← The Mel Robbins Podcast
The Mel Robbins Podcast
Neurosurgeon’s Protocol to Feel Better Now: The Best Ways to Heal Your Body & Live Pain Free
01:12:39
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 a...
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- [00:00]
A
Hey, it's your friend Mel. And welcome to the Mel Robbins Podcast. You know, I don't know about you, but I tend to take my health for granted until I'm in pain. And right now I am dealing with this issue. It's in my shoulder. I mean, it's causing me so much like, ugh, nerve pain. Now. In the past, I would have felt helpless, I would have worried. But this morning I didn't because I knew exactly what was happening. I knew exactly what to do because of the conversation you're about to listen to right now. One of the world's most respected neurosurgeons and medical experts alive today is here in our Boston studios to reveal the new frontiers in healing, pain management and how you can feel better in your body starting today. And that's whether you're dealing with something that just happened like I am, or you've been living with an issue for a long time. There's a list of simple lifestyle changes that you and your loved ones can try for free that have been proven with research over time to eliminate chronic pain. Isn't that amazing? You're gonna leave this conversation so much smarter, you're going to feel hopeful. I'm so excited for me, for you, for the people that we care about. Because my friend, world renowned medical Expert, neurosurgeon number one New York Times bestselling author Dr. Sanjay Gupta, is here to reveal the secrets 99% of people don't know about pain and exactly what to do starting today to feel better. Now, Kristen Bell and Adam Brody are back bringing more swoon worthy moments to season two of Nobody Wants this. After the honeymoon phase ends, real life begins. Dive into the oh so relatable journey of what happens after happily ever after. With an acclaimed ensemble cast recognized by the Emmys and Golden Globes, Nobody Wants this delivers the rom com you've been waiting for. Proving that staying together is way more complicated and way more interesting than falling in love. Watch Nobody wants this season two on October 23rd only on Netflix. It's time to manifest easier and more Comfortable rides with OnStar. Use Google Assistant to easily make calls or send texts on the go and never stress about where you parked with vehicle locate. Plus enjoy the ease of a hands free drive with award winning available super cruise driver assistance tech. With convenient OnStar features like these, your rides can keep getting better. Visit onstar.com to learn more. OnStar better never stops. Hey, it's your friend Mel. And welcome to the Mel Robbins Podcast. I am so excited that you're here. It is such an honor to be together and to get to spend this time with you. And if you're a new listener or you're here because someone shared this episode with you, I just wanted to take a moment and personally welcome you to the Mel Robbins Podcast family. I can't wait for you to meet our guest today, Dr. Sanjay Gupta, and learn the new science of healing your body, stopping pain, and feeling better. Now, Dr. Sanjay Gupta is a board certified neurosurgeon. He completed his residency in neurosurgery at the University of Michigan and serves as associate chief of neurosurgery at Grady Memorial Hospital in Atlanta and a professor of neurosurgery at Emory University School of Medicine. For more than 20 years, he's been breaking down the biggest medical stories in the world as the chief medical correspondent for CNN, which is where Dr. Gupta and I met as colleagues and then we became friends. One of the things that I really admire about him is his commitment to serving and to seeing patients while he's doing all these amazing things. After the earthquake in Haiti and all the news coverage ended, for two years, Dr. Gupta was flying down on the weekends to continue to do surgeries there. And then he would fly back and be at work on Monday. And when my dad needed a life saving brain surgery at University of Michigan, Dr. Gupta, he's the kind of friend that was constantly checking in with me. He also turned down the invitation to become our U.S. surgeon General because he wanted to continue working as a practicing neurosurgeon. And on top of all of that, he's found the time to write five New York Times bestselling books. And now he is here in our Boston studios for one reason. He's here for you. He is here to unpack all of the exciting new research and science in his brand new book, it doesn't have to your smart guide to a pain free life. So please help me welcome the extraordinary Dr. Sanjay Gupta to the Mel Robbins Podcast.
- [05:13]
B
I've been really looking forward to this, Mel. I'm a huge fan of yours, a huge fan of the show and honored that you'd have me. Thank you.
- [05:19]
A
Of course. And I am excited to see you after we were colleagues and friends at cnn. I am proud of the work that you're doing. I'm so excited for your new New York Times bestselling book, it doesn't have to Hurt. We're gonna talk all things about living a pain free life based on the science. And I'd love to start by having you Tell me what could be different about my life if I take into account everything that you're about to teach us today.
- [05:52]
B
Most people are going to have pain at some point in their lives, but this idea that it has to become chronic pain, that it has to last, that is where the intervention can occur. And I think we haven't spent much time talking about this. People develop acute pain, and for some reason, it. It persists. It's like this memory loop just keeps getting played over and over in their brains. And I think we've learned a lot over the last decade about how to prevent that from happening. So not letting acute pain, which most people are going to experience, turn into chronic pain. If I had to add more to the title of the book, you always want longer titles. I would say it doesn't have to hurt as much or as long as.
- [06:34]
A
Oh, I love that. What is the difference between acute pain and chronic pain? Just for somebody like me who's not a medical doctor.
- [06:39]
B
Yeah. So acute pain is pain that you might feel in the moment.
- [06:42]
A
Touch.
- [06:43]
B
Hot pan. Hot. Move your hand away. Stubbed toe. Chronic pain is when it just lasts so there's no ongoing insult or injury to your body. And yet the pain persists. People, they try and put a timeframe on it. So they say if you have pain like that every day for three months, at that point it's considered chronic pain.
- [07:04]
A
Okay.
- [07:05]
B
If you have it sort of every other day for six months, you know, you sort of get the idea. But it's pain that just. Just simply won't go away.
- [07:11]
A
Dr. Gupta, could you give us a quick list of just things that might be considered chronic pain?
- [07:16]
B
I think if you go literally from head to toe, I think headaches, such as migraine headaches, that'd be considered a type of chronic pain. That's a big percentage going into the face. There are people who have facial pain, like trigeminal neuralgia and tmj. Most joints can be a source of chronic pain, going from your shoulders, your elbows, your hips, your knees, down to your ankles. And then there's the back and the neck, which I think are big sources of chronic pain. So it's typically areas of the body which are moving a lot, but now you're not moving because you're in pain or things like headaches.
- [07:47]
A
And how many people struggle with this? Because I found the research really surprising, because I think you hear the word chronic pain and you're like, oh, that's for old people.
- [07:54]
B
No. You know, I gotta tell you, Mel, it was so interesting. Because I first talked to my publisher about this and I thought, how big a problem is this, really? I'm a neurosurgeon, so I'm seeing pain all the time. But I thought I was seeing a very select, you know, sort of segment of the population. It's about somewhere between one in five and one in four people in the United States, really. So you're talking over 50 million adults are dealing with chronic pain, meaning every.
- [08:18]
A
Day for more than three months. They're feeling pain every day for more.
- [08:21]
B
Than three months, and for many of them, decades. So three months is sort of the minimum. But when I started really researching this book and talking to so many patients with pain, it is a daily negotiation for them. Every day, like you wake up and you may think, I have a little bit of ache and pain here and there. But every day pain is sort of the biggest driving force in their life. They wake up with it, they go to sleep with it, they think about it all day. If they have a conversation with somebody in their life, they're probably going to talk about their pain. So it's, it's for about 17 million people, it completely interferes with their, their ability to conduct their lives. So they are unable to hold on jobs, go to school, you know, have terrible relationships, all these things. It is, it is really awful. And I have to say I was, I was stunned even as someone who, who sort of works in that field, the magnitude of pain that we have in the United States and frankly many countries around the world.
- [09:17]
A
You know, one of the things I also wanted to ask you though is that for somebody that doesn't wake up every day and experience chronic pain or doesn't have that kind of nagging sensation, why is it important to listen to and watch this and learn from you today?
