On a physical level, BDSM "sensation play" involves applying carefully controlled stimulus to the human body so that it reacts as if it were actually hurt. This releases pleasurable endorphins, creating a sensation somewhat like runner's high or the afterglow of orgasm, sometimes called "flying". The sensation is related to but distinct from pain. Some writers use the term "body stress".

Note that safety and consent are of paramount importance: all activities should be safe, sane and consensual.

In BDSM play, the top applies sensation to the bottom by spanking, slapping, pinching, stroking or scratching with fingernails, or using implements like straps, whips, paddles, canes, knives, hot wax, ice, clothespins, bamboo skewers , etc. The sensation of being bound with rope, chains, straps, cling wrap, handcuffs or other materials can also be part of the experience.

BDSM players are highly inventive in employing their tools in play, sometimes using ordinary household items as sex toys, known as "pervertables".

In BDSM, the stimulus is always applied in a controlled fashion, with an eye to safety. E.g. a top should know which areas of a bottom's body to avoid while whipping.

BDSM play can be compared to music, with each sensation like a note. Different sensations are combined in different ways to produce the total experience.

Creating a pleasurable BDSM experience has a lot to do with a competent top and the bottom being in the right state of mind. Trust and sexual arousal help a person prepare for the intense sensation.