Does ksharsutra or ksharkarma is painful procedure?

No, not at all the procedure performed under local anaesthesia by making that area numb so there is no chance of pain during procedure. Post procedure pain is bare minimal, can be managed with hot sitz bath i.e. by sitting in luke warm water for 10-15 minutes. Some patient need painkiller pills once or twice in a week. for more info : https://www.arogyampilesclinic.com/faq/