- [09:38]
B
One of the things I think we really have to be mindful of is that chronic pain is now the fastest growing condition in the United States. Faster than dementia, faster than diabetes, faster than cancer. I mean, the numbers again are mind boggling. So my point being that this is growing. So for a lot of people, hopefully they never have chronic pain. But you know, the, the likelihood of that happening is certainly increasing. But I think, you know, Mel, the thing about pain is that it's, it's really reflective, I think, of the entire integrated system that is our body. You know, you think of I hurt my toe or I hurt my finger, but the idea that, you know, everything in your body, the finger and the toe certainly, but the tendons, the nociceptors, which are Pain receptors, the firing mechanisms that go to your spinal cord up to your brain, how your brain consciously sort of processes that experience. It's all fully integrated. So if it's not working well, you're likely to hurt more. And so you think, I smashed my finger with a hammer. Your experience on Tuesday, having done that could be totally different than the same exact thing on Wednesday, based on whether you got a good night's sleep, whether you had a tough call with your mom, what the weather's like outside, what your past history with pain is, if you have a history of depression or anxiety. My point being that pain is perhaps the most integrated sensation that we have as humans. And that's wondrous for a neuroscientist like me, but it's also very mysterious. And so it presents opportunities and it presents challenges.
- [11:15]
A
I want to make sure I understand what you just said, because you basically said, if I, you know, I'm doing a project at home and I miss the nail and hit my thumb and it's Tuesday, and optimal lifestyle conditions, I'm in a good mood, I've eaten, I've exercised, I've done all the things that everybody that is an expert and done the research says you should do to be in your best health. The pain that I would feel in that moment is different than on a day where I haven't slept. I'm not, I haven't eaten, my stress level is through the roof. Is the pain worse when you haven't slept and you haven't eaten? Is that, Is that what you're telling me?
- [11:53]
B
Yeah, I think the evidence is very clear now that if you're not optimized in your own life, your pain is going to be worse for the exact same injury. Or if a patient comes into the emergency room, they have the exact same looking X Ray 2 patients, you can almost predict, based on other factors, seemingly arbitrary factors, which of those patients is going to be in greater pain and also the likelihood that it would turn into chronic pain. Going back to that thing like this should not cause chronic pain. You'll immediately pull your finger away and that's reflex. That's not really a pain response. But. But then the idea that, ah, that really hurts.
- [12:31]
A
Yes.
- [12:32]
B
And maybe even how you would quantify it yourself, both in terms of intensity and unpleasantness. Those are the two things pain folks really want to know. Not only how much does it hurt, but how unpleasant is it? Which is, again, people are going to define this differently, but it could be so variable, person to person, and so variable within the Same person, which is remarkable.
- [12:54]
A
So is it also true that if the amount of pain and the unpleasantness that you feel varies day to day based on how you're feeling, conditions that may or may not be under your control, is it also true that if you look at those and you focus on a more holistic approach, it's also the solution to minimizing chronic pain that you feel?
- [13:17]
B
I think so. I think that is where the science is headed.
- [13:20]
A
Wow.
- [13:21]
B
That you should start thinking of chronic pain much in the same way that you think of any other chronic disease you're trying to avoid diabetes, you're trying to avoid heart disease. People would not put pain necessarily in that same category, right?
- [13:33]
A
I wouldn't.
- [13:34]
B
Because you think of it just purely like a physical sort of sensation.
- [13:37]
A
Yes.
- [13:37]
B
But I think we're starting to understand that pain is really affected by all these different things in the body, much like many of these other chronic diseases are. So if you're optimized in your life, and, you know, some of it is very tangible stuff, if you decrease inflammation in your body overall, then an injury is less likely to hurt as much because you're not sort of harnessing as much inflammation over inflammation to it. If you're. If you're physically active, if you're doing all the things to. To keep your body and your muscles and your tendons strong, you're not likely to hurt as much. We kind of get that. But the idea that if you don't have depression, something wouldn't hurt as much. This is more of a revelation.
- [14:18]
A
Wow.
- [14:18]
B
One of the. One of the doctors I interviewed for the book said this quote to me, which really stuck with me, and the quote was, chronic pain hardly ever occurs in isolation. It always comes with baggage attached. Now, baggage, I don't mean this in a pejorative way, but baggage could be all kinds of things. It can, again, be depression, anxiety, poor sleep. You have to address the baggage as much as you address the pain. And if you look at good pain doctors, I visit a lot of pain clinics. I mean, they have psychologists on staff, and many times it's the psychologist that is the first person to see that patient.
- [14:54]
A
Why?
- [14:55]
B
Because that baggage is the one thing that probably no one else has addressed. Because they get pain medications, they may get procedures. They're always trying to treat the chronic pain, like an acute pain, like an immediate pain, but now it has all this baggage attached to it. If you don't address the baggage, you're probably never going to be able to actually fully address the pain. And you Know, look, this is a provocative area in pain medicine. And there has been these authors before me, like John Sarno, who anybody who knows reads about pain will know that name because he wrote a book about back pain and he sort of really championed this idea of psychosomatic.
- [15:32]
A
Yes.
- [15:33]
B
And you know, in his New York Times obituary, there was some line in there that said something like, half the country thought this guy was a prophet and half the country thought he was a pariah. Because the idea of saying, hey, look, your brain is deciding this. All these different things play a role. Some people thought, you're minimizing my pain, you're marginalizing folks who are in chronic pain. I don't think that was his intent. It's certainly not my intent. But at the same time, this idea that, yeah, a psychologist maybe should be involved in dealing with your chronic pain because there's that baggage attached. And that baggage, by the way, is a two way relationship. If you have more baggage, more pain. But if you have more pain, you have more baggage. I think sleep is a really good example. A lot of people I talk to for the book said, I'm not getting good sleep because of my pain.
- [16:23]
A
Well, that makes sense.
- [16:24]
B
That makes sense, right?
- [16:25]
A
And it's sort of like a chicken and an egg thing. Do you have pain because you're not getting sleep or you don't sleep because you have pain?
- [16:30]
B
That's right.
- [16:31]
A
So how do you untangle that knot?
- [16:32]
B
I think you have to address both. That's the thing. I think we live in a very monotherapy, sort of simplistic culture sometimes when it comes to medicine. I wanted to identify the problem as elegantly as I can and then address that single problem. But the idea that maybe your pain is worse because you're not getting sleep, that bidirectional thing, because I think most people think I'm not getting good sleep because of the pain. So take more pain meds, do things to address the pain. But what the studies have shown is if you address the sleep as a primary sort of thing, you can greatly.
- [17:08]
A
Reduce your pain scores simply by addressing sleep.
- [17:11]
B
Sleep. That, that, that's the thing. And this is measurable. I think that people have sort of anecdotally known this for some time, but, you know, understandably, or a society that wants data and evidence and facts and proof of that. You know, we treat symptoms far more than we treat root causes. And I think pain is probably the best example of that in society. You know, at one point we are what, not even 5% of the world's population, and we are taking 90% of the world's pain meds.
- [17:41]
A
Wait, say that again.
- [17:42]
B
We are not even 5% of the world's population, and we were taking 90% of the world's pain medications.
- [17:50]
A
What does that tell you?
- [17:52]
B
Tells me we don't like pain. We have deep disdain for pain in this country. And look, I don't like pain either, but the idea that you can overly medicalize something, that you can overly proceduralize something, we did 1.2 million spinal operations last year. Okay? To give you context, in the UK they did about 50,000. Now they're a quarter of our population. But still, you do the math. If they were doing our rate, it would, you know, still be one sixth of what we do here in this country. So we don't like pain, and we'll do anything to rid ourselves of pain, but most of the things that we do do not necessarily treat the root cause. There's even cultural things when it comes to pain. I mean, this book that I wrote is not about the opioid epidemic. Although you can't talk about pain in this country without talking about it. Like, how did that happen? How did we get to the point where 80 to 90% of opioids were being used in the United States alone, worldwide, you know, consumption. To be honest, I think part of that was because pain sort of became considered what they call the fifth vital sign. So, you know, it's as important as respirations and heart rate and all these other things. When you go into the emergency room, people would ask be about their pain. They came in for a cold, you know, so pain just became something that everyone was super focused on. And I think it led to a lot of treatment when treatment wasn't always necessary. I don't want that to come off non empathetic. Like I'm really, really empathetic to people's pain. But at the same time, can we say we've over treated it, we've over operated on it, and we even do things culturally that don't happen in other places around the world. The data suggests very much that's the case.
