Neurosurgeon’s Protocol to Feel Better Now_ The Best Ways to Heal Your Body _ Live Pain Free

Name: Neurosurgeon’s Protocol to Feel Better Now_ The Best Ways to Heal Your Body _ Live Pain Free
Uploaded: 2025-10-17T17:40:04+00:00
Duration: 1 h 8 min 16 s
Channel: Mel Robbins

Mel Robbins

1 week ago

In today’s episode, you’re going to learn the new science of healing your body, stopping pain, and feeling better now.

One of the world’s most respected neurosurgeons and medical experts alive is here to reveal the new frontiers in
pain management and how you can feel better in your body starting today.

Whether you’ve been living with a chronic condition, you’re dealing with an injury that just happened, or you’re listening for a loved one, you’re going to learn so much from our expert.

Dr. Sanjay Gupta, MD is a world-renowned neurosurgeon, CNN’s Chief Medical Correspondent, and author of the New York Times bestselling book, “It Doesn't Have to Hurt: Your Smart Guide to a Pain-Free Life.”

In this conversation, you’ll learn:
-The new science of chronic pain
-Why your pain is real, even when doctors can’t find the cause
-The groundbreaking pain management options that are available to you that work with your body's natural intelligent systems of healing
-How to prevent acute injuries from turning into chronic pain
-How your nervous system stores pain
-The 5 steps to start feeling better
-The biggest myths about healing (and what you should never do right after an injury)
-Specific interventions you can try, without medication or surgery, to start feeling better now
-How to support a loved one who is in pain or dealing with a chronic illness

You’ll walk away with a new understanding of pain and a real path to relief – starting today.

For more resources related to today’s episode, click here for the podcast episode page: https://www.melrobbins.com/episode/ep...

Follow The Mel Robbins Podcast on Instagram: / themelrobbinspodcast

I’m just your friend. I am not a licensed therapist, and this podcast is NOT intended as a substitute for the advice of a physician, professional coach, psychotherapist, or other qualified professional. Got it? Good. I’ll see you in the next episode.

In this episode:
00:00 Meet the Guest
03:08 What is Chronic Pain?
09:30 How to Use Your Mind to Control Pain
16:59 The Future of Pain Medicine
23:38 Why Meditation is a Powerful Tool in Managing Pain
29:23 The Incredible Rubber Hand Research Study That Proves We Can Fake Pain
37:12 Why Physical Activity is Important for Pain Management
44:58 Train Your Brain to Manage Pain
53:43 Why Does My Jaw Hurt?
56:46 How to Reduce Pain

Category

🛠️

Lifestyle

Transcript

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00:00:00Most people are going to have pain at some point in their lives, but this idea that it has to become

00:00:05chronic pain, that it has to last, that is where the intervention can occur, and I think we haven't

00:00:10spent much time talking about this. Today on the Mel Robbins podcast, we're going to learn the

00:00:15exciting new science about how to heal your body, how to live pain-free, how to feel better now,

00:00:21from world-renowned neurosurgeon Dr. Sanjay Gupta. Chronic pain is now the fastest growing condition

00:00:28in the United States, faster than dementia, faster than diabetes, faster than cancer,

00:00:33somewhere between one in five and one in four people in the United States. Really? So you're

00:00:38talking over 50 million adults are dealing with chronic pain. What is the difference between acute

00:00:42pain and chronic pain? So acute pain is pain that you might feel in the moment, you know, touch hot

00:00:47pan, hot, move your hand away. Chronic pain is when it just lasts, so there's no ongoing insult or

00:00:54injury to your body, and yet the pain persists. Pain is the most mysterious sensation that we

00:00:59human beings experience. You've got to treat it that way. I'm saying this as a neuroscientist,

00:01:06but all pain is in the brain. I don't want that to sound minimizing, okay, but that is where pain is.

00:01:13Pain is in the brain. If your brain doesn't decide you have pain, then you don't have pain. I think the

00:01:18evidence is very clear now that if you're not optimized in your own life, your pain is going

00:01:23to be worse for the exact same injury. There's options out there. There's hope.

00:01:30Hey, it's your friend Mel, and welcome to the Mel Robbins Podcast.

00:01:40Please help me welcome the extraordinary Dr. Sanjay Gupta to the Mel Robbins Podcast.

00:01:46I've been really looking forward to this. I'm a huge fan of yours, a huge fan of the show,

00:01:50and honored that you'd have me. Thank you.

00:01:52Of course, and I am excited to see you after we were colleagues and friends at CNN. I am proud of

00:01:59the work that you're doing. I'm so excited for your new New York Times bestselling book,

00:02:05It Doesn't Have to Hurt. We're going to talk all things about living a pain-free life based on

00:02:10the research and the science, and I'd love to start by having you tell me,

00:02:16what could be different about my life if I take into account everything that you're about to teach

00:02:24us today? Most people are going to have pain at some point in their lives, but this idea that it

00:02:31has to become chronic pain, that it has to last, that is where the intervention can occur, and I

00:02:37think we haven't spent much time talking about this. People develop acute pain, and for some reason,

00:02:41it persists. It's like this memory loop just keeps getting played over and over in their brains,

00:02:48and I think we've learned a lot over the last decade about how to prevent that from happening.

00:02:52So not letting acute pain, which most people are going to experience, turn into chronic pain.

00:02:59If I had to add more to the title of the book, you always want longer titles, I would say it doesn't

00:03:04have to hurt as much or as long. Oh, I love that. What is the difference between acute pain and chronic

00:03:10pain? Just for somebody like me who's not a medical doctor? Yeah, so acute pain is pain that you might

00:03:14feel in the moment. You don't touch hot pan, hot, move your hand away, stub toe. Chronic pain is when

00:03:20it just lasts. So there's no ongoing insult or injury to your body, and yet the pain persists. People, they try

00:03:30and put a time frame on it. So they say if you have pain like that every day for three months, at that point,

00:03:36it's considered chronic pain. Okay. If you have it sort of every other day for six months, you know, you sort of get

00:03:41the idea, but it's pain that just simply won't go away. Dr. Gupta, could you give us a quick list of just things that

00:03:47might be considered chronic pain? I think if you go literally from head to toe, I think headaches, such

00:03:52as migraine headaches, that'd be considered a type of chronic pain. That's a big percentage. Going into

00:03:57the face, there are people who have facial pain, like trigeminal neuralgia and TMJ. Most joints can be a

00:04:05source of chronic pain, going from your shoulders, your elbows, your hips, your knees, down to your

00:04:08ankles. And then there's the back and the neck, which I think are big sources of chronic pain. So it's

00:04:14typically areas of the body which are moving a lot, but now you're not moving because you're in pain

00:04:19or things like headaches. And how many people struggle with this? Because I found the research

00:04:24really surprising because I think you hear the word chronic pain and you're like, oh, that's for old

00:04:27people. No, you know, I got to tell you, Mel, it was so interesting because I first talked to my

00:04:31publisher about this and I thought, how big a problem is this really? I'm a neurosurgeon, so I'm seeing

00:04:37pain all the time. Right. But I thought I was seeing a very select, you know, sort of segment of the

00:04:41population. It's about somewhere between one in five and one in four people in the United States.

00:04:47Really? So you're talking over 50 million adults are dealing with chronic pain.

00:04:51Meaning every day for more than three months, they're feeling pain?

