The only way for Dracula to retrieve the gems, which are necessary for the longevity of his health and magic, is by placing his hand inside the opening of the box, with the mechanism securing it in place and puncturing it in order for his blood to be spilt, so that he could obtain a gem, hence the name "pain box".
Obtaining a single gem of any type from a Pain Box will instantly replenish Dracula's bar of the specified type. In order to extend the Health, Void, and Chaos bars, the player needs to find 5 of them, which are scattered throughout the levels of the game. Luckily, they are easy to locate since Pain Boxes emit a vertical blue light around them.
- Pain Boxes make a hissing noise when you approach them.
- Like the Map Rooms, it is assumed that only Dracula can access Pain Boxes as their design would kill a normal person.