Have any artists incorporated physical pain with composition and performance?

Self-harm, suicide and pain in general are all central themes in many subgenres of metal (especially black metal). Some performers have been known to cut themselves with razor blades on-stage during concerts and/or during the recording process. The late Pelle Ohlin (‘Dead’) of Mayhem did the former and much more in order to feel like a corpse while performing. The mysterious Nattramn of Silencer allegedly did the latter to achieve his highly unusual scream.

My question is, have any artists taken this concept of pain as an essential part of the musical experience to the next level by composing music that will (intentionally) be physically painful to play? This could be achieved through high complexity, high speeds, unique instruments specifically designed to inflict pain when played, etc. I do not disagree with self-harm, but it seems so artificial to bring razor blades to your show in case your music isn’t moving enough. Seems like a good idea to just, I don’t know, incorporate the pain into the music. That’s what metal is all about, after all.

Thanks in advance!

P.S. This idea was probably inspired by the movie Whiplash. We must all earn our parts sooner or later… 🙂