Spiritual pain/suffering is commonly experienced by persons with life-limiting illness and their families.Physical pain itself can be exacerbated by non-physical causes such as fear, anxiety, grief, unresolved guilt,depression and unmet spiritual meets. Likewise, the inability to manage physical pain well can be due to emotionaland spiritual needs. This is why a holistic, interdisciplinary assessment of pain and suffering is required for eachpatient and family. The mind, body and spirit are understood in relationship to each other and, in those cases, inrelationship to a deity or deities are important to understand. Cultural interpretations of pain and sufferingmay conflict with the goals of palliative care. Understanding the spiritual framework of the patient and familycan help to assure that the physical and spiritual suffering of the patient can be eliminated to provide a peacefuldeath. Spiritual practices may help in the management of physical pain.