Feel Better Now: Neurosurgeon Reveals the New Science of Healing Your Body & Stopping Pain Today

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. Today on the Mel Robbins podcast,

this. Today on the Mel Robbins podcast, we're going to learn the exciting new science about how to heal your body, how to live painfree, how to feel better now

from worldrenowned neurosurgeon Dr. Sanjay Gupta. Chronic pain is now the

Sanjay Gupta. Chronic pain is now the fastest growing condition in the United States. Faster than dementia, faster

States. Faster than dementia, faster than diabetes, faster than cancer.

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.

>> What is the difference between acute pain and chronic pain?

>> So acute pain is pain that you might feel in the moment. You know, touch hot pan, hot, move your hand away. Chronic

pain is when it just lasts. So there's

no ongoing insult or injury to your body. And yet the pain persists. Pain is

body. And yet the pain persists. Pain is

the most mysterious sensation that we human beings experience. You've got to treat it that way.

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

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. I think the evidence is very

have pain. 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.

There's options out there. There's hope.

>> Hey, it's your friend Mel and welcome to the Mel Robbins podcast.

Please help me welcome the extraordinary Dr. Sanjay Gupta to the Mel Robbins podcast. I've been really looking

podcast. I've been really looking forward to this, man. I'm a huge fan of yours, a huge fan of the show, and honored that you'd have me. Thank you.

>> 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

CNN. I am proud of the work that you're doing. I'm so excited for your new New

doing. I'm so excited for your new New York Times best-selling book, It Doesn't Have to Hurt. We're going to talk all things about living a pain-free life

based on the research and 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.

>> Most people are going to have pain at some point in their lives. Um 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

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 a a 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.

>> 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.

>> Yeah. So, so acute pain is pain that you might feel in the moment, you know, touch hot pan, hot, move your hand away.

Okay. Stub 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 they try and put a time frame on it. So, they say if you have pain like that every day for 3 months, at that point it's considered chronic pain.

>> Okay? If you have it sort of every other day for 6 months, you know, you sort of get the idea, but it's pain that just just simply won't go away.

>> Dr. Gupta, could you give us a quick list of just things that might be considered chronic pain?

>> 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

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

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.

>> And how many people struggle with this?

Because I I I found the research really surprising because I think you hear the word chronic pain and you're like, "Ah, it's for old people." No, you know, I got to 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 right?

>> 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 day for more than three months, they are feeling pain.

>> Every day for more than three months and for many of them decades. So three

months is sort of the minimum. But when

I started, you know, 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 the the biggest driving force in their life. They wake up with it, they go to

life. They wake up with it, they go to sleep with it, they think about it all day. If they have a conversation with

day. If they have a conversation with somebody in their life, they're probably going to talk about their pain. Um 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. 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? One one of the things I think

you today? One 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 mindboggling. 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 the likelihood of that happening is certainly increasing. But I think you

certainly increasing. But I think you know Mel the 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

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 the the finger and the toe certainly but the tendons the noceptors which are

pain receptors the 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,

integrated. So if it's not working well, >> okay, >> you're likely to hurt more. And so you think, I smashed my my finger with 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.

>> I I I want to make sure I understand what you just said because you basically said if I, you know, am doing a project at home and I miss the nail and hit my thumb >> Yep.

>> and it's Tuesday and optimal lifestyle conditions. I'm in a good mood. I've

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?

>> Yeah. I I 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, two 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

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 you you'll immediately pull your finger away, right? And that's reflex. That that's

right? And that's reflex. That that's

not really a pain response.

>> But then the idea that ah that really hurts.

>> Yes.

>> And maybe even how you would quantify it yourself both in terms of intensity and unpleasantness. Those are the two things

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 it could be so variable person to person and so variable within the same

person which is remarkable.

>> So is it also true that if the amount of pain and the unpleasantness that you feel varies dayto-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?

>> I I I think so. I I think that that that is where the science is headed. Wow.

>> That you 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? Because you think of it just purely like a physical sort of sensation. Yes,

of sensation. Yes, >> 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

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, overinflammation to it. If you're if you're physically

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.

>> Wow.

>> 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

isolation. It always comes with baggage attached. Now baggage, I don't mean this

attached. Now baggage, I don't mean this in a porative 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.

>> Why? Because that baggage is the one thing that probably no one else has addressed because they get pain medications. They may get procedures.

medications. They may get procedures.

They're always trying to treat the chronic pain like an acute pain, like an immediate pain. Yeah.

immediate pain. Yeah.

>> But now it has all this baggage attached to it. If you don't address the baggage,

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's 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.

>> Yes.

>> 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

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 mar 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

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

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 I think sleep is a

baggage. I think I think sleep is a really good example. A lot of people I talked to for the book said, "I'm not getting good sleep because of my pain."