00:04:54Every day for more than three months and for many of them, decades. So three months is sort of the

00:04:58minimum. But when I started, you know, really researching this book and talking to so many patients

00:05:03with pain, it is a daily negotiation for them. Every day. Like you wake up and you may think,

00:05:10I have a little bit of ache and pain here and there, but every day pain is sort of the biggest

00:05:15driving force in their life. They wake up with it. They go to sleep with it. They think about it all

00:05:20day. If they have a conversation with somebody in their life, they're probably going to talk about

00:05:24their pain. So it's for about 17 million people, it completely interferes with their ability to

00:05:32conduct their lives. So they are unable to hold on jobs, go to school, you know, have terrible

00:05:38relationships, all these things. It is, it is really awful. And I have to say, I was, I was stunned,

00:05:43even as someone who, who sort of works in that field, the magnitude of pain that we have in the

00:05:48United States and frankly, many countries around the world. You know, one of the things I also

00:05:52wanted to ask you though, is that for somebody that doesn't wake up every day and experience chronic

00:05:59pain or doesn't have that kind of nagging sensation, why is it important to listen to

00:06:10and watch this and learn from you today? One of the things I think we really have to be mindful of

00:06:15is that chronic pain is now the fastest growing condition in the United States. Faster than dementia,

00:06:22faster than diabetes, faster than cancer. I mean, the numbers again, are mind boggling. So my point

00:06:28being that this is growing. So for a lot of people, hopefully they never have chronic pain,

00:06:34but you know, the, the, the likelihood of that happening is certainly increasing. But I think,

00:06:38you know, Mel, the, the thing about pain is that it's, it's really reflective, I think,

00:06:42of the entire integrated system that is our body. You know, you think of, I hurt my toe or I hurt my

00:06:48finger, but the idea that, you know, everything in your body, the, the, the finger and the toe

00:06:53certainly, but the tendons, the nociceptors, which are pain receptors, the, the firing mechanisms,

00:06:58that go to your spinal cord, up to your brain, how your brain consciously sort of processes that

00:07:03experience. It's all fully integrated. So if it's not working well, you're likely to hurt more.

00:07:10And so you think I smashed my, my finger with, with a hammer. Your experience on Tuesday, having done

00:07:19that could be totally different than the same exact thing on Wednesday, based on whether you got a good

00:07:26night's sleep, whether you had a tough call with your mom, what the weather's like outside, what

00:07:30your past history with pain is. If you have a history of depression or anxiety, my point being

00:07:35that pain is perhaps the most integrated sensation that we have as humans. And that's wondrous for a

00:07:43neuroscientist like me, but it's also very mysterious. And so it presents opportunities and it presents

00:07:49challenges.

00:07:50I want to make sure I understand what you just said, because you basically said, if I, you know,

00:07:55I'm doing a project at home and I miss the nail and hit my thumb and it's Tuesday and optimal lifestyle

00:08:03conditions, I'm in a good mood, I've eaten, I've exercised, I've done all the things that everybody

00:08:09that is an expert and done the research says you should do to be in your best health. The pain that I

00:08:16would feel in that moment is different than on a day where I haven't slept, I'm not, I haven't eaten,

00:08:23my stress level is through the roof. Is the pain worse when you haven't slept and you haven't eaten? Is

00:08:28that, is that what you're telling me?

00:08:29Yeah. I, I think the evidence is very clear now that if you're not optimized in your own life, your pain is

00:08:36going to be worse for the exact same injury. Or if a patient comes into the emergency room, they have the exact same

00:08:42looking x-ray to patients. You can almost predict based on other factors, seemingly arbitrary factors,

00:08:49which of those patients is going to be in greater pain. And also the likelihood that it would turn

00:08:54into chronic pain, going back to that thing, like this should not cause chronic pain. You'll immediately

00:09:00pull your finger away. Right. And that's reflex. That's not really a pain response. But then the idea

00:09:06that, ah, that really hurts. Yes. And maybe even how you would quantify it yourself, both in terms

00:09:12of intensity and unpleasantness. Those are the two things pain folks really want to know. Not only how

00:09:18much does it hurt, but how unpleasant is it? Which is, again, people are going to define this differently,

00:09:23but it could be so variable person to person and so variable within the same person, which is

00:09:30remarkable. So is it also true that if the amount of pain and the unpleasantness that you feel varies

00:09:38day to day based on how you're feeling, conditions that may or may not be under your control, is it

00:09:44also true that if you look at those and you focus on a more holistic approach, it's also the solution

00:09:51to minimizing chronic pain that you feel? I think so. I think that that is where the science is headed.

00:09:57Wow. You should start thinking of chronic pain much in the same way that you think of any other

00:10:02chronic disease. You're trying to avoid diabetes. You're trying to avoid heart disease. People would

00:10:07not put pain necessarily in that same category, right? I wouldn't. Because you think of it just

00:10:11purely like a physical sort of sensation. Yes. But I think we're starting to understand that pain is

00:10:17really affected by all these different things in the body, much like many of these other chronic

00:10:21diseases are. So if you're optimized in your life, and some of it is very tangible stuff,

00:10:27if you decrease inflammation in your body overall, then an injury is less likely to hurt as much

00:10:33because you're not sort of harnessing as much inflammation, over-inflammation to it.

00:10:38If you're physically active, if you're doing all the things to keep your body and your muscles and

00:10:43your tendons strong, you're not likely to hurt as much. We kind of get that. But the idea that if you

00:10:49don't have depression, something wouldn't hurt as much. This is more of a revelation.

00:10:54Wow.

00:10:55One of the doctors I interviewed for the book said this quote to me, which really stuck with me.

00:10:59And the quote was, chronic pain hardly ever occurs in isolation. It always comes with baggage

00:11:07attached. Now, baggage, I don't mean this in a pejorative way, but baggage could be all kinds of

00:11:12things. It can, again, be depression, anxiety, poor sleep. You have to address the baggage as much as

00:11:18you address the pain. And if you look at good pain doctors, I visit a lot of pain clinics.

00:11:23I mean, they have psychologists on staff and many times it's the psychologist that is the first

00:11:28person to see that patient. Why?

00:11:31Because that baggage is the one thing that probably no one else has addressed because they get pain

00:11:37medications. They may get procedures. They're always trying to treat the chronic pain like an

00:11:42acute pain, like an immediate pain. Yeah.

00:11:44But now it has all this baggage attached to it. If you don't address the baggage,

00:11:48you're probably never going to be able to actually fully address the pain. And, you know,

00:11:53look, this is a provocative area in pain medicine. And there has been these authors before me like

00:11:58John Sarno, who anybody who knows, reads about pain will know that name because he wrote a book

00:12:02about back pain. And he sort of really championed this idea of psychosomatic.

00:12:08Yes.

00:12:10And, you know, in his New York Times obituary, there was some line in there that said something

00:12:14like half the country thought this guy was a prophet and half the country thought he was a pariah

00:12:18because the idea of saying, hey, look, your brain is deciding this. All these different things

00:12:25play a role. Some people thought you're minimizing my pain. You're marginalizing folks who are in

00:12:32chronic pain. I don't think that was his intent. It's certainly not my intent. But at the same time,

00:12:37this idea that, yeah, a psychologist maybe should be involved in dealing with your chronic pain

00:12:42because there's that baggage attached. And that baggage, by the way, is a two-way relationship.

00:12:48If you have more baggage, more pain. But if you have more pain, you have more baggage.

00:12:52I think sleep is a really good example. A lot of people I talked to for the book said,

00:12:58I'm not getting good sleep because of my pain.

00:13:00Well, that makes sense.

00:13:01That makes sense, right?

00:13:02And it's sort of like a chicken and an egg thing. Do you have pain because you're not getting sleep?

00:13:05You don't sleep because you have pain.

00:13:07That's right.

00:13:08So how do you untangle that knot?

00:13:09I think you have to address both. That's the thing. I think we live in a very monotherapy,

00:13:15sort of simplistic culture sometimes when it comes to medicine.

00:13:18I want to identify the problem as elegantly as I can and then address that single problem.

00:13:25But the idea that maybe your pain is worse because you're not getting sleep,

00:13:31that bi-directional thing. Because I think most people think,

00:13:33I'm not getting good sleep because of the pain. So take more pain meds,

00:13:36do things to address the pain. But what the studies have shown is if you address the sleep

00:13:41as a primary sort of thing, you can greatly reduce your pain scores.

00:13:46Simply by addressing sleep.

00:13:49That's the thing. And this is measurable. I think that people have sort of anecdotally

00:13:53known this for some time. But understandably, we're a society that wants data and evidence

00:13:58and facts and proof of that. We treat symptoms far more than we treat root causes. And I think

00:14:05pain is probably the best example of that in society. At one point, we are what? Not even 5%

00:14:13of the world's population. And we are taking 90% of the world's pain meds.

00:14:17Wait, say that again?

00:14:19We are not even 5% of the world's population. And we were taking 90% of the world's pain medications.

