The man's face doesn't show pain, only a calm, trancelike state.
An alternate meaning for this card is Suspended Mind, which the Hindus call "Samadhi." It is an exalted mental state in which one attains the Divine Consciousness of Pure Being.
One writer notices that The Hanged Man appears to be "a pendulum at rest." This card may stand for a time when everything "just stands still," a time of rest and reflection before moving on (similar to the
Four of Swords).
One is reminded of the legend of Odin who hung on a tree for nine days. He lost an eye, but gained inner wisdom. Because the Hanged Man is upside down, he sees everything differently.
The glow around his head is called a nimbus.
In some early Tarot decks, this card was "The Traitor." In Italy in the 1300's, the prescribed punishment for treason was to be hanged upside down (though not necessarily by one foot).
In the BOTA version of this card (shown above), the frame on which the man hangs is drawn so that it resembles the Hebrew letter
("kheth"), which is the eighth letter of the Hebrew alphabet. Nobody knows the significance of this.