE-TE-TE-TE-TE-TE-TE. Are those expressions really different in other languages? I don’t think this is really cultural - you won’t give an f for culture in you are in pain… So, is there a reason for those differences?
There’s a couple threads on this that might be of interest:
One thread.
Another one.
A more recent one.
A very old one.
I’m not sure if they go into reasons for this, though. I would assume it’s somehow cultural/enivornmental: you use whatever words everyone else uses. Why different cultures use different sounds? I don’t know. I assume it’s kind of like language.
In Dutch we are supposed to say “au”, i.e., without the “ch”.
Although if something is really painful what comes out is more like “aaaaahhh”.
In Polish, it’s something like “au” or “aua,” which is pronounced in English as “ow” or “ow-ah.”
Papapishu!
Some languages lack or don’t go for certain phonemes. It’s similar to how roosters make different sounds the world over.
“Ouch” is something English-speakers say when they’re in control of their faculties, e.g. during very mild pain. Speakers of other languages have been taught other words for that situation. In Japan it’s “itai.” Cadmium poisoning is referred to in Japan as “Itai-Itai Disease”, due to the constant severe pain it causes.
When something really hurts, culture and language get tossed out the window and you just scream wordlessly; pretty much the same regardless of your native tongue.
If I hear someone actually say “ouch” in English, I just ignore it, assuming that they are not too disabled to remember the comic book word they are supposed to say when they do something discomfortingly misadventurous.
In English, I usually say “Ow!”, so I suppose that I sound like a Dutchman.
When working rescue, my crew was treating a French-Canadian with a fractured femur - a very painful injury. As we were removing him from the remains of his car (an unavoidably bumpy process), he would literally exclaim, “Oh, la la la la!”, repeatedly.
A childhood friend would call me out on this. If I hurt myself and exclaimed “ouch”, he would say I’m faking it because if I were in real pain, I wouldn’t have the mental composure necessary to pronounce the final “ch” sound. I kind of understood what he was saying but my reactionary utterance of pain to this day (in English) is still “ouch”, if not “fuck”.
This if from “itai” (meaning “it hurts”), which regresses to the shortened “ita” or “ite”. No one would actually say “ita-ta-ta…” or “ite-te-te…” to express pain and it’s usually done for comedic effect, perhaps similar to when a English speaking person exclaims “yowzers”.
In Afrikaans, the word is “Eina” (I mean the word used when you’re in real or pretend pain, it’s the same)
I don’t think I’ve ever said “ouch” in my life, just “ow.”
+1
A great old-fashioned word. Correct me if I’m wrong, but the mere addition of the “rs” changes it’s meaning from “whoa,” “man oh man,” “well blow me down,” “well dip me I’m honey and smack my bottom.” (I think I just made that last one up.)
Personal anecdote: a few decades ago, human resources brought me up on charges of anti-black racism (by a woman who told me earlier how she was itching to get a lawsuit going for racism against her) for using the word/expression “yowzah.”
Also, “step right up,” by carny barkers, who promise said experiences?
It was no joke, believe me, when I protested I had never even heard the word before, and in fact had no idea what it meant. Only afterward a co-worker told me that even if I had magically produced the syllables, it had zero racial connotation. I’ve since seen or heard it.
So that’s how I know the word “yowzah.”
Since I don’t know how long, I’ve taken to using the word “Yikes” for situations of physical pain about which I need to expostulate (I can’t think of a time when that silly word “expostulate” is more correct) about a repeated pain coming in spurts, which I know will continue, but I need also to reassure myself that it is relatively handle-able and will be over fairly soon. I saw it first in Charlie Brown books as a kid–used for sticky situations or shocking situations–and the word I guess has silly, distracting memories. Can’t think where also you ever see it… In fact, I’ve never heard it.
Eg, waves of stomach cramps.
Just for the record, the term for all this is Onomatopoeia. It’s when a word, an official dictionary word, has its origin in phonetics (i.e. sound). The word ‘splash’ for example is an official English word, it’s not slang. It can be a noun (a splash), a verb (to splash) and can be conjugated (splashed, splashing, splashes etc.) but its origin is still the audible interpretation of the sound water (or a liquid) makes when striking something. Naturally different cultures will vary their interpretation of it in their own language…
One of my colleagues at work was a Pakistani, and instead of making an “a-shoo!” sound when sneezing, he’d go “heh-shoo!”. Durn foreigners. 
I suppose there are people who have gotten accustomed to saying “ouch” when sudden pain strikes, but not around my household (screaming semi-unintelligble expletives is typical).