00:14:27What does that tell you?

00:14:29It tells me we don't like pain. We have deep disdain for pain in this country. And look,

00:14:34I don't like pain either. But the idea that you can overly medicalize something,

00:14:38that you can overly proceduralize something. We did 1.2 million spinal operations last year.

00:14:45Okay? To give you context, in the UK, they did about 50,000. Now, they're a quarter of our

00:14:50population. But still, you do the math. If they were doing our rate, it would still be one-sixth

00:14:56of what we do here in this country. So we don't like pain. And we'll do anything to rid ourselves

00:15:03of pain. But most of the things that we do do not necessarily treat the root cause.

00:15:08There's even cultural things when it comes to pain. I mean, this book that I wrote is not about

00:15:14the opioid epidemic. Although you can't talk about pain in this country without talking about it.

00:15:19Like, how did that happen? How did we get to the point where 80 to 90% of opioids were being used

00:15:24in the United States alone? Worldwide consumption. To be honest, I think part of that was because

00:15:32pain sort of became considered what they call the fifth vital sign. So it's as important as

00:15:38respirations and heart rate and all these other things when you go into the emergency room.

00:15:42People would be asked about their pain if they came in for a cold. So pain just became something

00:15:48that everyone was super focused on. And I think it led to a lot of treatment when treatment wasn't

00:15:57always necessary. Because I don't want that to come off non-empathetic. Like, I'm really,

00:16:02really empathetic to people's pain. But at the same time, can we say we've over-treated it?

00:16:07We've over-operated on it. And we even do things culturally that don't happen in other places

00:16:12around the world. The data suggests very much that's the case.

00:16:15Well, I don't think that's the case you're making at all in your book. I think the case

00:16:19that you're making is one that's extraordinarily exciting and optimistic. Because you're basically

00:16:23saying that you may have lived a long time with this. You may have been over-medicated.

00:16:29It has certainly impacted your life. And for you and your loved ones, there's exciting research

00:16:36that suggests there are things that you can do beyond what you have been told.

00:16:42That's right. For somebody who may be listening, who is either experiencing pain day-to-day,

00:16:48maybe you have the kind of job that's really beaten your body up, or you had an accident

00:16:54decades ago and it still hurts your back or still hurts your neck. What are you, Dr. Gupta,

00:17:00excited about after doing all this research for this new bestseller that you've learned about the

00:17:08kind of frontier of science and how we can think differently about pain and think differently

00:17:16about treating it and relieving people of it?

00:17:18I think there's two sort of broad areas that I'm really excited about. One is, you know,

00:17:23high-tech, innovative work that is happening, which as a neuroscientist was really mind-blowing

00:17:30for me. And I've been in this world for 25 years, so I've learned a lot. But I think the second thing

00:17:36is because opioids sort of sucked up all the oxygen in the room for 25 years, you got opioids for

00:17:44everything. Kidney stone, dental procedure, hip fracture, everything was treated with an opioid.

00:17:50As a result, all these other modalities, some of which are not new, some of which are quite old,

00:17:56actually, got short shrift. They just were not utilized for things.

00:18:01What are some of those modalities?

00:18:03So, if somebody comes into the emergency room with a hip fracture, which is a really common problem,

00:18:09especially as people get older, they almost assuredly would get opioids. Now, in many ERs

00:18:14around the country, they're giving nerve blocks. So, it takes about 10 minutes and they're essentially

00:18:20numbing up the area around the hip and giving this nerve block. Helps with pain immediately.

00:18:26Pain scores drop to zero. But also, it obviates the need or prevents the need for opioids going into

00:18:31the future. They don't need opioids after that. They've gotten rid of that acute pain syndrome.

00:18:37When I was in this emergency room in Brooklyn, Maimonides, which is this really cool place,

00:18:42by the way, it's level one trauma center, super diverse. They speak 120 languages there.

00:18:47And they are championing what they refer to as opioid optimized ERs, which is not to say opioid

00:18:55free because opioids can still play a role, but they will use opioids as a last resort instead of

00:19:01a first resort. But they were using virtual reality.

00:19:04How does that help with pain?

00:19:06There was a 76-year-old woman who came in with terrible knee pain, bad enough to take her to an

00:19:11emergency room in the middle of the day, which, you know, that's a big ask of somebody, right?

00:19:15It's her whole day. And they put on virtual reality goggles, 20 minutes, took her to a nice

00:19:21Indonesian beach somewhere. And her pain scores dropped from about an eight to a three.

00:19:27How does it work?

00:19:28What's your theory?

00:19:30People often say it's distraction. I think it's probably some component of distraction from the

00:19:35pain. But I think it's also leaning into this idea that we do truly have this integrated system.

00:19:42If you are on an Indonesian beach, your stress levels are probably dropping. You're probably

00:19:49releasing more of the feel-good hormones. You're activating something in your body known as your

00:19:53endogenous opioid system.

00:19:55What is that?

00:19:56It is our body making opioids. You know, the opioid pills that you take, like many things in medicine,

00:20:03got their inspiration from the human body. So many of the things that we do in medicine take our

00:20:09inspiration from the human body. But let me tell you the big difference between the opioids you make

00:20:13versus the opioids you take. Opioids you take, like pills and stuff like that,

00:20:19they may decrease pain, but they may also enhance memory. Okay? So they actually,

00:20:27in some ways, are forcing you to remember that experience or remember that pain, sort of creating

00:20:32that memory loop around pain. And they also decrease mood. You know, after a while, if you've ever spoken

00:20:37to an opioid addict, they're at some point not taking opioids to get high. They're taking it to

00:20:44not feel terrible, right? To feel some sense of normalcy again. So point being that opioids decrease

00:20:52mood, they increase memory in a bad way, meaning making you remember the painful experience, even as

00:20:58they decrease pain. But your own natural opioids also decrease pain. They decrease or inhibit memory

00:21:06of the painful experience, and they improve mood. It's remarkable to me. So you ask, what is the

00:21:14mechanism of something like virtual reality goggles, or frankly, a lot of these modalities? In some ways,

00:21:19they're letting the body do its job, and they're helping it along the way. It's your own endogenous

00:21:25opioid system that we're just trying to give it a little push, a little nudge, you know, sort of

00:21:30make it work. And if you can get it working, it's fantastic. I personally think it's very exciting to

00:21:39be reminded that even if you're somebody that is experiencing chronic pain right now, or you have

00:21:45somebody that you love in your life who is, that even if it's from an acute injury, even if it's from

00:21:52an old injury, even if it's been nagging around for a while, that your body is designed, it has this

00:22:01incredible intelligence to it, to have you forget the pain. What you're here to suggest is that there

00:22:10are really exciting things to consider that both help your body feel less pain, but also help your body

00:22:18release these natural healing things that we haven't been talking about. That's right. That's right.

00:22:22Are there ways at home that if you don't have a VR set, that you could extrapolate this exciting research

00:22:31and stimulate the release of that, I can't even remember what, natural something, something system?

00:22:38Yeah, there are lots of things that we can do. A lot of people refer to this whole

00:22:43endogenous opioid system as a component of the placebo effect, right?

00:22:48It doesn't sound like a placebo. It sounds like it's working.

00:22:50Yeah, but placebos can work.

00:22:52Okay.

00:22:53That's the thing is that everything gets tested against a placebo. And people have often asked,

00:22:58I gave that person a sugar pill and yet they improved. How could that possibly be? It's not

00:23:06the sugar pill, obviously. It's your expectation that that was going to help.

00:23:10And when you expect something to help, it helps. Expectations and experience are inextricably

00:23:19linked. If you expect something to work for your pain, it's far more likely to work. It's far more

00:23:25likely to change your experience. And what is at the root of that is probably this endogenous opioid

00:23:31system. You're just basically making your body create all these various substances that are going

00:23:36to make you feel better. One of the things I got really interested in now with regard to what you

00:23:40can do at home is meditation. I think a lot of people hear meditation. Yeah, sounds good. I mean,

00:23:48I like to meditate every now and then. It relaxes me, chills me out, whatever. Me too.

00:23:53What I think has happened over the last decade is that these researchers have decided to really put

00:23:58it to the test and figure out how do we actually test the value of something like meditation.

