Which type of hemorrhoid is typically associated with pain?

External hemorrhoids are typically associated with pain due to their location and the presence of sensory nerve endings in the skin around the anal area. These hemorrhoids occur outside the rectum, where they can become engorged, and if thrombosed (developed a blood clot), they can create significant discomfort. The skin in this region is highly sensitive, which is why external hemorrhoids can be painful during activities such as sitting, straining, or having a bowel movement.

In contrast, internal hemorrhoids are located within the rectum and are usually not painful because they are above the dentate line, an area that lacks sensory nerve endings. While internal hemorrhoids can cause bleeding and discomfort due to protrusion, they typically do not elicit the acute pain associated with external hemorrhoids. Therefore, the answer accurately reflects the understanding that external hemorrhoids are primarily the type associated with pain.