- [19:38]
A
Well, I don't think that's the case you're making at all in your book. I think the case that you're making is one that's extraordinarily exciting and optimistic because you're basically saying that you may have lived a long time with this, you may have been overmedicated. It has certainly impacted your life. And for you and your loved ones, there's exciting research that suggests There are things that you can do beyond what you have been told.
- [20:04]
B
That's right.
- [20:06]
A
For somebody who may be listening, who is either experiencing pain day to day, maybe you have the kind of job that's really beaten your body up, or you had an accident decades ago and it still hurts your back or still hurts your neck. What are you, Dr. Gupta, excited about after doing all this research for this new bestseller that you've learned about the kind of frontier of science and how we can think differently about pain and think differently about treating it and relieving people of it?
- [20:41]
B
I think there's two sort of broad areas that I'm really excited about. One is, you know, high tech, innovative work that is happening, which as a neuroscientist was really mind blowing for me. And I've been in this world for 25 years, so I learned a lot. But I think the second thing is because opioids sort of sucked up all the oxygen in the room. For 25 years, you got opioids for everything. Kidney stone, dental procedure, hip fracture, everything was treated with an opioid. As a result, all these other modalities, some of which are not new, some of which are quite old, actually got short shrift. They just were not utilized for things.
- [21:23]
A
What are some of those modalities?
- [21:26]
B
So if somebody comes into the emergency room with a hip fracture, which is a really common problem, especially as people get older, they almost assuredly would get opioids. Now, in many ers around the country, they're giving nerve blocks, so takes about 10 minutes and they're essentially numbing up the area around the hip. And giving this nerve block helps with pain. Immediately, pain scores drop to zero. But also it obviates the need or prevents the need for opioids going into the future. They don't need opioids after that. They've gotten rid of that acute pain syndrome. When I was in this emergency room in Brooklyn, Maimonides, which is this really cool place by the way. It's level one trauma center, super diverse. They speak 120 languages there. And they are championing what they refer to as opioid optimized ERs, which is not to say opioid free, because opioids can still play a role. But they will use opioids as a last resort instead of a first resort. But they were using virtual reality.
- [22:27]
A
How does that help with pain?
- [22:28]
B
There was a 76 year old woman who came in with terrible knee pain, bad enough to take her to an emergency room in the middle of the day, which you Know, that's. That's a big ask of somebody, right? Your whole day. And they put on virtual reality goggles. 20 minutes took her to a nice Indonesian beach somewhere, and her pain scores dropped from about an 8 to a 3. How does it work?
- [22:50]
A
What's your theory?
- [22:52]
B
People always often say it's distraction. I think it's probably some component of distraction from the pain. But I think it's also leaning into this idea that we do truly have this integrated system. If you are on an Indonesian beach, your stress levels are probably dropping. You're probably releasing more of the feel good hormones. You're activating something in your body known as your endogenous opioid system.
- [23:18]
A
What is that?
- [23:18]
B
It is our body making opioids. You know, the opioid pills that you take, like many things in medicine, got their inspiration from the human body. So many of the things that we do in medicine take our inspiration from the human body. But let me tell you the big difference between the opioids you make versus the opioids you take. Opioids, you take like pills and stuff like that. They may decrease pain, but they may also enhance memory, okay? So they actually in some ways are forcing you to remember that experience or remember that pain, sort of creating that memory loop around pain, and they also decrease mood. If you've ever spoken to an opioid addict, they're at some point not taking opioids to get high. They're taking it to not feel terrible, right? To feel some sense of normalcy again. So point being that opioids decrease mood, they increase memory in a bad way, meaning making you remember the painful experience even as they decrease pain. But your own natural opioids also decrease pain. They decrease or inhibit memory of the painful experience, and they improve mood. It's remarkable to me. So you ask, what is the mechanism of something like virtual reality goggles or frankly, a lot of these modalities. In some ways, they're letting the body do its job and they're helping it along the way. It's your own endogenous opioid system that we're just trying to. Just trying to give it a little push, little nudge, sort of make it work. And if you can get it working, it's fantastic.
- [24:54]
A
I personally think it's very exciting to be reminded that even if you are somebody that is experiencing chronic pain right now, or you have somebody that you love in your life, who is that? Even if it's from an acute injury, even if it's from an old injury, even if it's been nagging around for a while that your body is designed, it has this incredible intelligence to it to have you forget the pain. What you are here to suggest is that there are really exciting things to consider that both help your body feel less painful, but also help your body release these natural healing things that we haven't been talking about.
- [25:41]
B
That's right. That's right.
- [25:42]
A
Are there ways at home that if you don't have a VR set that you could extrapolate this exciting research and stimulate the release of that?
- [25:54]
B
Yeah, there are lots of things that we can do. A lot of people refer to this whole endogenous opioid system as a component of the placebo effect. Right.
- [26:03]
A
It doesn't sound like a placebo. It sounds like it's working.
- [26:06]
B
Yeah, but placebos can work.
- [26:07]
A
Okay.
- [26:08]
B
That's the thing, is that, you know, you. Everything gets tested against the placebo. And people have often asked, I gave that person a sugar pill, and yet they improved. Like, how could that possibly be? It's not the sugar pill, obviously. It's your expectation that that was going to help. And when you expect something to help, it helps. Expectations and experience are inextricably linked. If you expect something to work for your pain, it's far more likely to work. It's far more likely to change your experience. And what is at the root of that is probably this endogenous opioid system. You're just basically making your body create all these. These various substances that are going to make you feel better. One of the things I got really interested in, Mel, with regard to what you can do at home is meditation. I, you know, I think a lot of people hear meditation. Yeah, sounds good. I mean, I like to meditate every now and then. It relaxes me, chills me out, whatever. Me too. What I think has happened over the last decade is that these researchers have decided to really put it to the test and figure out how do we actually test the value of something like meditation? So there's these researchers at ucsd. Eric Garland sort of leads this team, and they created a really fascinating experiment where they basically put these heating filaments on your arm. Okay. I did this experiment myself. These heating filaments are hot, really hot, just to the point where you. You're not getting burned, but you're almost at that point. Like, if you were touching a really hot plate, you would drop it. And these are on your arm.
- [27:41]
A
Okay.
- [27:42]
B
And you sit there, premeditation. And they basically measure your pain scores and your unpleasantness scores. These Two things. And then you go through this guided meditation. And it's a very specific meditation. It's part of something known as the More protocol, which is mindfulness oriented recovery enhancement. And you see how much did your pain scores and your unpleasantness scores drop?
- [28:06]
A
Now are you meditating while the things.
- [28:08]
B
On your arm you're meditating while the things on your arm you meditate before. And then you continue to meditate as you start to go through the experiment.
- [28:14]
A
What did you experience?
- [28:16]
B
So numerically I experienced a drop in my pain scores from a 7.4 to, to a 2 and my unpleasantness score from a 5 to a 1.8.
- [28:26]
A
Wow.
- [28:27]
B
Very significant. And that was just purely meditation. To give it even more context, what Eric Garland and his team will say is, what else in society kind of gives you similar relief from pain and unpleasantness? And the thing that they came up with was 5 milligrams of oxycontin. The idea that meditation could give you that sort of relief was pretty mind numbing, I think, for a lot of people. I don't mean to suggest that that pain relief lasts forever, just like oxycontin doesn't last forever. But during the time that people meditate, they can drop their pain scores significantly. And that's just your mind. People really aren't sure why these things work and it's hard to study. But what they do know from an outcome standpoint is that these patients are getting tremendous relief. There's options out there, there's hope out there. But pain is the most mysterious sensation that we human beings experience. You've got to treat it that way.