>> Well, that makes sense.

>> That makes sense, right?

>> And it's sort of like a chicken and an egg thing. Do you have pain because

egg thing. Do you have pain because you're not getting sleep? You don't

sleep because you have pain.

>> That's right.

>> So, how do you untangle that knot?

>> I think you have to address both. That

that's the thing. I think we live in a very monootherapy sort of simplistic culture sometimes when it comes to to medicine.

um I want to identify the problem as as elegantly as I can and then address that single problem. But the idea that maybe

single problem. But the idea that maybe your pain is is worse because you're not getting sleep. That birectional thing

getting sleep. That birectional thing because I think most people think I'm not getting good sleep because of the pain. So take more pain meds, do things

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 reduce your pain scores

>> simply by addressing sleep.

>> Sleep. That that that's the thing. And

and this is measurable. I think that people have sort of anecdotally known this for some time. But you know, understandably, we're 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

causes. And I think pain is probably the best example of that in society. Um, you

know, at one point we are what, not even 5% of the world's population and we were taking 90% of the world's pain meds.

>> Wait, say that again.

>> We are not even 5% of the world's population and we were taking 90% of the world's pain medications.

So >> what does that tell you?

>> 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

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 at if they were doing our rate, it would, you know, still be

16th of of what we do here in this country. So, we don't like pain and

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

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?

Um 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 asked about their pain if 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 um a lot of treatment. Yeah.

>> When treatment wasn't always necessary.

I don't want that to come off non-empathetic. Like I I'm I'm really

non-empathetic. Like I I'm I'm really really empathetic to people's pain.

>> But at the same time, can we say we've overtreated it? We've overoperated on it

overtreated it? We've overoperated on it and we even do things culturally that don't happen in other places around the world. The data suggests very much

world. The data suggests very much that's the case.

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

think what you're 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 are there's exciting research that suggests there are things that you can do

>> beyond what you have been told.

>> That's right. for somebody who may be listening who is either experiencing pain daytoday. Maybe you you have the

pain daytoday. Maybe you 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. I

>> I think there's two sort of broad areas that I'm really excited about. one is

you know high techch innovative work that is happening which as a neuroscientist was really mindblowing for me and I've been in this world for

25 years so I learned a lot but I think the 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 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 uh

shrift. They just were not utilized uh for things.

>> What are some of those modalities?

>> So, 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 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 obiates the need or prevents the need for opioids going into the future. They don't need opioids after that. They they've gotten rid of that acute pain syndrome.

>> When I was in this emergency room in Brooklyn, my monities, which is this really cool place, by the way, it's 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.

>> How does that help with pain? There was

a 76-y 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, her

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 eight to a three. How does it work? So,

>> what's your theory?

>> People often say it's distraction. I

think it's probably some component of distraction from the pain. Um, but I think it's also leaning into this idea that we do truly have this integrated system. If you are on an Indonesian

system. If you are on an Indonesian beach, your stress levels are probably dropping. You're probably releasing more

dropping. You're probably releasing more of the feel-good hormones. You're

activating something in your body known as your endogenous opioid system.

>> What is that?

>> 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 op 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

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. You know

after a while if you ever talking if you 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 to to feel some sense of normaly again. So point being that

normaly again. So point being that opioids decrease mood. They 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

decrease pain. They decrease or inhibit memory of the painful experience and they improve mood. It it's 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 are letting the body do its job and they're helping it along the way. It's your own

indogenous opioid system that we're just trying to just trying to give it a little little push, little nudge, you know, sort of make it work. And if you can get it working, it's it's fantastic.

I personally think it's very exciting to be reminded that even if you're 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 But to have you forget the pain.

>> What you're here to suggest is that there are really exciting things to consider that both help your body feel less pain but also help your body release these natural healing things

that we haven't been talking about.

>> That's right. That's right. Are there

ways at home that if you don't have a VR set that you could extrapolate this exciting research and stimulate the re release of that I can't even remember

what natural something something system.

>> Yeah, there there are lots of things that we can do. A lot of people refer to this whole endogenous opioid system as as a component of the placebo effect, right?

>> Doesn't sound like a placebo. It sounds

like it's working. Yeah, but placeos can work.

>> Okay, >> that's the thing is that, you know, you everything gets tested against a placebo and people have often asked, I I gave that person a sugar pill and yet they

improved. Like, how could that possibly

improved. Like, how could that possibly be? It's not the sugar pill, obviously.

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

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 indogenous 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, Mel, with regard to what you can do at home is meditation.

