Seventy-five American Indians, ages 25 to 84, representing 14 tribal nations, participated in this study. The historical, cultural, and behavioral responses to physical pain were examined. Data were collected over a 7-month period with a survey instrument that included the Universal Pain Scale, activities of daily living, causes of pain, cultural beliefs, and self-help-seeking behaviors. Also, recommendations for Western biomedical health care professionals are offered to improve services for the American Indian population. Findings demonstrate that culture plays a crucial role in wellness and significantly affects help-seeking behaviors, treatment regimens, responses to pain, and pain management.