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.

By reason of the voice of my groaning,.... Under the burden of sin, and pressure of afflictions:
my bones cleave to my skin; was quite emaciated, reduced to a skeleton, became nothing but skin and bone (e); which sometimes is occasioned, as by outward afflictions, so by soul troubles: or "to my flesh" (f); flesh is put for skin; see Job 19:20.
(e) "Ossa atque pellis sum", Plauti Capteivei, Acts. 1. Sc. 2. v. 26. Asinaria 3. 6. v. 28. (f) "carni meae", V. L. Pagninus, Montanus, &c.

voice . . . groaning--effect put for cause, my agony emaciates me.

Skin - My flesh being quite consumed.