00:24:04So there's these researchers at UCSD, Eric Garland sort of leads this team, and they created a really

00:24:11fascinating experiment where they basically put these heating filaments on your arm. Okay. I did this

00:24:16experiment myself. These heating filaments are hot, really hot, just to the point where you're not

00:24:22getting burned, but you're almost at that point. Like if you were touching a really hot plate,

00:24:25you would drop it. And these are on your arm. Okay. And you sit there pre-meditation and they

00:24:32basically measure your pain scores and your unpleasantness scores, these two things. And

00:24:38then you go through this guided meditation. And it's a very specific meditation. It's part of

00:24:42something known as the MORE protocol, which is mindfulness-oriented recovery enhancement. And you

00:24:48see how much did your pain scores and your unpleasantness scores drop. Now, are you meditating while

00:24:54the things on your arm? You're meditating while the things on your arm. You meditate before,

00:24:57and then you continue to meditate as you start to go through the experiment.

00:25:01What did you experience?

00:25:03So numerically, I experienced a drop in my pain scores from a 7.4 to a 2, and my unpleasantness

00:25:10score from a 5 to a 1.8.

00:25:13Wow.

00:25:14Very significant. And that was just purely meditation. To give it even more context,

00:25:20what Eric Garland and his team will say is, what else in society kind of gives you similar

00:25:26relief from pain and unpleasantness? And the thing that they came up with was five milligrams of

00:25:33Oxycontin. The idea that meditation could give you that sort of relief was pretty mind-numbing,

00:25:41I think, for a lot of people. I don't mean to suggest that that pain relief lasts forever,

00:25:45just like Oxycontin doesn't last forever. But during the time that people meditate,

00:25:51they can drop their pain scores significantly. And that's just your mind. People really aren't

00:25:57sure why these things work, and it's hard to study. But what they do know from an outcome

00:26:02standpoint is that these patients are getting tremendous relief. There's options out there.

00:26:07There's hope out there. But pain is the most mysterious sensation that we human beings

00:26:13experience. You've got to treat it that way. Wow. What are the things that you wish people in

00:26:20pain knew? And what do you wish are the one or two things that you'd start doing right now? We're

00:26:27going to get into a lot of the protocol and more specific stuff, but just a bit of here's the North

00:26:34Star of what's possible. Because you may be right now in a day-to-day life where you just think

00:26:39you're stuck with this back, or you're stuck with this knee, or you're stuck feeling like this

00:26:45forever. You know, I preface all these conversations I have with patients with a reminder that,

00:26:53look, I don't want to say anything that's going to minimize their pain. Because I think when I say

00:26:59something like, all pain resides in the brain, I'm not at the same time saying, it's all on your head.

00:27:05Those are two different things. And I'm saying this as a neuroscientist. But all pain is in the

00:27:11brain. I don't want that to sound minimizing, okay? But that is where pain is. Pain is in the

00:27:18brain. If your brain doesn't decide you have pain, then you don't have pain. And by the way,

00:27:23the flip is also true, which is the brain can decide you do have pain for no reason. People who

00:27:29have limbs that are missing. They have phantom limb pain. How could that be that it's not even

00:27:35there anymore, and it still hurts? Or something known as chronic regional pain syndrome, which is

00:27:41basically pain in your hands or feet without any injury or any obvious trauma or anything.

00:27:47So, you know, I start there often when I talk to patients, just sort of reminding them of that,

00:27:52that for some reason, no fault of your own, but there's this memory loop that is continuing to get

00:27:57replayed over and over again that's causing that pain. Let's address that in some way.

00:28:04Addressing that baggage as much as you're addressing the pain. It's not... I think that one of the

00:28:09questions that I think a lot of people have is why? Why does the body do that? Is it a glitch

00:28:17of our central nervous system to just keep playing those memory loops? If you talk to people like

00:28:23Bessel van der Kolk, who wrote this great book called The Body Keeps the Score, I think what

00:28:28Bessel would suggest is that there's something else that's probably happened in your life.

00:28:35And maybe you can't remember it, but the body keeps the score. And maybe by addressing some of those

00:28:41things that perhaps aren't in conscious awareness for you, you're not thinking about day to day.

00:28:45You're not thinking about why your jaw hurts. You're not thinking about why that might be

00:28:49necessarily. Trying to treat the symptom more than the cause. And you may not be able to identify

00:28:53the cause yourself. Here's what I find super exciting about this. Because when I've been in

00:28:58pain, I want to defend it. Because it feels very real. But if you could just open your mind to the

00:29:05possibility, that maybe you don't need to fix your back or your leg or your neck, maybe that part of

00:29:13the solution is really addressing the memory loop that's playing in your head that opens up a whole

00:29:19different possibility and an avenue of treatment and pain relief that you haven't even considered.

00:29:25In fact, you write, I want to read to you from your blockbuster book, It Doesn't Have to Hurt.

00:29:30This comes from page number nine. The point is that the brain creates pain on cue from a vast array of

00:29:39stimuli, biology, psychology, social, emotional, environmental, even cultural. And just as we

00:29:46now understand that the brain can be nurtured, developed, and optimized at any age, there's

00:29:51growing evidence that the brain can also rewire itself in ways that change the neural circuitry for

00:29:59pain? Yes. Really? Yeah. Reducing its intensity or duration and potentially eliminating it altogether.

00:30:07So you're saying that there's growing evidence that your brain can rewire itself and change that

00:30:13memory loop and the neural circuitry for pain, even pain that happened a long time ago that you're still

00:30:19remembering. Still dealing with, still remembering. Neuroplasticity, you know, which is sort of the name

00:30:25for this larger concept of being able to change your brain? There's this phrase, I think it came

00:30:31from like the 1940s, Hebbian, Hebb was the doctor who coined this, but basically neurons that fire

00:30:37together, wire together. The thing about neuroplasticity that I think a lot of people don't

00:30:42realize is that it's not an inherently benevolent process, nor is it malevolent, nor is it bad.

00:30:48It's neutral. It'll kind of do whatever you ask it to do. So if you're hyper-focused on the pain,

00:30:55you're firing neurons together and they're going to wire together and that's going to reinforce the

00:31:00memory loop. What is I think fascinating about pain is that pain circuits travel and they go through

00:31:05all these various areas. Your amygdala, which is your emotional center, it tends to be larger in

00:31:11patients who are in chronic pain. Their prefrontal cortex tends to be smaller. So their judgment and

00:31:17things like that tend to not be as good because their prefrontal cortex is shrunk to some extent.

00:31:23But it also goes through the hippocampus, which is your memory store. So you might start to

00:31:29really remember it well. Your past experiences with pain, you remember those and they may amplify

00:31:37your current episode with pain. So every time you start to have a twinge of pain, it's like, man,

00:31:43it just skyrockets. It's like, it just went from zero to a hundred just like that. And I've seen

00:31:48this in patients, even like in real time, they'll be in my office and they'll sort of be there. And

00:31:54then all of a sudden they're cringing. Nothing happened to them, right? It wasn't like they fell

00:31:58or anything. They're just sitting there. Like what is going on there? Why is that suddenly gone from

00:32:04zero to a hundred or from 10 to a hundred? A lot of that is because this very complicated sort of loop

00:32:10of pain circuitry, including memory. Well, let me ask you a question. Just like even in

00:32:14the basics. So I kind of understand this when that object hits my foot, right? I'm taking it like

00:32:21the skin and nerves and everything send a signal up to the brain in nanoseconds. And then your brain

00:32:27has to like a supercomputer register what just happened. Yes. Why does it tell me it's painful?

00:32:33Well, what is the purpose of that? So if it's an acute pain, it's, you know, oftentimes it's to teach

00:32:37you a lesson like, hey, Mel, don't be a klutz. Don't drop that vase on your foot anymore.

