What about total cumulative pain suffered? If somebody particularly nasty managed to find a way to continuously torture a person while staying just below the threshold of complete organ failure, and the victim was artificially kept alive and suffering for several years, that would tick both your criteria at the same time
Junko Furuta? The worst ways to go must involve longevity of the harm committed, over acuity of pain, no?
What about total cumulative pain suffered? If somebody particularly nasty managed to find a way to continuously torture a person while staying just below the threshold of complete organ failure, and the victim was artificially kept alive and suffering for several years, that would tick both your criteria at the same time