Pain always appears in a particular way, so perceived meaning is extremely important in the way that pain is felt. However, this essential aspect of pain remains poorly understood in pain research and clinical contexts. What meanings matter most to patients with pain? How do such meanings change over time and how do they interact with neurophysiological activity and therapeutic outcomes? The study of the meanings of pain using valid qualitative or mixed methods can be usefully integrated into the quantitative medical evidence-base and into evidence-based medical practice.