Palliative care practitioners are able to capably manage pain in serious or advanced illness in the majority of patients using a critical thinking process of drug therapy selection (along with nonpharmacologic intervention). However, in some cases the situation is more complicated. Participants in this presentation will learn about the evidence that guides the management of tenesmus pain, local or topical pain (e.g., wound care pain), pain associated with hyperalgesia, and complicated neuropathic pain. Complicated pain management is definitely not “one size fits all!”