painful
acute
afflictive
agonizing
atrocious
biting
consuming
cramping
cruel
desolating
distressing
excruciating
gnawing
grave
griping
hard
harrowing
harsh
heartbreaking
heartrending
heartsickening
heartwounding
hurtful
hurting
paroxysmal
piercing
poignant
pungent
racking
rending
severe
sharp
shooting
spasmatic
spasmic
spasmodic
stabbing
stinging
tearing
tormenting
torturing
200-mile
42-day
agonising
casuistical
downhill
eighteen-hour
forty-five-degree
four-mile
grueling
hours
month-long
neo-soviet
pretrial
quarter-point
three-hour
wire-drawn
pleasant