However, taking into account a certain fluctuation between the two terms, we can also use them here as synonyms.
Since pain in every form and degree is a complex event that concerns the whole person, and not just the part that is affected by it, it has always been the subject of questioning not only by medical sciences, but also by philosophy and ethics, psychology and sociology, theology and spirituality.

Illness and pain

A life situation in which pain is easily experienced is the time of illness. When it arrives, the perception of bodily well-being that is enjoyed when there is health turns into malaise, accompanied in a large percentage of cases by the experience of physical pain with greater or lesser intensity. Undoubtedly, the presence of pain is what most makes the disease condition painful and motivates its rejection.
If, upon the onset of sudden and unexpected pain, a person remains astonished, surprised by something unexpected and which always brings a novelty, in the case of recurrent pain one might think of a certain habituation, not only due to the innate ability to adapt that man possesses, but because the unpredictability character would be missing and it is almost "expected" to happen. But in reality this is not the case. Especially persistent pain, which exceeds the ability to tolerate, completely absorbs the strength of the sick person, also draining the mental and spiritual energies that would allow him to cope constructively with the aggression of the disease. The expression "going mad with pain" expresses in an extremely adequate and effective way the excess of suffering which can even affect mental balance.
When not even drugs are able to eliminate it, the pain amplifies and becomes pervasive throughout the person, spreading by contagion from the body to the spirit. From a merely organic symptom it then transforms into "total pain", where the pain of the body and that of feelings mix and merge, until they reach the mind and the soul. In this condition of “total pain”, it seems that it completely absorbs all the energies and the rest of the person's life, the external and internal world, as if nothing else could exist and matter.

Uselessness of pain?

The first attitude of ethical relevance when faced with pain is its condemnation. It is evil, it is opposed to man's innate desire for well-being and full life, it must therefore be condemned and if possible eliminated. But is it always just a bad thing? Is pain immoral? Is the pain useless? Should it be eliminated at any cost?
At first glance we should answer in the affirmative. Man's instinct and will to escape pain make everything done for this purpose considered ethically good. But ethical reflection cannot be satisfied with this first instinctive response. While it is certainly immoral to procure or impose it, it is more difficult to ascertain whether or not it can play a positive role in our lives.
Even considering only the organic point of view, it performs – at least initially – a positive function: it is like the alarm signal launched by the organism that something is threatening our physical integrity. Even more complex is its evaluation on an existential level. Here the experience of pain can have an ambivalent character: it can destroy man, plunge him into solitude, make him regress psychologically, push him to desperation, to madness; on the contrary, it can be a stimulus to grow, to discover new values, it can push towards solidarity, becoming a way of fuller realization of one's life (this was the case for example of Christ, of the martyrs...). The contemporary thinker Salvatore Natoli succinctly expresses this ambivalence: «If we do not perish, we grow through pain».
For the ancient classical world, pain promotes man's knowledge of himself and the world. The Greek aphorism is well known: "Man is an apprentice and pain is his master." Or Aesop's sentence (in the fable “The Dog and the Cook”): «Sorrows are lessons».
Even for the atheist philosopher F. Nietzsche, the experience of illness and pain favors a change in life in the person, stimulates them to move from the surface to the depth, from the adolescent state to that of maturity: «Only great pain is the extreme liberator of the spirit (…). I doubt that pain "makes you better", yet I know that it digs deep into us."
Another philosopher, the French Maurice Blondel, compares the painful experience to the act of the farmer who spreads the seed on the earth; this must rot to be fruitful. This is what happens to us: «Pain is like this decomposition necessary for the birth of a fuller work. Anyone who has not suffered for something does not know it or love it (…). The meaning of pain is to reveal to us what escapes knowledge and selfish will, to be the path to effective love."
But pain can only produce a positive effect if accepted; when it is rejected it has the opposite effect: «It spoils, sours and hardens those it cannot soften and improve» (M. Blondel). Here acceptance should not be understood as passive resignation, or renunciation of doing everything possible to avoid it and alleviate it. But as a disposition to integrate the experiences of pain into the whole of our life, as a not only quantitatively but also qualitatively relevant portion of it.

Fight the pain

In every era, man has never stopped fighting pain, and everything he has done to improve the painful conditions of existence is to be considered ethically good. But in the modern era, thanks to the extraordinary achievements of science and technology, man is not satisfied with dominating and alleviating pain, he would like (sometimes claims) to eliminate it definitively. It is the dream of every materialistic society: a life without pain or in which pain is an accident that can always be solved.
From the Roman world we get this aphorism: «Divinum est sedare difficilem». In a time when there were very few remedies for pain, and everything concerning man's life was attributed to the gods, in the same way that the presence of evil was attributed to the intervention of an evil divinity, so the alleviation of pain could only be invoked by a benevolent god. This aphorism indicated on the one hand that the alleviation of pain exceeds human capabilities, on the other that it is a highly desirable and appreciable act: whoever succeeds in doing so rises to a higher dignity and is worthy of gratitude and praise.
Pain must therefore first of all be fought, in all its expressions. This is also - for believers - the teaching of the Gospel and of the Church. Jesus always did his best to overcome evil in all its forms and expressions. He did not ask for his own passion and death, they were inflicted on him by the violence and opposition of his adversaries: he suffered them out of coherence with his choice of love and radical donation to the Father and to us. His freedom consisted not in seeking suffering for itself, but in not backing away from the inevitable prospect of it. For the rest, Jesus has always committed himself to fighting suffering, through healing and the preaching of God's merciful love, clearly demonstrating that God does not want men to suffer, but that they have life and have it in abundance, that is, that they are happy.
From the golden rule of ethics, which requires "doing good - avoiding evil", two equally dutiful behaviors derive: avoiding avoidable pain, therefore first of all not causing it, and alleviating it as much as possible; and adequately assist those who suffer from it.
We will talk about it in future articles.