The purpose of this study was to determine the scope and breadth of recreation therapy (RT) treatment interventions currently used in practice that address pain management. A total of 1,296 Certified Therapeutic Recreation Specialists participated in the study (a 21.6% response rate). Less than half (42.6%) reported that pain management (PM) was a RT treatment goal. For those not using PM, the predominant reason was a lack of training/education on pain. The top 10 RT interventions to manage pain included music, relaxation, deep breathing, exercise, distraction, coping skills, stress management, guided imagery, yoga, and play. Findings from this study provide some insight into the extent to which PM is used in RT programs and provides suggestions to address concerns regarding lack of expertise as well as lack of assessing pain. There is a clear need to develop additional training, PM protocols, and establish pain practice groups to address these needs.