Before going to Pain Island, I would recommend that you carry as many Glass Spheres as possible, that you can obtain from Cygnus when he raids Altaruk with the pirates... They are expensive, but they can be worth the price.

Also, try not to go there if you have 10-20 HPs or it's a certain death that you will meet.

To access to Pain Island, you need to clear a cutter in NW corner of Pirates' Cove, then take a skimmer from here. Be careful as you might find yourself in Altaruk and miss Pain island... You have to always say YES to "travel the Silt sea with skimmer" and NO to "return to Altaruk". After a while, you might find yourself in Pain Island. You will soon understand why it's called "Pain island", but don't panic, you can stop loosing HPs by going in inventory.

You will normally find a box on the ground. You might want to rub it, but not yet. Before that, you can move to left edge of the isle, and you will notice that your glass sphere wants freedom. Let it go, and... Some strange item might appear on the ground. It's always a UNIQUE.

UNIQUES are items that only one person can have. If you have one UNIQUE (Belt of Strength, for example), nobody else in Athas can have it. But that also means that if somebody has it in Athas, you can't have it. The interest is that UNIQUES transforms into mushrooms after a while, so everybody has a chance to get a UNIQUE one day.

Several different UNIQUES can be found in Genie island, and some more can be found in other questing places. Here is a list of all the UNIQUES I know.

Even if the UNIQUE is available, there's a random factor which decides if you will gain it or not. So you'd better muliply the chances, using the following tip, assuming you have come with plenty of spheres.

Drop a bag with the spheres on the ground, keep just one sphere on you and move left. Let the sphere go, collect the possible UNIQUE you have got, then pick another sphere, etc. If you don't have anything after using 5 or 6spheres, it's just that really no UNIQUE is available.

Don't forget to keep one sphere for other use(s) that you might discover sooner or later.

Also, you might LOOSE items there (stolen by the Genie?), so if you have all what you need, just don't go to pain island. The finest players aren't the one who have the most powerful items, anyway ;-)

Then it's time to rub the box, so that a Genie will appear and let you out of here if you solve a little riddle... So you will find yourself back in Altaruk. Sometimes he doesn't appear, or the box is not here, or you failed to solve the riddle. Well, just CAD! I suggest you wait a moment in inventory to let the system save the contents of your inventory, before CADing...