- [29:29]
A
Wow. Let's take a quick pause so that we can give our sponsors a chance to share a few words. And I also want to give you a chance to share this exciting information from Dr. Sanjay Gupta with the people that you care about. Everybody deserves to feel better. And this research and this information is going to help you and the people that you care about do exactly that. And don't go anywhere. We've got so much more to dig into and to teach you when we return, so stay with us. How do you show love for your cat? Have you thrown her a birthday party? Taken him for a walk in a cat backpack? Built him his own catio? Sometimes love for your cat can get lost in translation. Wellness pet food transforms your love for your cat into real visible benefits through complete and balanced meals they can taste and crave. From real shreds of chicken and fish and wellness appetizing entrees to protein packed culinary crafted recipes with Wellness Signature selects to over 90 mouthwatering options in Wellness complete health. Here's a delicious dish for every feline family member. Every Wellness pet food recipe is crafted with premium ingredients to promote whole body health so you and your cat can enjoy a life of well being together. Give your cat vet recommended scientifically proven nutrition with wellness cat food. That's the kind of love you both understand. Wellness Pet Food feed well. Be well. With a U.S. bank Smartly Visa Signature Card, you earn unlimited 2% cash back on every purchase. Yep, every purchase. 2% cash back on a new TV and sofa. 2% cash back on groceries even 2% cash back on concert tickets. Visit usbank.com smartlycard to learn more. The creditor and issuer of this card is U.S. bank National association pursuant to a license from Visa USA Inc. Some restrictions may apply. There's nothing better than feeling like someone has your back and that things are going to get done without you even having to ask. That kind of reliability is rare, but AT&T is making it the norm. With the AT&T guarantee, staying connected matters. Get connectivity you can depend on. That's the AT&T guarantee. Visit att.com guarantee to learn more. AT&T connecting changes everything. Terms and conditions apply. Visit att.comguaranty for details. Welcome back. It's your buddy Mel Robbins. Today you and I are getting a one on one consultation and session with the inspiring and incredible Dr. Sanjay Gupta. So Dr. Gupta, what are the things that you wish people in pain knew and what do you wish are the one or two things that you'd start doing right now? We're going to get into a lot of the protocol and more specific stuff but just a bit of here's the North Star of what's possible because you may be right now in a day to day life where you just think you're stuck with this back or you're stuck with this knee or you're stuck feeling like this forever.
- [32:48]
B
I preface all these conversations I have with patients with with a reminder that look, I, I don't want to say anything that's going to minimize their pain because I, I think when I say something like all pain resides in the brain. I'm not at the same time saying it's all on your head. Those are two different things. And I'm saying this as a neuroscientist but all pain is in the brain. That I don't want that to sound minimizing. Okay? But that is where pain is. Pain is in the brain if your brain doesn't decide you have pain, then you don't have pain. And by the way, the flip is also true, which is the brain can decide you do have pain for no reason. People who have limbs that are missing, they have phantom limb pain. How could that be? That it's not even there anymore and it still hurts? Or something known as chronic regional pain syndrome, which is basically pain in your hands or feet without any injury or any obvious trauma or anything. So, you know, I start there often when I talk to patients, just sort of reminding them of that, that for some reason, no fault of your own, but there's this memory loop that is continuing to get replayed over and over again that's causing that pain. Let's address that in some way addressing that baggage as much as you're addressing the pain. It's not. I think the. The. One of the questions that I think a lot of people have is why? Why does the body do that? Is it a glitch of our central nervous system to just keep playing those memory loops? If you talk to people like Bessel van der Kolk, who wrote this great book called the Body Keeps a Score, I think what Bessel would suggest is that there's something else that's probably happened in your life and maybe you can't remember it, but the body keeps the score. And maybe by addressing some of those things that perhaps aren't in conscious awareness for you, you're not thinking about day to day. You're not thinking about why your jaw hurts. You're not thinking about why that might be necessarily trying to treat the symptom more than the cause. And you may not be able to identify the cause yourself.
- [34:55]
A
But here's what I find super exciting about this, because when I've been in pain, I want to defend it because it feels very real. But if you could just open your mind to the possibility that maybe you don't need to fix your back or your leg or your neck, maybe that part of the solution is really addressing the memory loop that's playing in your head that opens up a whole different possibility and an avenue of treatment and pain relief that you haven't even considered. In fact, you write, I wanna read to you from your blockbuster book, it doesn't have to hurt. This comes from page number nine. The point is that the brain creates pain on cue from a vast array of stimuli. Biology, psychology, social, emotional, environmental, even cultural. And just as we now understand that the brain can be nurtured, developed, and optimized at any age, there's growing evidence that the brain can also rewire itself in ways that change the neural circuitry for pain.
- [36:00]
B
Yes.
- [36:01]
A
Really?
- [36:02]
B
Yeah.
- [36:02]
A
Reducing its intensity or duration and potentially eliminating it altogether. So you're saying that there's growing evidence that your brain can rewire itself and change that memory loop and the neural circuitry for pain, even pain that happened a long time ago, that you're still.
- [36:20]
B
Remembering, still dealing with, still remembering. Neuroplasticity, you know, which is sort of the name for this larger concept of being able to change your brain. There's this phrase, I think it came from, like the 1940s. Hebian Heb was the doctor who coined this. But basically, neurons that fire together, wire together. The thing about neuroplasticity that I think a lot of people don't realize is that it's not an inherently benevolent process, nor is it malevolent, nor is it bad. It's neutral. It'll kind of do whatever you ask it to do. So if you're hyper focused on the pain, you're firing neurons together and they're going to wire together, and that's going to reinforce the memory loop. What is, I think, fascinating about pain is that pain circuits travel and they go through all these various areas. Your amygdala, which is your emotional center, it tends to be larger. In patients who are in chronic pain, their prefrontal cortex tends to be smaller. So their judgment and things like that tend to not be as good because their prefrontal cortex has shrunk to some extent. But it also goes through the hippocampus, which is your memory store. So you might start to really remember it well, your past experiences with pain, you remember those, and they may amplify your current episode with pain. So every time you start to have a twinge of pain, it's like, man, it just like skyrockets. It's like it just went from 0 to 100, just like that. And I've seen this in patients, even, like in real time. They'll be in my office and they'll know, sort of be there, and then all of a sudden they're. They're cringing. Nothing happened to them, Right. It wasn't like they fell or anything. They're just sitting there like, what. What is going on there? Why is, why is that suddenly gone from 0 to a hundred or from 10 to 100? A lot of that is because this very complicated sort of loop of, of pain circuitry, including memory.
- [38:11]
A
Well, let me ask you a question. Just like, even in the basics. So I Kind of understand this. When that object hits my foot, right? I'm taking it. Like, the skin and nerves and everything send a signal up to the brain in nanoseconds. And then your brain has to. Like a supercomputer register what just happened.
- [38:29]
B
Yes.
- [38:29]
A
Why does it tell me it's painful? Well, what is the purpose of that?
- [38:32]
B
So if it's an acute pain, it's, you know, oftentimes it's to teach you a lesson. Like, hey, Mel, don't be a klutz. Don't drop that face on your foot anymore. Yeah, I mean, it's the same thing with, you know, hot pan or stubbing your toe in the corner of your bed.
- [38:43]
A
That. I understand all that.
- [38:45]
B
It's all part of the. These are systems. These are the warning systems. But, you know, your brain, in some ways, is the ultimate regulator of your pain. And it's kind of like you're scrolling your social media feed. Okay. Just imagine the brain scrolling the social media feed.
- [38:58]
A
It's like.
- [38:59]
B
And then all of a sudden, something incendiary pops up. Okay, that's the vase falling on the foot. I'm thinking, wait a second, is that. Is that real or is that fake? First of all, the brain's deciding all this in a split second. And then it's starting to take all these other things into account. You know, has this happened to you before? Did it hurt last time it happened to you? How much did it hurt? Any history of depression? Anxiety? All these different things come into play. That's the thing. When I started writing this book, I thought I was pretty smart on this because, you know, 25 years I've been taking care of patients with pain, and I learned a lot. And, you know, it's a fine line trying to navigate how to teach people about pain versus just treating their pain.
