Non–coding RNAs, including microRNA and lncRNA, affect various cellular functions primarily by regulating diverse stages of gene expression, such as transcription, translation, and epigenetic modulation. In recent years, it has been shown that many non–coding RNAs are dysregulated in pain disorders and can be a potential therapeutic target. Intriguingly, a part of non–coding RNAs are encapsulated in extracellular vesicles and are abundantly released into the extracellular space. These extracellular non–coding RNAs can be taken up by nearby or even distant cells and exert their own functions, indicating that they act as important mediators of cell–cell communication. In fact, some extracellular microRNAs have been shown to cause hyperalgesia by acting nearby neurons and immune cells. In addition, extracellular non–coding RNAs in blood and cerebrospinal fluid are expected as a biomarker for various purposes, such as diagnosis, drug responsiveness prediction and prognosis, in pain disorders. In this review, we summarize current insights into the significance of extracellular non–coding RNA in pain disorders and their treatment.