There are generally four possibilities for painful hemangioma: 1. Excessive perfusion pressure within the hemangioma leads to painful sensory nerves around the hemangioma. 2. Painful nerves are caused by the invasion of the hemangioma into the surrounding nerves. 3. Thrombus is formed because the blood flow in the hemangioma slows down and turbulence is generated, so thrombus is formed. 4.After the formation of thrombus, fibrosis gradually appears, and calcium deposition occurs over time, leading to calcification and finally the formation of venous stone, which itself can cause pain, especially when pressed. These are the four causes of hemangioma pain.