- [39:40]
A
Right. And also, since it's such a brand new way to think about it without making someone feel disempowered. Because even if your brain is misfiring, you're the one that's still feeling it.
- [39:55]
B
That's right. Your brain is now deciding this is a more significant injury.
- [39:59]
A
Got it.
- [40:00]
B
And you know, or.
- [40:01]
A
Oh, it's organizing a response to get you to take action. Because if it's more serious, you need help or people around you need help and you gotta do something.
- [40:12]
B
Yes.
- [40:12]
A
So the pain is like an alarm. Ding, ding, ding. Move. Do something.
- [40:16]
B
That's right.
- [40:16]
A
Okay.
- [40:17]
B
Pain is an alarm system in many ways.
- [40:20]
A
Well, I was just thinking about the fact that if that vase were not pottery and it were let's say Tupperware. If it hit the foot, even at an object that size, my brain would notice, but it would also register as not as painful.
- [40:35]
B
That's right. That's right.
- [40:37]
A
And so I can see what you mean, that what's happening to your foot or your hip or your back or whatever, or your tooth is just happening. It's your brain that is kind of registering how much we're going to care about this.
- [40:51]
B
Yep. And deciding then what your experience is going to be.
- [40:55]
A
Got it.
- [40:56]
B
Have you ever seen that experiment where they. They take a hand and then they take a dummy hand and they put it over here and so. And then they start your. And your actual hand is behind the back. And then they start sort of touching the dummy hand and touching your hand in the same places to sort of like I'm touching this finger.
- [41:11]
A
You mean like they're touching the dummy hand and you feel that in the hand behind the back?
- [41:14]
B
Well, they're touching. They're touching your hand in the back as well. So they're basically trying to get you to correlate the dummy with your hand.
- [41:21]
A
Okay.
- [41:21]
B
And so then all of a sudden the dummy hand starts to feel like your hand. And all of a sudden they take a hammer and they smash the hand.
- [41:28]
A
And then you pull your hand back. Right.
- [41:30]
B
It's not even your hand.
- [41:31]
A
Well, I don't even have the dummy hand and I felt like it was coming.
- [41:35]
B
Right.
- [41:35]
A
The mirror neurons are firing.
- [41:37]
B
That's right. So you know the idea that you can. You're tricking the brain, obviously. But the point is not to trick the brain. The point is to show you that all pain exists in the brain. Your brain decided that hurt even though it wasn't even your hand.
- [41:50]
A
This is like a whole new frontier in science.
- [41:54]
B
It really is.
- [41:55]
A
This feels like a great moment to take a quick break and there's two things I want you to do. I want you to listen to a word from our amazing sponsors. But I also want you to take a moment and share this life changing information with somebody that you care about. This is a free resource and gift that could truly change the trajectory of. Of someone's life because it's going to help them take control of their health. So thank you for doing that. Don't go anywhere and Sanjay and I will be waiting for you after this short break. So stay with us. Ever seen a group chat spiral into chaos? One second you're planning a birthday party. Five seconds later someone's dropping unrelated memes and someone else is RSVPing for the wrong week. Add in different types of phones and suddenly the cake photo is a blurry mess and no one knows who's replying to what. There's no need to stress for group chat that actually works. Just take a breath, use the five second rule. 5, 4, 3, 2, 1 and open WhatsApp. Start a poll to settle the real debates, Karaoke or chill dinner Pin key messages so the venue, address or surprise arrival time doesn't get buried. Use event invites to lock in details and track RSVPs. Send crisp, high res photos and videos that look amazing across devices and with end to end encryption. Every chat stays private. Even the one where someone asks who's this party for again? Now the birthday plans are chaos free and no one is showing up a week late. It's time for WhatsApp message privately with everyone. You know, there's something in my kitchen that I'm absolutely obsessed with. The Vitamix Ascent X5. It's not just a blender, it's a time saver. This blender is next level. And the Robbins family, we use that sucker every single day. It has 10 preset blending programs. So suddenly blending isn't a task. It's kind of addictive. You hit the button. Bam. Perfect soups, perfect smoothies, perfect dips, margaritas, whatever you want. Craving a spicy roasted veggie soup? Done. How about a killer green smoothie packed with protein? Say no more. Whatever you make, it comes out right every time. And it gets better. This blender cleans itself. You just add warm water and dish soap, hit blend. Boom. You're done. I didn't even know that was possible, but it's glorious. The Vitamix Ascent X5 has easily become the star of the kitchen. And I know I can turn whatever's into the fridge into something that tastes amazing without the mess. If you're trying to eat healthier, save time, or just actually enjoy using your kitchen again, this is it. The Vitamix Ascent X5 is the essential your kitchen needs. Shop now at Vitamix.com ascentx5 to shop now. So lately, I'm just into simplifying. Absolutely anything I can simplify, whether it's my routine, my schedule, even what I'm wearing. And one thing I keep reaching for. My Vuori performance joggers. I wear them everywhere. Taking a yoga class, Vuori. Running errands, Viori. Recording a podcast episode, Viori. Catching a flight, going for a walk, watching tv. Viori, Vuori, Vuori. And here's why. These joggers are part of The Viori Dream knit collection. This is like the smoothest, stretchiest, most amazing soft fabric. I never want to take these things off. I mean, why would you? When they're soft, super lightweight, and yes, wick away sweat and they move with you thanks to their four way performance stretch. So whether I'm lounging or lunging these joggers, my uniform Viori is an investment in your happiness. For our listeners. They're offering 20% off your first purchase. Get yourself some of the most comfortable and versatile clothing on the planet@vuori.com Mel that's V-O-R-I.com Mel exclusions apply. Visit the website for full terms and conditions. Welcome back. It's your friend, Mel Robbins. Thank you, thank you. Thank you for being here with us today and for being interested in this incredible research. And thank you for sharing this with people that you care about. What an awesome resource to have. Sanjay, I'm so excited by everything that you've shared so far and I know you've got so much more to teach us. So this is the next question. I really understand this now in the example of dropping a ceramic vase on my foot versus a Tupperware one. And I understand that it creates an alarm system, right, that is designed to get you to really, like, pay attention. Like, we got an issue here. This is threatening. You deal with it. Which is why if you don't feel pain, you're not even gonna pay attention to it. Right? If you have more like a structural issue, so you've got a disc problem in your back or you have arthritis in your knee, does it work the same way or how is that different? Or is it different at all?
- [46:46]
B
I think it's different because when you have a structural problem, whether it be in your spine or a joint, you're continuously activating those pain receptors.
- [46:53]
A
Okay.
- [46:54]
B
And so that, that, that is a little different than somebody who basically you look at them and you got, there's nothing going on here structurally, anatomically. Otherwise there's no injury, whatever it might be. So then it's, then you have to focus more on what else, what other parts of this pain system are not working properly. And that's all going to be in the brain. So, you know, like Rich Roll, I talked to him the other day. He, he had a very significant spine problem.
- [47:20]
A
Oh, my gosh. And he did surgery where they went in the front and the back.
- [47:23]
B
Doctor and the back. Yes, yes. I, you know, Rich is a good friend. We were talking throughout that entire process, and, you know, he's A ultraman athlete, you know, just, I think he was shocked at how much his post op recovery sort of took. Now, one thing that Rich would say if he were here was that he'd been dealing with chronic pain really for 13 years, since 2012. And part of the reason that it took a lot longer for him to heal and he's still not completely recovered from a pain standpoint. His pain, which was acute back in 2012, started to basically be encompassed by all this baggage that we talk about.
- [48:01]
A
Yep.
- [48:02]
B
And Rich is as smart as he is and as resilient as he is, probably wasn't addressing the baggage that came with this, that idea of even a guy like him. So this should, you know, he. He's an ultraman, he's an athlete, he takes great care of himself, yet he still had this because of that, that added baggage. I think now that he's addressing that more, I think in a very, very intentional way, he's starting to get relief from his pain.