00:32:42Yes. I mean, it's the same thing with, you know, hot pan or stubbing your toe on the corner of your

00:32:45bed. That I understand. All that. It's all part of the, these are lessons. These are the warning

00:32:50systems. But, you know, your brain in some ways is the ultimate regulator of your pain. And it's kind

00:32:55of like you're scrolling your social media feed. Okay. Just imagine the brain scrolling a social media

00:33:00feed. Okay. It's like, and then all of a sudden something incendiary pops up. Okay. That's the vase

00:33:05falling on the foot. I'm thinking, wait a second. Is that, is that real? Or is that fake? First of

00:33:11all, the brain's deciding all this in a split second. And then it's starting to take all these

00:33:15other things into account. You know, has this happened to you before? Did it hurt last time

00:33:21it happened to you? How much did it hurt? Any history of depression, anxiety, all these different

00:33:27things come into play. That's the thing. When I started writing this book, I thought I was

00:33:31pretty smart on this because, you know, 25 years I've been taking care of patients with

00:33:35pain and I, and I learned a lot and, you know, it's a fine line trying to navigate, um, how

00:33:42to teach people about pain versus just teaching, just treating their pain.

00:33:46Right. And also since it's such a brand new way to think about it without making someone

00:33:54feel disempowered because even if your brain is misfiring, you're the one that's still feeling

00:34:02it. That's right. Your brain is now deciding this is a more significant injury. Got it.

00:34:07And you know, or, or, or. Oh, it's organizing a response to get you to take action because

00:34:13if it's more serious, you need help or people around you need help and you got to do something.

00:34:19You got, yes. So the pain is like an alarm, ding, ding, ding, move, do something. That's

00:34:24right. Okay. Pain is, is, is an alarm system in many ways. Well, I was just thinking about

00:34:29the fact that if that vase were not pottery and it were, let's say Tupperware, if it hit

00:34:35the foot, even at an object that size, my brain would notice, but it would also register as not

00:34:43as painful. That's right. That's right. And so I can see what you mean that what's happening to

00:34:50your foot or your hip or your back or whatever, or your tooth is just happening. It's your brain

00:34:55that is kind of registering how much we're going to care about this. Yep. And, and, and deciding then

00:35:02what your experience is going to be. Got it. Yeah. Have you ever seen that experiment where they,

00:35:07they take a hand and then they take a dummy hand and they put it over here. And so, and then they

00:35:12start your, and your actual hand is behind the back. And then they start sort of touching

00:35:17the dummy hand and touching your hand in the same places to sort of like, I'm touching

00:35:21this finger. You mean like they're touching the dummy hand and you feel that in the hand

00:35:24behind your back? Well, they're touching, they're touching your hand in the back as well. So

00:35:27they're basically trying to get you to correlate the dummy hand with your hand. Okay. Okay.

00:35:32And so then all of a sudden the dummy hand, it starts to feel like your hand and all of a

00:35:36sudden they take a hammer and they smash the hand. And then you pull your hand back.

00:35:39Right. It's not even your hand. Well, I don't even have the dummy hand and I felt

00:35:44like it was coming. Right. Well, the mirror neurons are firing.

00:35:47That's right. So, you know, the idea that you can, you're tricking the brain obviously,

00:35:53but the point is not to trick the brain. The point is to show you that all pain exists in

00:35:58the brain. Your brain decided that hurt, even though it wasn't even your hand.

00:36:02This is like a whole new frontier in science. It really is. I really understand this now in the

00:36:09example of dropping a ceramic vase on my foot versus a Tupperware one. And I understand that

00:36:14it creates an alarm system, right? That is designed to get you to really like pay attention.

00:36:21Like we got an issue here. This is threatening you deal with it, which is why if you don't

00:36:27feel pain, you're not even going to pay attention to it. Right. If you have more like a structural

00:36:32issue, so you've got a disc problem in your back or you have arthritis in your knee, does

00:36:40it work the same way or how is that different or is it different at all?

00:36:44I think it's different because when you have a structural problem, whether it be in your

00:36:47spine or a joint, you're continuously activating those pain receptors. Okay.

00:36:52And so that, that, that is a little different than somebody who, who basically you look at

00:36:56them and you got, there's nothing going on here structurally, anatomically, otherwise there's

00:37:01no injury, whatever it might be. So then it's, then you have to focus more on what else, what

00:37:07other parts of this pain system are not working properly. And that's all going to be in the

00:37:11brain. So, you know, like a rich role, I talked to him the other day, he, he had a very significant

00:37:17spine problem. Oh my gosh. And he did surgery where they went in the front and the back.

00:37:21And the back. Yes. Yes. I, I, I, you know, rich is a good friend. We were talking throughout

00:37:26that entire process and you know, he's a ultra man athlete, you know, just, I think he was

00:37:31shocked at how much his post-op recovery sort of took. Now, one thing that rich would say

00:37:38if he were here was that he'd been dealing with chronic pain really for 13 years since

00:37:422012. And part of the reason that it took a lot longer for him to heal and he's still

00:37:48not completely recovered from a pain standpoint, his pain, which was acute back in 2012 started

00:37:55to basically be encompassed by all this baggage that we talk about.

00:37:59Yeah.

00:38:00And rich is a smart as he is and as resilient as he is probably wasn't addressing the baggage

00:38:05that came with this, that idea of even a guy like him. So this should, you know, he he's

00:38:10an ultra man. He's an athlete. He's takes great care of himself. Yet he still had this

00:38:14because of that, that added baggage. I think now that he's addressing that more, I think in

00:38:20a very, very intentional way, he's starting to get relief from his pain.

00:38:23I would love to have you just tick off before we jump into the protocol that people can follow.

00:38:30What constitute baggage that creates a greater pain sensation and goes along with it? So that

00:38:38as you're listening on behalf of yourself or a loved one, and you may have a structural issue,

00:38:44you may need surgery for something, you may need physical therapy. But there's probably some things

00:38:51that are weighing you down that both increase pain and also help alleviate it and help accelerate your

00:38:59healing. So what is like the top five things of baggage that you tend to see?

00:39:04Previous history of pain is a big one. If you've had pain in the past, then you have a relationship

00:39:10with pain. And for many people, that amplifies a future pain experience. Depression. About 40%

00:39:17of people with chronic pain also have depression. Anxiety. Mostly untreated forms of this, but even

00:39:25in people who have some forms of treatment, they may still have added chronic pain. Poor sleep.

00:39:31That was a big one. That was a big one. And again, it's a bi-directional sort of relationship.

00:39:37Pain worsens sleep. Sleep worsens pain. But those are some of the big things I think that have always

00:39:43felt a little squishy in terms of the relationship to pain. What about high levels of stress in your

00:39:47life? You mentioned depression, anxiety, a history of pain, which I would think makes you brace more

00:39:53for pain. That's right. The not getting enough sleep, stress. Is there anything else that you think

00:40:00is important for somebody to like, okay, check, check, check. These are things that I need to look at.

00:40:04I think certainly how we move, how we nourish ourselves, and how we rest, I think are things

00:40:12that are important with all chronic diseases, but especially with pain. And I think the idea that

00:40:18as a general rule, if you're told that you're in pain, you're told to not move, to sort of stay still.

00:40:26And I think the data is very clear on this, that that's not the right answer. Look, if you have a

00:40:32broken foot or something like that, no one's telling you to walk on that. But for the most part, movement

00:40:38is really important. Let's talk about the MEAT protocol, because now you're going into movement.

00:40:42So I really want to talk about what to do. And you write and unpack the MEAT protocol, but what is it?

00:40:48This is an acronym, and it's to be sort of a countermeasure to the RICE protocol. If you sprain

00:40:56your ankle, for example. So RICE is rest, ice, compression, elevation. Okay. First of all,

00:41:05mobilizing, which is the M in MEAT, then exercising, continuing to actually be actively moving,

00:41:13analgesia or pain medication, if you need it, and treatment, such as physical therapy,

00:41:20things like that, tend to be much better in terms of preventing chronic pain. So it might

00:41:28it hurt more in the moment to not ice it, compress it, elevate it. Yeah, it might. But what you're

00:41:35trading off is a decreased likelihood of developing chronic pain. Why would resting develop chronic pain?

