This article discusses the integrated approaches to pain that have developed within the pain medicine movement and the hospice and palliative care movement. Such approaches blend biomedical, social, emotional and spiritual aspects of the pain experience. However, patients and healthcare staff may hold different beliefs about pain, such as patients having a medical understanding about pain while healthcare practitioners may use concepts such as 'total pain' or 'psychological pain'. Some of the problems related to interpreting an account of pain are discussed and suggestions are made for developing pain assessment, education and research.