- [48:26]
A
I would love to have you just tick off before we jump into the protocol that people can follow, what constitute baggage that creates a greater pain sensation and goes along with it. So that as you're listening on behalf of yourself or a loved one, and you may have a structural issue, you may need surgery for something, you may need physical therapy, but there's probably some things that are weighing you down that both increase pain and also help alleviate it and help accelerate your healing. So what is like the top five things of baggage that you tend to see?
- [49:03]
B
Previous history of pain is a big one. If you've had pain in the past, then you have a relationship with pain. And for many people, that amplifies a future pain experience. Depression. About 40% of people with chronic pain also have depression. Anxiety. Mostly untreated forms of this. But even in people who have some forms of treatment, they may still have added chronic pain. Poor sleep. That was a big one. And again, it's a bi directional sort of relationship. Pain worsen sleep. Sleep worsens pain. But those are, those are some of the big things, I think, that have always felt a little squishy in terms of the relationship to pain.
- [49:41]
A
What about high levels of stress in your life? You mentioned depression, anxiety, a history of pain, which I would think makes you brace more for pain. That's right, the not getting enough sleep, stress. Is there anything else that you think is important for somebody to like? Okay, check, check, check. These are things that I need to look at.
- [50:00]
B
I think certainly how we move, how we nourish ourselves, and how we Rest, I think, are things that are important with all chronic diseases, but especially with pain. And I think the idea that as a general rule, if you're told that you're in pain, you're told to not move, to sort of stay still. And I think the data is very clear on this, that that's not the right answer. Look, if you have a broken foot or something like that, no one's telling you to walk on that. But for the most part, movement is really important.
- [50:34]
A
Let's talk about the MEAT Protocol, because now you're going into movement. So I really want to talk about what to do. And you write and unpack the MEAT protocol. But what is it?
- [50:44]
B
This is an acronym and it's to be sort of a countermeasure to the RICE protocol if you sprain your ankle, for example. So RICE is rest, ice, compression, elevation, okay, first of all, mobilizing, which is the M and meat, then exercising, continue to actually be actively moving. Analgesia or pain medication if you need it, and treatment such as physical therapy, things like that tend to be much better in terms of preventing chronic pain. So might it hurt more in the moment to not ice it, compress it, elevate it? Yeah, it might. But what you're trading off is a decreased likelihood of developing chronic pain.
- [51:33]
A
Why would resting develop chronic pain?
- [51:36]
B
When I was working on the book, I really wanted to try and answer a question, which was, who is more likely to develop chronic pain? So, you know, seemed like a fair question. Not everyone develops chronic pain. Despite the numbers as high as they are, most people don't develop chronic pain. But who is. And I started talking to these researchers and they were asking the same question. And one of the things they found was that at the time of your injury, whatever it might be, the people who had the lowest levels of inflammation were the most likely to have chronic pain.
- [52:08]
A
Why? Because wouldn't you want to reduce inflammation? That's why I'm resting and elevating and icing and compressing.
- [52:14]
B
I think what the researchers sort of realized is that when you are sending all those healing molecules to your site of injury, letting the body do its job, it's actually pretty good at doing that. All that swelling and that inflammation again, if it's broken, go get it treated and get it fixed. I'm talking more like a sprained ankle or something like that. Something that's non surgical. If you, if you allow the body to do its job, then it's. It's more likely to sort of do the job in the moment and Not. Not sort of layer out your pain over weeks, and it's almost like you're going to hurt a certain amount. Do you want it to hurt now for a little bit, or do you want to have that pain continue for a long time? I'm greatly simplifying here, but that's sort of where these researchers landed. They said the least inflammation was the most problematic. And what do we do when we rest and ice and compress and you elevate, you're decreasing inflammation. And we just learned that decreasing inflammation is more likely to result in chronic pain. So we do things because they feel good in the moment, but not necessarily good for us in the long term.
- [53:19]
A
So what does movement mean if you're hurting? Like light movement, like just stretching it, rolling it, like that kind of thing?
- [53:26]
B
Yeah, mostly not resting, you know, getting up and walking around, going for walks still, you know, it might hurt again if it's. But for most people, continuing to move it, getting those, those. If you have to imagine it, imagine those healing molecules getting to that site of injury and sort of doing their job. The body does a remarkable job of actually treating pain and treat injuries if you let it. But so much of what we do is sort of interfering with that process. We're blocking it by decreasing blood flow to the area, decreasing inflammation, all with the hopes that we're going to get rid of the pain and it's going to go away forever.
- [53:59]
A
Well, you know, what's interesting is that if I think about this on a common sense standpoint, if I am feeling stiff, if I sit, I'm going to get stiffer.
- [54:07]
B
I know, right?
- [54:07]
A
If I stretch, which I would assume is sort of what you're talking about, because you're actually, in stretching your muscles or reaching for your toes, you are signaling and sending more blood flow and molecules to those areas that are tight. And so stretching kind of blows when you first do it first thing in the morning. Cause you're creaky and at least I am. And you can't. But it's kind of amazing how after just five minutes of moving and stretching, your body is designed to feel better, to loosen up. And that's kind of what you're talking about, isn't it?
- [54:42]
B
That's right. People who are moving into older age, where they're just constantly moving, they're far less likely to have chronic pain.
- [54:50]
A
How can you start to retrain your brain to experience pain differently? Because I feel smarter. I feel like I'm getting this.
- [54:59]
B
You're going to be the best judge of how to retrain your brain. And what I mean by that is that just simply paying attention to your pain and maybe even keeping a pain journal for a period of time to sort of.
- [55:11]
A
Wouldn't that make it worse? Well, or does it make it better? Better because you're now starting to go, you know what? I'm going to stop assuming I'm in pain all the time, and I'm going to start to notice when I'm not. Is that what you're doing?
- [55:21]
B
I think you're trying to find the things that are correlating with your pain. Oh, every time I talk to my mom, my back hurts a little bit.
- [55:28]
A
Well, that may be your mom, not mine.
- [55:30]
B
I'm kidding. Mom. Mom. She watches your show. So I got to say this.
- [55:34]
A
I love you. You did a great job. Mom. But that's going to cause you a lot of pain. He was just kidding. Can you give me some examples of what you've seen that. That have a correlation to when people's pain spikes?
- [55:45]
B
Yeah. So, you know, sometimes it can be really obvious things. Some people are going to hurt more in the morning. Some people are waking up in the middle of the night with their pain. Is a pain worse in the morning or at night? What things make your pain better or worse? Besides medications I'm talking about, I always feel okay when I'm doing X, Y or Z and starting to, to dig into, to those types of things. The, the point a little bit in terms of training the brain is that no one has really been talking about this. I'm not the first by any means. Guys like John Sar, people have done this for some time, but the idea that it has largely been ignored. Looking at these other things, maybe medications are necessary for certain things like migraine headaches. There's new classes of medications, neuropathic pain that can be, you know, that sort of lancinating, terrible lightning like pain that you get in your arm or your legs. Some of those you may need medications. But the idea that despite those medications, you continue to have chronic pain. What are your triggers for that? Figuring out what those triggers are will, I think, be the first step towards training your brain. And I, I don't want to over or underemphasize the value of true brain training, whether it be meditation, whether it be virtual reality. I would say look at the data. I mean, I'm not just telling you this, and I was a skeptic of this. You know, I'm a neurosurgeon. I'm the guy who opens the head and you Know does things to the brain. The idea that meditation could, could cause these changes. We now know meditation objectively and measurably changes your brain. It causes thickening in certain areas of the brain that help reduce chronic pain. So there is, there is really active brain training that can help you in the moment and, and help decrease your pain long term as well. And these are all within your reach. I mean, you don't have to go to some fancy clinic to be able to do a lot of this.
- [57:30]
A
You know, so many people deal with back pain. Are there things that you found in all this research that are kind of top of the list to lessen back pain?