00:41:42When I was working on the book, I really wanted to try and answer a question, which was,

00:41:47who is more likely to develop chronic pain? So, you know, seemed like a fair question. Not

00:41:51everyone develops chronic pain, despite the numbers as high as they are. Most people don't

00:41:55develop chronic pain, but who is? And I started talking to these researchers, and they were asking

00:42:01the same question. And one of the things they found was that at the time of your injury, whatever

00:42:06it might be, the people who had the lowest levels of inflammation were the most likely to have chronic

00:42:13pain. Why? Because wouldn't you want to reduce inflammation? That's why I'm resting and elevating

00:42:19and icing and compressing. I think what the researchers sort of realized is that when you

00:42:24are sending all those healing molecules to your site of injury, letting the body do its job,

00:42:29it's actually pretty good at doing that. All that swelling and that inflammation, again,

00:42:35if it's broken, go get it treated and get it fixed. I'm talking more like a sprained ankle or

00:42:39something like that, something that's non-surgical. If you allow the body to do its job,

00:42:46then it's more likely to sort of do the job in the moment and not sort of layer out your pain over

00:42:52weeks and months. It's almost like you're going to hurt a certain amount. Do you want it to hurt

00:42:56now for a little bit or do you want to have that pain continue for a long time? I'm greatly

00:43:01simplifying here, but that's sort of where these researchers landed. They said the least

00:43:06inflammation was the most problematic. And what do we do when we rest and ice and compress and you

00:43:12elevate? You're decreasing inflammation and we just learned that decreasing inflammation is more

00:43:17likely to result in chronic pain. So we do things because they feel good in the moment, but not

00:43:23necessarily good for us in the longterm. So what does movement mean if you're hurting like light

00:43:29movement, like just stretching it, rolling it like that kind of thing? Yeah, mostly not resting,

00:43:34you know, getting up and walking around, uh, going for walks still, you know, it might hurt again if

00:43:39it's, but for most people continuing to move it, getting those, those, if you have to imagine it,

00:43:45imagine those healing molecules getting to that site of injury and sort of doing their job.

00:43:49The body does a remarkable job of actually treating pain and treating injuries if you let it. But so

00:43:54much of what we do is sort of interfering with that process. We're blocking it by decreasing blood

00:44:00flow to the area, decreasing inflammation, all with the hopes that we're going to get rid of the pain

00:44:05and it's going to go away forever. Well, you know, what's interesting is that if I think about this

00:44:08in a common sense standpoint, if I am feeling stiff, if I sit, I'm going to get stiffer. If I stretch,

00:44:16which I would assume is sort of what you're talking about, because you're actually in stretching your

00:44:22muscles or reaching for your toes, you are signaling and sending more blood flow and molecules to those

00:44:30areas that are tight. And so stretching kind of blows when you first do it first thing in the

00:44:35morning, cause you're creaky and at least I am, and you can't, but it's kind of amazing how after

00:44:40just five minutes of moving and stretching, your body is designed to feel better, to loosen up. And

00:44:47that's kind of what you're talking about, isn't it? That's right. People who are moving into older age,

00:44:53where they're just constantly moving, they're far less likely to have chronic pain.

00:44:58How can you start to retrain your brain to experience pain differently? Because I feel smarter.

00:45:05I feel like I'm getting this. You're going to be the best judge of how to retrain your brain. And

00:45:11what I mean by that is that just simply paying attention to your pain and maybe even keeping a

00:45:18pain journal for a period of time to sort of- Wouldn't that make it worse? Or does it make it

00:45:22better? Better because you're now starting to go, you know what? I'm going to stop assuming I'm in pain

00:45:27all the time and I'm going to start to notice when I'm not. Is that what you're doing?

00:45:30I think you're trying to find the things that are correlating with your pain. Every time I talk

00:45:35to my mom, my back hurts a little bit. Well, that may be your mom, not mine.

00:45:39I'm kidding, mom. She watches your show. I got to say this.

00:45:43We love you. You did a great job, mom. But that's going to cause you a lot of pain. He was just kidding.

00:45:49Can you give me some examples of what you've seen that have a correlation to when people's pain

00:45:54spikes? Yeah. So, you know, sometimes it can be really obvious things. Some people are going to hurt

00:46:00more in the morning. Some people are waking up in the middle of the night with their pain. Is the pain

00:46:03worse in the morning or at night? What things make your pain better or worse? Besides medications

00:46:09I'm talking about. I always feel okay when I'm doing X, Y, or Z and starting to dig into those

00:46:14types of things. I think the point a little bit in terms of training the brain is that no one has

00:46:20really been talking about this. I'm not the first by any means. Guys like John Sarno, people have done

00:46:26this for some time. But the idea that it has largely been ignored looking at these other things.

00:46:31Maybe medications are necessary for certain things like migraine headaches. There's new classes of

00:46:36medications. Neuropathic pain. That can be, you know, that sort of lancinating, terrible lightning-like

00:46:41pain that you get in your arm or your legs. Some of those you may need medications. But the idea that

00:46:46despite those medications, you continue to have chronic pain. What are your triggers for that?

00:46:53Figuring out what those triggers are will, I think, be the first step towards training your brain.

00:46:59And I, you know, I don't want to over or underemphasize the value of true brain training,

00:47:04whether it be meditation, whether it be virtual reality. I would say, look at the data. I mean,

00:47:10I'm not just telling you this. And I was a skeptic of this. You know, I'm a neurosurgeon. I'm the guy

00:47:16who opens the head and, you know, does things to the brain. The idea that meditation could cause these

00:47:22changes. We now know meditation objectively and measurably changes your brain. It causes thickening

00:47:28in certain areas of the brain that help reduce chronic pain. So there is really active brain

00:47:34training that can help you in the moment and help decrease your pain long-term as well. And these are

00:47:39all within your reach. I mean, you don't have to go to some fancy clinic to be able to do a lot of this.

00:47:43You know, so many people deal with back pain. Are there things that you found in all this research

00:47:49that are kind of top of the list to lessen back pain, Dr. Gupta?

00:47:54If you've, you know, again, get it checked out. I mean, I evaluate a lot of back pain. Make sure

00:47:59there's not a structural problem like our friend Rich Roll had, something like that. Let's say you've

00:48:03looked at everything and they say, hey, all your scans and everything are normal, which is what

00:48:08happens 90% of the time when I see a patient, x-rays, MRIs, all that sort of stuff. Then I think,

00:48:13you know, really understanding that the back is something that I think a lot of people will rest

00:48:19in response to pain. They sit a lot. And when you're sitting, you're basically axial loading

00:48:27that part of your spine a great deal. So despite the fact that you're told the rest, I'm going to

00:48:31sit down instead of stand, that's probably making it worse. And I think as a general rule, sort of

00:48:36applying the same meat protocol for this, the mobilization, the exercise, and reminding yourself

00:48:44that there's nothing toxic happening in my body. People will say, I don't want to go for a long walk

00:48:50or do something like that. I'm going to hurt, you know, my back hurts. I'm going to damage it more.

00:48:53No, you're not. If you've already checked that out and you can check that part off the list,

00:48:58like you're not damaging your back to go for a walk, then when you actually go for a walk or actually

00:49:03get mobile, you are probably going to actually help relieve your pain. Think about recruiting those

00:49:09healing molecules to actually go to the site of your pain and help. Chill out those nociceptors,

00:49:16decrease the amount of transmission going to your brain and, you know, help you feel better.

00:49:20What about the person that's scared to? You know what I'm saying? Because I think when you're in pain,

00:49:24because I mean, it was like, you're right. Because if you think about how stiff most of us are in the

00:49:28morning, a little bit of stretching, like it loosens things up. But if you're in chronic pain,

00:49:35I think there's a fear that you're going to injure yourself and make it worse. So if you talk to your

00:49:42doctor and you don't have a structural issue and it's just the pain and the fear that's keeping you

00:49:48from trying a Hatha yoga class or rolling out a mat and doing a gentle stretching routine or going for

00:49:55a walk, what would you say to somebody who's scared or afraid they're just going to make it worse?

00:50:01First thing I would say is I understand. I get that. That is a common way of thinking.

