Is anemia always present in sickle cell anemia? and for how long can i experience pain without this being a crisis for sickle cell?

Sickle cell...: ...Disease always has at least some anemia to it, but people with sickle trait are perfectly healthy. And if there is any pain attributable to sickling, that's a crisis by definition: it means that somewhere, clumps of sickled cells are blocking blood circulation.

They call it sickle: Cell anemia because, indeed, patients essentially all have anemia. The anemia actually improves the rheologic (flow) properties of blood in these patients, whose rbcs are otherwise rigid with reduced degrees of freedom for deformability. Sickle cell pain occurs due to microvascular occlusion and tissue compromise. Oral opiates/ nsaids may provide relief, but IV opiates may be needed (pain crisis).