- [57:40]
B
Dr. Gupta, if you've, you know, again, get, get it checked out. I mean, I evaluate a lot of back pain, make sure there's not a structural problem, like our friend Rich Roll had, something like that. Let's say you, you've looked at everything and they say, hey, all your scans and everything are normal. Which is what happens 90% of the time when I see a patient, X rays, MRIs, all that sort of stuff. Then I think, you know, really understanding that the back is something that I think a lot of people will rest in response to pain. They sit a lot. And when you're sitting, you're basically axial loading that part of your spine a great deal. So despite the fact that she told the rest, I'm going to sit down instead of stand. That's probably making it worse. And I think as a general rule, sort of applying the same meat protocol for this, the mobilization, the exercise, and reminding yourself that there's nothing toxic happening in my body, people will say, I don't want to go for a long walk or do something like that. I'm going to hurt. You know, my back hurts. I'm going to damage it more. No, you're not. If you've already checked that out and you can check that part off the list, like you're not damaging your back to go for a walk. Then when you actually go for a walk or actually get mobile, you are probably going to actually help relieve your pain. Think about recruiting those healing molecules to actually go to the site of your pain and help chill out those nociceptors, decrease the amount of transmission going to your brain and help you feel better.
- [59:06]
A
What about the person that's scared to. You know what I'm saying? Because I think when you're in pain. Cause I was like, you're right. Because if you think about how stiff most of us are in the morning, a little bit of stretching it loosens things up. But if you're in chronic pain, I think there's a fear that you're gonna injure yourself and make it worse. So if you talk to your doctor and you don't have a structural issue and it's just the pain and the fear that's keeping you from trying a hatha yoga class or rolling out a mat and doing a gentle stretching routine or going for a walk, what would you say to somebody who's scared or afraid they're just gonna make it worse?
- [59:46]
B
First thing I would say is, I understand. I get that that is a common way of thinking. We looked at some studies that basically showed that if you could explain to somebody that their pain is being generated in a way that is not continuously assaulting their body, that there's not some toxic force inside their body, they're not going to damage themselves by doing these types of movements, that seemed to really be helpful. I think it was close to 60% benefit in terms of overall approach to how they were thinking about their chronic pain and their likelihood of actually moving instead of just lying in bed or rest all the time. So it is an important conversation to have. But I think people often assume, because pain is an alarm system, that if I'm hurting, that there's something wrong.
- [60:30]
A
Yes, of course.
- [60:30]
B
But at some point with chronic pain, it's not that there's anything wrong anymore. Maybe it's a glitch in the central nervous system, maybe it's some repressed sort of thing, you know, like Bessel van der Kolk talks about. But it's not a structural problem in your back. You should move.
- [60:46]
A
What I love about what you're saying is that. And I really think I'm getting this, and I really hope, as you're listening and you're watching this, that you're starting to really get this, too, that unless it is an acute injury right now, or unless a medical expert, licensed doctor, professional has told you that you have a structural issue that prevents you from doing certain things, that thinking about it in the area of back pain, as your back is your back, but the pain center is up here in your mind, and that if your doctor or medical professional has said that it is safe for you to start moving, then the only thing stopping you from one thing that could make you feel better is actually the thing that's playing in your mind. It's not located in your back. It's a hard thing to wrap your brain around. But when you explain it that way, and I'm like, oh, it's a glitch. And so the glitch up here is keeping me from doing the one thing. And just think about how much better you feel when you just stretch a little or you just, like, stretch your legs and go for a walk around the block. You always feel better.
- [61:59]
B
You do.
- [61:59]
A
But if the glitch in your brain scares you and makes you think it's going to get worse, you won't do it. And what you're here to say is, if your doctor says this is going to be good for you, then you got to stop letting the glitch in your mind from preventing you from doing these simple things.
- [62:15]
B
Yeah, I think that's exactly right. Evolutionarily, it made sense that if you felt pain, you were going to resist doing things. You were going to treat it like an alarm. It makes sense that that is how we humans evolved. Chronic pain, I don't think was on the bingo card when we evolved. You know, the idea that pain would come and stay. I think that that that mystifies people still to this day. Certainly mystified people in the beginning. Like, can you imagine, like, what is happening to me, that I continue to hurt despite the fact that nothing is happening in my body? Why does this thumb still hurt from a hammer blow, you know, several weeks ago, whatever it might be. But the idea that the body is actually pretty good at doing its job. What we have said in response to chronic pain is don't let the body do its job. You know, ice it and compress and elevate and don't move and rest, and all those things prevent the body from doing its job. Once you're convinced, and you should be convinced by a really honest conversation with whomever about your back or knee, whatever it might be, that there's not something that's continuously activating those pain receptors, then think about movement, think about exercise.
- [63:22]
A
Even I have tmj, but I didn't even consider that chronic pain.
- [63:26]
B
Right.
- [63:26]
A
It bothered me so much, I actually got surgery on the joint 20 years ago. But as I'm sitting there, did that help? Oh, it helped a lot. But so did the fact that I wear the bite guard. But I'm also hearing you talk, and I'm like, well, actually, the more I've prioritized sleep and the more that I'm moving my body and the more that I manage my stress. Funny thing, I'm not grinding my jaw into the ground as much anymore. And it's not as painful. I mean, it used to lock.
- [63:55]
B
Sanjay, really.
- [63:56]
A
And, you know, I'm about to turn you into our. Your personal team doctor here and ask you a bunch of questions.
- [64:02]
B
Okay.
- [64:03]
A
But, you know, the NIH says more than 10 million people in the US live with jaw pain.
- [64:07]
B
I think when you look at temporomandibular joints. So this. This joint.
- [64:10]
A
Is that what TMJ is?
- [64:11]
B
Tmj, exactly. Temporomandibular joint mouthful.
- [64:15]
A
Literally. Yes.
- [64:17]
B
You know, for a lot of people, there's different reasons for it, but one thing I would say is the numbers have gone up pretty significantly over the last couple of decades. Why would that be? We're not eating different foods necessarily. Like, why would our jaws be hurting a lot more? And I think it's, you know, goes back to many of the same things that are driving a lot of disease in our country. Again, you think of heart disease, you think I'm eating too much meat? Yeah, maybe to some extent. But there's also the stress that you live in. People who are socially isolated have more heart disease. What's the relationship there? Even if they're healthy eaters, we find that isolation triggers pain centers in the brain. My point being that there's lots of things that could be sort of driving the tmj, and many of the ills of our society are the same things that are driving chronic disease drive chronic pain. So, you know, getting to the root cause, you. You clearly had some root causes with regard to the amount of stress and everything else in your life. I don't know if you saw someone who's a specialist to deal with that part of your life. Maybe you did, but if you did, the idea that you're doing it because you want to fix your jaw, Right. I want to fix my pain. So I'm seeing a psychologist.
- [65:26]
A
I love this paradigm shift that you would go work on your mindset and work on your stress levels and work on your resilience, and that would cure your jaw pain.
- [65:40]
B
Yeah, or greatly mitigate it. I mean, none of this stuff has gotten much attention. You know, that's the thing, is that people wonder why these pains are increasing and why they're lasting longer. And I think it's because one of the fundamental things driving it, it has not really been addressed. We want the home runs. We want the knockout punch. That's what we want in society. Like, you get rid of my jaw pain right now. I don't want this anymore.
- [66:04]
A
So I got to get back to work, and then I got to go do that thing.
- [66:06]
B
I got a podcast, you know, whatever it might be. So give me a powerful pain medication or do surgery and maybe, you know, surgery is the right answer. I'm a surgeon. That can be the right answer in many cases, but not, not in most. 90% of the time probably is not the right answer for many things.
- [66:23]
A
I would love for you to read the dedication of this book.
- [66:28]
B
For my three daughters, Sage, sky and Soleil, every word in this book is for you. One of our greatest fears is seeing the people we love in pain. And with this book, I hope to prevent that from happening for you. Having parents who live a pain free life is the gift I aim to give you so that your mother and I may always be present, active and engaged. For my dear wife, Rebecca. You, like too many others, have lived with physical pain. Yet during those times when I felt powerless to help, you inspired me to dig deep into what is possible and put what I learned on the page. Thank you for always taking the time to listen, encourage, and offer stellar suggestions for how to make this book the best it could be. And for the millions of people out there with chronic pain, I know it presents you with profound challenges, often invisible to others. I wrote this book for you to share your stories and my confidence that together we can chart a path beyond pain, a path of action, hope, and healing.
