"Rough" originates from the Old English rūh (pre-1150).  Its meaning was "not smooth to the touch, course, hairy, or shaggy" and often used to describe hairy or unshorn items.  It stems from West Germanic *rukhwaz, indicating a common ancestor with Dutch ruig and German rauh.  The term historically applied to uncultivated ground, undressed hides, and later expanded to signify stormy weather, harsh actions, and crudely made items. 

According to the OED, rough (adjective and noun) was first used in English during the Old English period (pre-1150).  As a verb, its earliest recorded usage is later, during the Middle English period (1150–1500).  The earliest evidence for the verb is from 1484, found in the Rolls of Parliament regarding Richard III.  The adverb appeared around 1400 in works such as in Sir Gawain and the Green Knight.  The word rough was eventually used to describe "approximate" measurements or "crude" drafts since roughly the 1600s.  The original guttural "-gh-" sound (like in "loch") softened over time. 

Physically rough elements in writing—referring to the gritty, sensory, and often painful realities of a character's existence—are vital for creating an immersive, authentic, and emotionally impactful story. By focusing on the body's reaction to the world, writers can bridge the gap between the page and the reader, transforming a "flat" narrative into a tangible experience. 

The importance of physical roughness in storytelling based on the search results:
Fosters Emotional Connection and Empathy: 
Visceral Reactions: Describing a character’s pain—such as trembling, bleeding, or the desperate effort to breathe—connects directly to a reader’s gut, creating a deeper, more visceral experience than merely telling them a character is sad or scared. 
Humanizing Characters: Physicality makes characters feel like living, breathing, and flawed human beings, rather than mere plot devices. 
Resonance: Showing the "scars" (both literal and metaphorical) allows for a deeper exploration of human resilience, vulnerability, and the pursuit of healing, which resonates with readers' own life experiences. 

Enhances Realism and Grit:  
Avoiding "Superhero" Tropes: In intense scenes, portraying realistic consequences (pain, fatigue, limited movement) prevents protagonists from appearing invulnerable and unbelievable. When a character is injured, they should act injured, which increases the stakes and authenticity of the story. 
Focus on Sensory Detail: Incorporating touch and texture—the "scratchy" or "hard" elements of a world—immerses the reader in the setting. This includes sensations like sweat, pain, and discomfort. 
The "Rough Draft" Mentality: Physically "roughing out" a scene—focusing on action beats, setting, and raw, unfiltered movement—allows the story to feel like it is being extracted from the body, leading to more "truthful" and less polished, authentic writing. 

Moves Plot and Defines Character:  
"Show, Don't Tell": Physical movement—such as folding arms in defiance, biting a lip in anxiety, or wincing in pain—reveals a character's internal state without needing internal monologue, allowing the action to do the work of storytelling. 
Conflict and Tension: Rough, chaotic scenes filled with intense action or physical, emotional trauma are often the climax or turning points that keep readers engaged. 
Developing Action Beats: "Action beats" are small, physical movements (e.g., rubbing a nose, grabbing a tissue) that anchor characters in their environment and make their actions unique. 

Engages the Senses:  
Tactile Connection: Rough, textured writing allows readers to feel the story on their own skin, making them shiver or feel the heaviness of a scene. 
Physicalizing Emotion: By showing how pain or emotion moves, begins, and stabilizes within the body, the reader can experience the character's suffering rather than just hearing about it. 

Establishes Tone and Atmosphere:  
Grit and Tone: A gritty or raw style of writing is often necessary for thrillers, noir, or high-stakes stories to establish the necessary atmosphere. 
Contrast: Showing the "darkness" or "roughness" of a situation makes moments of light or joy shine brighter.

Including physically rough elements is crucial for moving beyond a "surface-level" story and, instead, creating one that is deeply felt and vividly remembered by the reader. 

Just the facts:

ROUGH Definition & Meaning - Merriam-Webster

ROUGH Synonyms: 695 Similar and Opposite Words | Merriam-Webster Thesaurus

Words that Sound Like ROUGH - Merriam-Webster

I had a list of seven more, then decided to just go with, words that sound like rough.