00:50:06We looked at some studies that basically showed that if you could explain to somebody

00:50:12that their pain is being generated in a way that is not continuously assaulting their body,

00:50:17that there's not some toxic force inside their body, they're not going to damage themselves by

00:50:22doing these types of movements. That seemed to really be helpful. I think it was close to 60%

00:50:27benefit in terms of overall approach to how they were thinking about their chronic pain and their

00:50:31likelihood of actually moving instead of just lying in bed or resting all the time. So it is an

00:50:39important conversation to have. But I think people often assume because pain is an alarm system that

00:50:44if I'm hurting that there's something wrong. Yes, of course.

00:50:47But at some point with chronic pain, it's not that there's anything wrong anymore. Maybe it's a glitch

00:50:52in the central nervous system. Maybe it's some repressed sort of thing, you know, like Bessel

00:50:57van der Kolk talks about. But it's not a structural problem in your back. You should move.

00:51:02What I love about what you're saying is that, and I really think I'm getting this,

00:51:09and I really hope as you're listening and you're watching this that you're starting to really get this

00:51:13to, that unless it is an acute injury right now, or unless a medical expert, licensed doctor,

00:51:23professional has told you that you have a structural issue that prevents you from doing

00:51:29certain things, that thinking about it in the area of back pain as your back is your back,

00:51:38but the pain center is up here in your mind. And that if your doctor or medical professional has

00:51:46said that it is safe for you to start moving, then the only thing stopping you from one thing that

00:51:54could make you feel better is actually the thing that's playing in your mind. It's not located in

00:51:59your back. It's a hard thing to wrap your brain around. But when you explain it that way,

00:52:04and I'm like, oh, it's a glitch. And so the glitch up here is keeping me from doing the one thing.

00:52:10And just think about how much better you feel when you just stretch a little, or you just like

00:52:13stretch your legs and go for a walk around the block. You always feel better. But if the glitch

00:52:18in your brain scares you and makes you think it's going to get worse, you won't do it. And what you're

00:52:22here to say is if your doctor says this is going to be good for you, then you got to stop letting the

00:52:31glitch in your mind from preventing you from doing these simple things.

00:52:34Yeah, I think that's exactly right. Evolutionarily, it made sense that if you felt pain, you were going

00:52:40to resist doing things. You were going to treat it like an alarm. It makes sense that that is how

00:52:46we humans evolved. Chronic pain, I don't think, was on the bingo card when we evolved. You know,

00:52:52the idea that pain would come and stay, I think that that mystifies people still to this day.

00:52:58Certainly mystified people in the beginning. Like, can you imagine? Like, what is happening

00:53:01to me that I continue to hurt despite the fact that nothing is happening in my body? Why does

00:53:05this thumb still hurt from a hammer blow, you know, several weeks ago? Whatever it might be.

00:53:10But the idea that the body is actually pretty good at doing its job. What we have said in response to

00:53:16chronic pain is don't let the body do its job. You know, ice it and compress it and elevate and don't

00:53:22move and rest and all those things prevent the body from doing its job. Once you're convinced,

00:53:27and you should be convinced by a really honest conversation with whomever about your back or

00:53:31knee, whatever it might be, that there's not something that's continuously activating those

00:53:36pain receptors, then think about movement. Think about exercise even.

00:53:43I have TMJ, but I didn't even consider that chronic pain.

00:53:46Right.

00:53:47It bothered me so much, I actually got surgery on the joint 20 years ago.

00:53:51But as I'm sitting here...

00:53:52Did that help?

00:53:52Oh, it helped a lot. But so did the fact that I wear the bike guard. But I'm also hearing

00:53:59you talk and I'm like, well, actually, the more I've prioritized sleep and the more that

00:54:04I'm moving my body and the more that I manage my stress, funny thing, I'm not grinding my

00:54:11jaw into the ground as much anymore. And it's not as painful. I mean, it used to lock, Sanjay.

00:54:16Really?

00:54:16And, you know, I'm about to turn you into our personal team doctor here and ask you

00:54:22a bunch of questions.

00:54:23Okay.

00:54:24But, you know, the NIH says more than 10 million people in the U.S. live with jaw pain.

00:54:28I think when you look at temporal mandibular joints, so this joint in here...

00:54:31Is that what TMJ is?

00:54:32TMJ, exactly.

00:54:34Really? That's a mouthful.

00:54:36Literally.

00:54:36Yes.

00:54:38But, you know, for a lot of people, there's different reasons for it. But one thing I would

00:54:42say is the numbers have gone up pretty significantly over the last couple of decades. Why would that

00:54:47be? We're not eating different foods necessarily. Like, why would our jaws be hurting a lot more?

00:54:52And I think it goes back to many of the same things that are driving a lot of disease in

00:54:56our country. Again, you think of heart disease, you think I'm eating too much meat. Yeah, maybe

00:55:01to some extent, but there's also the stress that you live in. People who are socially isolated

00:55:06have more heart disease. What's the relationship there? Even if they're healthy eaters, we find

00:55:11that isolation triggers pain centers in the brain. My point being that there's lots of things

00:55:16that could be sort of driving the TMJ, and many of the ills of our society are the same

00:55:21things that are driving chronic disease drive chronic pain. So, you know, getting to the

00:55:26root cause, you clearly had some root causes with regard to the amount of stress and everything

00:55:30else in your life. I don't know if you saw someone who's a specialist to deal with that

00:55:38part of your life. Maybe you did. But if you did, the idea that you're doing it because

00:55:43you want to fix your jaw, right? I want to fix my pain. So I'm seeing a psychologist.

00:55:48I love this paradigm shift that you would go work on your mindset and work on your stress

00:55:58levels and work on your resilience. And that would cure your jaw pain.

00:56:04Yeah. Or greatly mitigate it. I mean, none of this stuff has gotten much attention. You know,

00:56:09that's the thing is that people wonder why these pains are increasing and why they're lasting

00:56:14longer. And I think it's because one of the fundamental things driving it has not really

00:56:18been addressed. We want the home runs. We want the knockout punch. That's what we want

00:56:23in society. Like, you get rid of my jaw pain right now. I don't want this anymore.

00:56:27Because I got to get back to work.

00:56:28I got to get back to work.

00:56:28And then I got to go do that thing.

00:56:29I got a podcast, you know, whatever it might be. So give me a powerful pain medication

00:56:33or do surgery. And maybe, you know, surgery is the right answer. I'm a surgeon. That can be

00:56:38the right answer in many cases, but not in most. 90% of the time probably is not the right

00:56:45answer for many things.

00:56:46I would love for you to read the dedication of this book.

00:56:56For my three daughters, Sage, Sky, and Soleil, every word in this book is for you. One of our

00:57:02greatest fears is seeing the people we love in pain. And with this book, I hope to prevent

00:57:07that from happening for you. Having parents who live a pain-free life is the gift I aim

00:57:12to give you so that your mother and I may always be present, active, and engaged.

00:57:18For my dear wife, Rebecca, you, like too many others, have lived with physical pain. Yet

00:57:23during those times when I felt powerless to help, you inspired me to dig deep into what

00:57:28is possible and put what I learned on the page. Thank you for always taking the time to

00:57:33listen, encourage, and offer stellar suggestions for how to make this book the best it could

00:57:37be. And for the millions of people out there with chronic pain, I know it presents you with

00:57:42profound challenges, often invisible to others. I wrote this book for you to share your stories

00:57:47and my confidence that together we can chart a path beyond pain, a path of action, hope, and

00:57:54healing.

00:57:54How has Rebecca's journey impacted you?

00:57:58I mean, you know, she's my wife, you know, we've been married forever now. We've known

00:58:03each other for a long time. And, you know, I've been a doctor for a long time. And I think

00:58:10with my wife and my mom, pain came home. It came to visit my house. And, you know, I think

00:58:19I've always tried to treat my patients like family. But at the same time, like watching

00:58:24the ones that you love and you spend all this time with, so you really know them and you

00:58:29know how they are and you know their personalities, and you see pain hijack their lives, hijack

00:58:35their identity. And you're like, that's not the person I know. And, you know, it's pain

00:58:39talking, not them. I think that was tough. But I think at the same time, you know, I think

00:58:45our greatest joy sometimes now come in overcoming things, rising above. And I think in some ways,

00:58:52not that I wish that she had gone through what she went through, just like I don't wish

00:58:55that you had gone through what you went through, but she's doing great.

00:59:00How long did it take?

