What is the meaning of "with" in the following sentence,
His face was twisted with pain
Does "His face was twisted" mean "His face was twisted. And the pain was revealed in his face" ? Or does it mean "His face was twisted because of pain" ?
I thought that I understood this simple sentence, but now it is ambiguous. I have always interpreted "with" as "because of" in similar sentences. By the way, suddenly I feel like I have misinterpreted and understood it so far. Have I ever really known something wrong?