Painful duels represent a unique scenario where individuals engage in a competitive contest, with the outcome dependent on their ability to manage pain and outperform their opponent. Strategic aspects of painful duels include:

Elite Pain - Painful Duel 7 - 91355 (Dvd), Niet van toepassing

Across the ring stood Vane, a veteran with a suit scarred by dozens of previous encounters. The referee—a hovering drone with a cold, synthesized voice—announced the start of the final round. "Duel 5. Engagement authorized."

The Ossuary begins replaying auditory hallucinations of every scream ever uttered within it, layered over present sounds. Combatants must make a each round. Failure means they momentarily feel their opponent’s pain as their own, leading to paralysis or self-injury.