Extreme tattooing seems to be more about memory (skin as life blockchain?) while extreme piercings seem to be about something else since the ornamentation seems relatively low on information/symbolizing
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They're costly signals of tribal affiliation. Mostly just "counter-culture" as the tribe, but subcultures have their particular styles for both.
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I do see a vague correlation between "lots of piercings" and "masochism", if casual observation of kinksters counts.
Not sure I see the pain management: people I know who've developed fibro, etc. didn't suddenly fill their body with metal. OTOH, I don't know many heavy piercers.
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