Ouch! Pain Mechanics for RPGs

Obviously, characters in (most) RPGs experience lots of injury, whether being bashed with a mace, sliced with a sword, or crushed in some devious trap.  Such things can can kill, of course, but they can also hurt like hell, and this is something that most games don't worry about, and why should they?  Fantasy games are the stuff of heroic adventure, and as a rule, Conan and company never complained that their feet hurt on long marches...

Indeed, this is a fair argument against the sort of nasty critical hit tables some prefer.  Heroic fantasy is just that.  Heroic, meaning people don't come home with just a stump or minus an ear or whatever the table decides.  Heroic means you stay pretty! 

But many prefer RPGs as a SIMULATION, meaning that wounds and disfigurement are always possible.  And even in more heroic systems, pain is a way to emphasize the serious impact of injuries without lopping off body parts.  Pain can limit movement and interfere with any number of mental and physical functions vital to adventuring, often with fatal results, and this is worth looking at...

Now, pain can be introduced to play in two ways:

#1. PAIN AS HIT POINTS.  Most of us accept the idea of hits as a combination of luck and physical toughness, etc.  This is difficult to narrate sometimes, because how does one explain a successful combat roll that doesn't mean an actual physical hit?  One approach is to narrate this as PHYSICAL PAIN...

This is PAIN AS NARRATIVE JUSTIFICATION, and it's easy enough to describe in the "heat of battle" and can be used in combination with exhaustion as an explanatory device.  Borg just took 4 points of damage, which can be described as shooting pain in their side from the mighty hammer blow they sustained two rounds earlier...

Distinguishing between an actual "hit" and something like this can either be a matter of GM ruling or formal mechanics.

#2. PAIN AS CRITICAL HITS.  Once again, this can be added to an existing critical hit table or used as a replacement (the latter is useful when running a "heroic" campaign while ensuring a lasting impact to the most grievous of wounds)...  

Normally, the maximum result on attack dice indicates a critical hit, although some GMs extend this to modified results.  This convention is useful even if critical wounds aren't otherwise being enforced, because it tells a GM when a successful hit is actually physical vs. exhaustion and/or pain, making it useful when narrating combats because it provides an objective standard.

We won't tell you how to build your critical hit tables, but will offer the following guidance.  Note: The author suffers chronic pain from a spinal cord injury and has some experience here...

ARM/SHOULDER PAIN imposes a penalty of -5/10% to climbing and/or combat dice when the dominant hand is affected, two-handed weapons are employed, and/or shields are used. 

BACK PAIN limits acrobatics (-10/20% to related dice) and slows movement by half owing to a limp that might require use of a cane, staff, or similar device.  All motion is VERY LIMITED.

Some blows to the head have no
effect (old-school art by Jim Holloway)!

HEAD PAIN imposes a penalty of -5/10% to knowledge-related tasks, possibly extending to spells per the GM.  Concentration will suffer and the victim may become irritable, with similar impacts to any charisma-based actions - and for obvious reasons!

LEG/HIP PAIN is treated as arm/back/shoulder pain, something anyone with sciatica will easily attest.  You DO NOT want THIS...

NECK PAIN limits motion, subtracting -5/10% from attack, initiative, and similar dice.  It's easy to take our mobility for granted, but everything is attached to the neck, trust me!  

No doubt this can be expanded upon, and the GM can declare certain actions impossible while the effects of pain persist.

Fortunately, this can be dealt with.  Healing potions (and/or clerical miracles) eliminate pain as hit points are restored, and herbal remedies can be made available for sale, although druids, elves, and rangers might locate them in the wilderness.  Otherwise, normal rest and recovery to full hits is required, with other restrictions as befits the circumstances.

Obviously, this leaves plenty to the GM, but most penalties can be easily justified under the right circumstances...

Pain is serious business, and if you wish to preserve a heroic atmosphere minus disfigurement, but still want to convey the serious nature of injury, something like this might work.  And even when criticals are fully embraced, physical pain is another sadistic way to make unlucky adventurers pay! Compared to losing an ear, this seems like getting off easy, at least until penalties accumulate and adventuring gets deadlier as a result.  All we can say is OUCH!