Shigyakusan, a traditional Japanese prescription, has been prescribed for chronic diseases including gastritis, upper respiratory tract infection, hepatitis, irritable colon and so on. The effectiveness of shigyakusan against pain, however, has only been rarely reported. Here we report that shigyakusan was effective on pain such as intractable chronic and acute pain in 26 patients. Shigyakusan is composed of 7.5 g (dry weight/day) : saiko, shakuyaku, kijitsu and kanzo. Shigyakusan and kososan mimic the composition of saikosokanto. Pain alleviation periods were 3-90 days (26 ± 19). Pains were recognized in various regions including side of the flank and the thorax, the back, the tongue, the perineum, the elbow joint, the head and plantar areas. Abdominal findings as tension of the rectus abdominis, kyokyokuman (discomfort of the hypochondrium area) and sinkahiko (tenderness of the hypochondrium area) were recognized 58%, 46% and 38%, respectively. All patients were recognized with depressive conditions. Shigyakusan alleviated acute and chronic pain that had not been improved with Western medicine. Therefore, shigyakusan may be considered for prescription in patients with incurable pain.