They made it 'painfully' obvious/clear that we were not welcome. [=they made it very clear in a way that was rude or upsetting that we were not welcome]
His ankle is swollen and 'painful to the touch'. [=his ankle hurts if he touches it]
After the injury she was 'painfully' aware that her career in tennis would be over.
(..) and you've said almost nothing. What have i done to you? To me? You've changed, Bologa. I don't recognise you anymore. I have this painful feeling that something has broke between us. Something has broken inside me first. But maybe i still have something left... My mother... home. (..)1965 Forest of the Hanged