Pain science and management have long grappled with significant conceptual challenges, particularly the differentiation of pain from nociception. This chapter addresses this challenge by adopting the framework of biological autonomy, which conceptualizes living systems as self-regulating entities dynamically interacting with their environments. From this perspective, pain emerges as a context-sensitive phenomenon that protects autonomy by guiding adaptive behavior and anticipating future threats. In contrast, nociception is a mechanistic process that transduces and transmits noxious stimuli to elicit protective reflexes. By integrating insights from pain research, medicine, and philosophy, the chapter advances a relational and functional understanding of pain while outlining its practical implications.