Writhe: v. to move with (twisting and/or squirming) and/or contorting frequently feeling pain simultaneously
Writhing in pain is a terrifying experience to be in or to witness. If someone is twisting, squirming, and contorting then they are probably suffering greatly also.
Some exceptions to feeling pain while writhing is an acrobat or performer and a snake which can also twist, squirm, and contort while feeling little or no pain.
With this definition you can say that he was writhing after the accident without having to say that he was writhing in pain after the accident.
If you twist with pain or squirm with pain or contort with pain then you can be said to be writhing and if you do all three then you are probably in great pain.
Writhing without pain is the exception to the general rule.
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