INTRODUCTION Little is known about the public's preferences for pain management prior to attending an Emergency Department (ED). Therefore, the aim of the study was to explore (i) triage documentation of pre-hospital analgesic patterns for patients presenting in pain; (ii) patient documented explanations for not self administering an analgesic in the pre-hospital setting; (iii) triage nurse documentation of pain descriptors and or pain scores; and (iv) the disposition of ED patients presenting in pain. METHOD A 2-week retrospective exploratory review was conducted. RESULTS There were 2142 ED presentations during the 2-week study and 52% of patients had documented evidence of arriving with a painful condition. Of the 1113 patients 60% were documented to be in pain on arrival. Of the group documented to have arrived in pain only 28% self-administered or received an analgesic in the pre-hospital/community setting. Patients provided a variety of reasons for not self-administering a pre-hospital analgesic. CONCLUSION Unnecessary suffering may be avoided if the public had a better understanding of pain and the benefits of pain management. Further research is required to better understand the beliefs and attitudes towards pain and pain management by clinicians and the public.