By reason of the voice of my groaning - By suffering and trouble, so great as to produce groaning, my flesh is wasted away.
My bones cleave to my skin - Margin, “flesh.” The Hebrew word means “flesh.” The effect described is that of a wasting away or an emaciation of flesh from deep distress, so that the bones became prominent, and had nothing to hide them from view; so that they seemed to adhere fast to the flesh itself. See the notes at Job 19:20.