Whether or not it is painful when you have piles depends on the type of piles, the severity of the condition and the perirectal environment of the rectum. Internal haemorrhoids that grow inside the rectum generally rarely induce severe pain, but can be intensely painful if they are affected by infection or blood clots.
External haemorrhoids that occur at the end of the rectum can easily break down and induce symptoms of infection, bleeding and a higher likelihood of inducing pain.