00:59:02It took a while. I still remember when it sort of started in my mind for her because she had

00:59:07sort of been talking about it. But you keep thinking, oh, this is just a thing that'll

00:59:10go away in a little bit.

00:59:11She couldn't turn the doorknobs, you know, with their hand. And I thought, well, that seems like

00:59:17a very arthritic sort of component to this, like what is happening? And I remember lying in bed with

00:59:22her once and, you know, asking silly questions in retrospect, like how much does it hurt? Like,

00:59:27doc, how do I explain this to you? You want me to give you a number? Because my number would be

00:59:32immeasurable, right? You don't understand. Or I'd say point to where it hurts. And I remember she

00:59:37would point to a part on her body and she would basically say, this is the only place it doesn't

00:59:42hurt. And I think that was probably, you know, three or four year journey in some ways.

00:59:50Keep in mind, you know, the way the medical establishment works, especially with these

00:59:53kinds of pains, is you try a medicine. In this case, it may be a medication for autoimmune disease.

00:59:59And you need to give it months to see if it'll work, right? So it's not a fail fast sort of model.

01:00:05It's a long trial period sort of model. Maybe it's working, maybe it's not. So months would go by,

01:00:11didn't really work, go back to the drawing board, try something else. So, you know,

01:00:16we probably went through that cycle four or five times, six months pop. And then now she's on no meds.

01:00:22I am sorry that we went through this, but I'm grateful that you guys did because it clearly

01:00:29sparked what I think is going to be some of your most important work because it's personal,

01:00:37it's impactful. And as you said, the pain came home. But the story, which is very daunting and so

01:00:45many people can relate to it, also proves that over time, all of these changes that you're talking

01:00:54about that, that really galvanize the natural intelligence and desire of your body to heal and

01:01:01to be pain-free, they can work. And that is an incredible gift that you're giving to all of us. And

01:01:08so thank you to Rebecca. Thank you to your mom. Thank you to you.

01:01:13Well, I really appreciate that, Mel, especially coming from you. It's, you know, you write books,

01:01:19as you well know, and, you know, you spent three years, I spent three years working on the book and

01:01:24you, I was dreaming about it at some points, you know, just, it takes over your life and I wanted

01:01:30to learn everything I could. And had I written the book that I really wanted to write, it probably

01:01:34would have been, you know, this thick, you know, but on the other hand, I wanted to put things in the

01:01:41book that you can't just easily go and Google. Yes. I wanted to give you the why behind the what,

01:01:47because I felt like if you understood why these things worked and you could actually see the data

01:01:51and maybe even meet some of the researchers who many of them have pained themselves. And that's

01:01:56what inspired them to do this kind of work and understand their stories and then understand how

01:02:00they set up an experiment and how they validated the experiment and then what it means for you.

01:02:04So it's, it's powerful stuff. It's powerful for me. You know, I will, I incorporate these things

01:02:10into my own life as well. My wife gets tremendous relief from meditation now, and she is the biggest

01:02:15skeptic of all. I'm skeptical. Well, she's a lawyer, a former lawyer. She's a lawyer. Like, show me the

01:02:19data on this. I'm not, you know, there will be faith to abandon if you don't, this doesn't work for

01:02:24me, you know? So, um, but I did it with her and my mom who is an engineer, you know, so very science

01:02:30minded. First woman ever hired as an engineer at the Ford motor company, uh, back in the sixties.

01:02:36So, you know, just that, that sort of persona, I did meditation with her as well. And there's,

01:02:42it's not just meditation. It's all these other things. It's, it's the movement. You know, my wife's

01:02:46pain got so bad at times that when I would get home from work, I'd have to carry her up the stairs.

01:02:52She just couldn't go up the stairs on her own. Everything just hurt too much. It's grimacing

01:02:57every single movement. And, um, there's all these different things that we tried. It wasn't just

01:03:02meditation, but I think what was striking to me as we traveled to all these hospitals around the

01:03:08country, trying to get her care was that everyone's like, all right, let's try a TNF blocker. Let's try

01:03:12this particular pain medication. Let's try this autoimmune therapy. How about Humira? Have you done that?

01:03:18Which we greatly appreciated all that. She was still in pain though.

01:03:22So, you know, it's, it was the baggage that was not getting addressed and I felt helpless

01:03:28at times to try and help her. But, but the idea that, that ultimately, you know, I started

01:03:33meditating myself, doing these other things myself, really focusing on movement, I think

01:03:38really helped her. She ended up doing the Malibu triathlon with me. So it's.

01:03:42From being carried up the stairs to doing a triathlon using these approaches.

01:03:48It works. It works. What do you do if the person that you love is experiencing chronic pain and they just feel so discouraged?

01:04:00It's, it's, it's really hard now. It's, it's, um, you know, you're, you're talking about 50 million people right now. At least these are the people who actually come forward and raise their hand and say, I'm in chronic pain. A lot of people still don't because there's so much stigma attached to it. I think what I say, um, to people is that there's an off ramp. I don't know how many exits away it is. I don't know how long it's going to take to get there. But the idea that you imagine this to be the rest of your life. That does not have to be the

01:04:30case. If you're somebody who's listening and you're in chronic pain and you say, come on, man, like, really? I'm not saying don't rule out structural problems. I'm not saying don't treat pain if it's really bad. But what I'm saying is all the other things that probably got ignored should probably be addressed. It's going to greatly increase the likelihood that you're going to, to be able to relieve your pain.

01:04:53Well, one of the biggest things that I'm taking away from this is that like, if you're in pain.

01:05:00If it's not acute, it's actually a sign to move. It's a sign to lean into your life. And I feel like every one of us have been told the opposite.

01:05:10I know.

01:05:11And so that in and of itself is life changing. If the person listening were to do just one thing out of all the extraordinary stuff that you've shared, what do you think is the most important first step to take?

01:05:23I think it's very empowering to start to journal about your pain. I think part of the problem is that when patients often start to, they go to a doctor's office or they're describing, they're just saying, I'm in pain.

01:05:38But pain is complicated. There's all these different things that are sort of associated with it. So starting to really understand your pain. And when I say understand it, I mean, lean into the pain.

01:05:48Like, let's say the pain is in your thigh. Can you trace it? Are there hotspots in the pain? Can you identify that? Like really, really use as many adjectives as you can to, to, to almost some people like to draw the pain, you know?

01:06:02And so really like getting to know your pain, I think, and then understanding what makes it better, what makes it worse. Um, if you do have some of these things that we are not in any pejorative way referring to as baggage, depression, anxiety, fully understand that we are an integrated operating system.

01:06:22Our whole bodies are this fantastic integrated operating system with the parallel operating system known as consciousness. How cool is that? But this integrated operating system, you have to really be, uh, um, addressing all these things in order to, to address chronic pain. You are the, the most reliable narrator of your pain.

01:06:41So embrace that role. I think that's what pain doctors do with patients. They treat them as an active partner, not just a passive participant.

01:06:48Dr. Sanjay Gupta. What are your parting words? Um, I guess the parting words are something that I thought about a lot, which are, it doesn't have to hurt. It requires work, but it doesn't have to hurt as long. It doesn't have to hurt as bad.

01:07:07Well, I believe you. I'm so excited. Thank you. Thank you. Thank you for being here.

01:07:12What a pleasure. Thanks for having me, Mel.

01:07:14And I also want to thank you. Thank you for caring enough about yourself that you took the time to be here with me and to learn from Dr. Sanjay Gupta.

01:07:25I, there's no doubt that if you put to use everything that you just learned today, you're going to feel better. You're going to be happier.

01:07:32I'm so excited to hear how this works for you and the people that you care about. And in case nobody else tells you, I wanted to be sure to tell you as your friend that I love you and I believe in you and I believe in your ability to create a better life.

01:07:45and prioritizing your health is one of the best ways that you can do it. Alrighty. I will see you in the very next episode. I'll be there to welcome you in the moment you hit play.

01:07:55And thank you for watching all the way to the end and sharing this with the people in your life that you want to live a healthier and a happier life. Alrighty.

01:08:04Here is the very next video that you are going to love watching. And I'll be there to welcome you in the moment you hit play.