- [67:26]
A
How has Rebecca's journey impacted you?
- [67:29]
B
I mean, you know, she's my wife. You know, we've been married forever now. We've known each other for a long time, and I've been a doctor for a long time. And I think with my wife and my mom, Pain came home, they came to visit my house. And you know, I think I've always tried to treat my patients like family, but at the same time, like watching the ones that you love and you spend all this time with, so you really know them and you know how they are and you know their personalities and you see pain hijack their lives, hijack their identity. And you're like, that's not the person I know. And you know, it's pain talking, not them. I think that that, that was. That was tough. But I think at the same time, you know, I think our greatest joy sometimes now come in overcoming things, rising above. And I think in some ways, not that I wish that she had gone through what she went through, just like I don't wish that you had gone through what you went through. But she's doing great.
- [68:26]
A
How long did it take?
- [68:27]
B
It took a while. I still remember when it sort of started in my mind for her because she had sort of been talking about it. But you, you keep thinking, oh, this is Just a thing that'll go away in a little bit. And she couldn't turn the doorknobs, you know, with their hand. And I thought, well, that seems like a very arthritic sort of component to this, like what, what is happening? And I remember lying in bed with her once and, you know, asking silly questions in retrospect, like, how much does it hurt? Like, doc, how do I explain this to you? You want me to give you a number? Because my number would be immeasurable, right? You don't understand. Or I'd say point to where it hurts. And I remember she would, she would point to a part on her body and she would basically say, this is the only place it doesn't hurt hurt. And I think that was probably three or four year journey in some ways. Keep in mind the way the medical establishment works, especially with these kinds of pains, is you try a medicine, in this case, it may be a medication for autoimmune disease, and you need to give it months to see if it'll work. So it's not a fail fast sort of model. It's a long trial period sort of model. Maybe it's working, maybe it's not. So months would go by, didn't really work. Go back to the drawing board, try something else. So you know that we probably went through that cycle four or five times. Six months, pop. And then now she's on Nomads.
- [69:46]
A
I am sorry that we went through this, but I'm grateful that you guys did because it clearly sparked what I think is going to be some of your most important work because it's personal, it's impactful, and as you said, the pain came home. But the story, which is very daunting and so many people can relate to it, also proves that over time, all of these changes that you're talking about that really galvanize the natural intelligence and desire of your body to heal and to be pain free. They can work. And that is an incredible gift that you're giving to all of us. And so thank you to Rebecca, thank you to your mom, thank you to you.
- [70:35]
B
Well, I really appreciate that, Mel, especially coming from you. It's, you know, you write books, as you well know, and you know, you spent three years. I spent three years working on the book. And I was dreaming about it at some points, you know, just, it takes over your life. And I wanted to learn everything I could. And had I written the book that I really wanted to write, it probably would have been, you know, this, this thick.
- [70:57]
A
We wouldn't have read it. It's much smaller.
- [71:01]
B
But on the other hand, I wanted to put things in the book that you can't just easily go and Google.
- [71:05]
A
Yes.
- [71:05]
B
I wanted to give you the why behind the what, Because I felt like if you understood why these things worked and you could actually see the data and maybe even meet some of the researchers who many of them have pain themselves and that's what inspired them to do this kind of work and understand their stories and then understand how they set up an experiment and how they validated the experiment and then what it means for you. It's powerful stuff. It's powerful for me, you know, I will. I incorporate these things into my own life as well. My wife gets tremendous relief from meditation now, and she is the biggest skeptic of all. I'm skeptical.
- [71:37]
A
She's a lawyer, a former lawyer. She's a lawyer.
- [71:38]
B
Like, show me the data on this. I'm not, you know, there will be faith to abandon if you don't. This doesn't work for me, you know, so. But I did it with her and my mom, who is an engineer, you know, so very science minded. First woman ever hired as an engineer at the Ford Motor Company back in the 60s. So, you know, just that sort of Persona. I did meditation with her as well. And there's. It's not just meditation. It's all these other things. It's. It's the movement. You know, my wife's pain got so bad at times that when I would get home from work, I'd have to carry her up the stairs. She just couldn't go up the stairs on her own. Everything just hurt too much. Just grimacing, every single movement. And there's all these different things that we tried. It wasn't just meditation. But I think what was striking to me as we traveled to all these hospitals around the country trying to get her care, was that everyone's like, all right, let's try a TNF blocker. Let's try this particular pain medication. Let's try this autoimmune therapy. How about Humira? Have you done that? Which we greatly appreciated all that. She was still in pain, though. So, you know, it's. It was the baggage that was not getting addressed. And I felt helpless at times to try and help her. But the idea that ultimately I started meditating myself doing these other things myself, really focusing on movement, I think really helped her. She ended up doing the Malibu Triathlon with me.
- [73:00]
A
From being carried up the stairs to doing a triathlon using these approaches, it works. It works what do you do if the person that you love is experiencing chronic pain and they just feel so discouraged?
- [73:18]
B
It's really hard. Mel, 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 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 case. Fear of 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. 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 be able to relieve your pain.
- [74:08]
A
Well, one of the biggest things that I'm taking away from this is that if you're in pain, if 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.
- [74:23]
B
I know.
- [74:24]
A
And 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?
- [74:37]
B
I 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. But 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. Like, let's say the pain is in your thigh. Can you trace it? Are there hot spots in the pain? Can you identify that? Like, really, really use as many adjectives as you can. Some people like to draw the pain, you know, so really like getting to know your pain, I think, and then understanding what makes it better, what makes it worse. 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. Our 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 addressing all these things in order to address chronic pain. You are the most reliable narrator of your pain, so 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.
- [75:59]
A
Dr. Sanjay Gupta, what are your parting words?
- [76:02]
B
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.
- [76:14]
A
Well, I believe you. I'm so excited. Thank you. Thank you. Thank you for being here.
- [76:20]
B
What a pleasure. Thanks for having me, Mel.
- [76:22]
A
And 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. There's no doubt that if you put to use everything that you just learned today, you are gonna feel better. You're gonna be happier. I'm so excited to hear how this works for you and the people that you care about. In case somebody else tells you 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. And prioritizing your health is one of the best ways that you can do it. All righty. I will see you in the very next episode. I'll be there to welcome you in the moment you hit play. I'm excited for the conversation today. It's such an honor to be together to get this. Oh, my God. He completed his residency in neurosurgery at the University of Michigan. My mouth is like. You know, one of the things that I really admire about Dr. Gupta is his. I was chewing through that retainer, let me tell you that. My guard. Basically snapping it in half. How do you stay still? I mean, don't you want that?
- [77:32]
B
Well, I mean, there are certain procedures you really have to stay still for, but other procedures, you don't necessarily.
- [77:40]
A
Gotcha. Okay. What does that mean?
- [77:41]
B
Propofol is the thing that made you not aware.
- [77:44]
A
Okay. I thought it was, like, a condition. I'm like, I'm really sorry that happened to you.
- [77:47]
B
Propofol is the. Maybe you saw this, but it's. It's like, looks like white milk in an IV Bag. People call it milk of amnesia.
- [77:55]
A
Oh, clever.
- [77:56]
B
Yeah, right.
- [77:57]
A
I love you and I believe in you and I believe in your ability to create a better life and priort and prioritizing your health is one of the best ways that you can do it. Oh, and one more thing and no, this is not a blooper. This is the legal language. You know what the lawyers write and what I need to read to you. This podcast is presented solely for educational and entertainment purposes. 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 or professional coach, psychotherapist or other qualified professional. Got it? Good. I'll see you in the next episode.
- [78:44]
B
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- [79:20]
A
I'm Angie Hicks, co founder of Angie. When you use Angie for your home projects, you know all your jobs will be done well, from roof repair to emergency plumbing and more done well. So the next time you have a home project, leave it to the pros. Get started at Angie Combination.