Manage pain that is very piercing (7)
I believe the answer is:
achieve
'manage' is the definition.
(I've seen this before)
'pain that is very piercing' is the wordplay.
'pain' becomes 'ache' (ache is a kind of pain**).
'that is' becomes 'ie' ('i.e.' can be a synonym of 'that is').
'very' becomes 'v' (abbreviation).
'piercing' indicates putting letters inside (some letters pierce a hole in others).
'ie'+'v'='iev'
'ache' placed around 'iev' is 'ACHIEVE'.
(Other definitions for achieve that I've seen before include "Accomplish, gain by effort" , "Attain (goal)" , "wrap up" , "Gain or reach by effort" , "Effect" .)