The song is about The Painkiller, a personage created by Judas Priest. He is sent to the world to destroy evil and rescue mankind.
This is the title track to the last Judas Priest album before lead singer Rob Halford left the band to pursue a solo career. It also marks the debut of their new drummer, Scott Travis, the first American admitted into the band. The album was finished in the spring of 1990 but its release was delayed because the band had to stand trial, accused of inserting subliminal messages into their album Stained Class that caused two troubled teens to shoot themselves. They were exonerated, but before an arduous trial where they had to convince a judge they were not evildoers out to subvert the youth. The album was well received and the subsequent tour was a winner, but Rob Halford found he couldn't make music outside the band without quitting Judas Priest. He was replaced in 1996 by a fan who sang in a cover band - Tim "Ripper" Owens - and returned in 2003.
Frontman Rob Halford told Kerrang! magazine May 25, 2013 that this is the song he's most proud to have written. He explained: "I think it's a wonderful statement. It embodies what metal is - it's everything a full-on screamy metal track should have. Everybody is going a million miles an hour on it, and yet the melody still comes across. That statement that 'He is the Painkiller' - you get 30,000 metalheads chanting it at a festival and it's a great feeling. It's become a very important song for Priest, and for metal too, I think."
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