Translation of "smertefuld" into English

At vælge livet, kan være en mere smertefuld form for død.

Sometimes choosing life is just choosing a more painful form of death.

Jeg havde aldrig forestillet mig, at du har haft sådan en smertefuld barndom.

I never imagined you'd had such an agonizing past.

Det skal også bemærkes, at døden som følge af sonarstøj er langsom og ekstremt smertefuld.

It should also be noted that dying from the effects of sonar injury is an extremely painful, agonising and slow form of death.