The psalm opens with a cry: My God, my God, why have you forsaken me? He is far from saving him and from the words of his groaning. He cries by day and night and finds no rest. Yet he acknowledges that God is holy, enthroned on the praises of Israel, and that his fathers trusted in him and were delivered.
David describes himself as a worm and not a man, scorned by mankind and despised by the people. All who see him mock him, make mouths at him and wag their heads, saying that he trusts in the Lord, let him deliver him. He remembers that God took him from the womb and made him trust at his mother's breasts. Bulls of Bashan surround him and lions roar. He is poured out like water, his bones are out of joint, his heart is like wax, his strength is dried up like a potsherd and his tongue sticks to his jaws. Dogs encompass him; they have pierced his hands and feet, and he can count all his bones. They divide his garments among them and cast lots for his clothing.
He cries again: O Lord, do not be far off; come quickly to help me. Then the psalm turns: David will tell of God's name to his brothers and praise him in the midst of the congregation, for God has not despised or abhorred the affliction of the afflicted. The humble shall eat and be satisfied, and all the ends of the earth shall remember and turn to the Lord. Future generations will be told that he has done it.