I, you know, I think a lot of people hear meditation. Yeah, it sounds good. I

hear meditation. Yeah, it sounds good. I

mean, I like to meditate every now and then. relaxes me, chills me out,

then. relaxes me, chills me out, whatever. Me, too. Um,

whatever. Me, too. Um,

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,

the 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

that point. Like if you were touching a really hot plate, you would drop it. And

these are on your arm. Okay? 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. And it's a very specific meditation. And it's part of something

meditation. And it's part of something known as the more protocol, which is mindfulness oriented recovery enhancement. And you see how much did

enhancement. And you see how much did your pain scores and your unpleasantness scores drop.

>> Now, are you meditating while the things on your arm?

>> You're meditating while the things on your arm. You meditate before and then

your arm. You meditate before and then you continue to meditate as you start to go through the experiment.

>> What did you experience?

>> So, numerically, I experienced a drop in my pain scores from a 7.4 four to a two and my unpleasantness score from a five to a 1.8.

>> Wow.

>> Very significant. And that was just purely meditation.

To 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 and

unpleasantness.

And the thing that they came up with was 5 milligrams of Oxycontton. The idea

that meditation could give you that sort of relief was pretty pretty mind-numbing, I think, for a lot of people. I don't mean to suggest that

people. I don't mean to suggest that that pain relief lasts forever, right?

>> Just like Oxycontton doesn't last forever. But during the time that people

forever. But during the time that people meditate, they can drop their pain score significantly. And that's just your

significantly. And that's just your that's just your mind. People really

aren't sure why these things work. And

it 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.

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

beings experience. You've got to treat it that way.

>> Wow. 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 like a lot of the protocol and and like more specific stuff, but just a bit of like here's the northstar 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. You

know, I I preface all these conversations I have with patients um with with a reminder that look, I I I don't want to say anything that's going to minimize their pain.

>> Because I 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 in your head. Those are two different

your head. Those are two different things. And I'm saying this as a

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

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

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. H how could that be? That it's not even there anymore and

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

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. Um, addressing

that baggage as much as you're addressing the pain. It's not I think the the one of the the questions that I think a lot of people have is 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 Vanderolk who wrote this great book called the body keeps a score. I think

what Bessel would suggest um 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

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 like you're not thinking about why you're you're just 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

the cause. And you may not be able to identify the cause yourself. Here's what

I find super exciting about this. Cuz

you know, 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.

>> Yes. that you haven't even considered.

In fact, you write, I want to 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 Q from a vast array of stimuli, biology, psychology, social emotional environmental even cultural. And just as we now understand

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.

>> Yes.

>> Really?

>> Yeah.

>> 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 remembering, >> still dealing with, still remembering >> neuroplasticity, you know, which is sort of the the the name for this larger concept of being able to change your

brain. There's this phrase I I think it

brain. There's this phrase I 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

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 hyperfocused on the

do. So if you're hyperfocused 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 who are in chronic pain.

Their preffrontal cortex tends to be smaller. So their judgment and things

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 al also goes through

some extent. But it al also goes through the hippocampus which is your memory store. So you might start to really

store. So you might start to really remember it well. Uh 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 zero to 100 just like that. And I've seen this in patients even like in real time. They'll

be in my office uh Mel and and they'll they'll, you know, sort of be there and then all of a sudden they're they're cringing. Nothing happened to them,

cringing. Nothing happened to them, right? It wasn't like they fell or

right? It wasn't like they fell or anything. They're just sitting there

anything. They're just sitting there like what what is going on there? Why is

why is that suddenly gone from zero to 100 or from 10 to 100? A lot of that is because this very complicated sort of loop of of pain circuitry including memory.

>> 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 nanconds and then your brain has to like a superco computer register >> what just happened? Yes.

>> Why does it tell me it's painful?

>> Well, >> what is the purpose of that?

>> So if it's an acute pain, it's, you know, often time it's to teach you a lesson like, "Hey Mel, don't be a klutz.

Don't drop that vase on your foot anymore." Yeah,

anymore." Yeah, >> I mean it's the same thing with, you know, a hot pan or stubbing your toe on the corner of your bed. All that it's it's all part of the these are lessons.

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 a social media feed. It's like da da da da. And then all of a sudden something

da. 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. Um, you know, have has this happened to you before?

Did it hurt last time it happened to you? How much did it hurt? Uh um any

you? How much did it hurt? Uh um any history of of depression, anxiety, all these different things come into play.

That 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 and I learned

a lot. And you know, it's a fine line

a lot. And you know, it's a fine line trying to navigate um how to teach people about pain versus just teaching just treating their pain,

>> right? And also since it's such a brand

>> 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.

>> That's right. Your brain is now deciding this is a more significant injury.

>> Got it. and you know or or >> 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 got to do something.

>> You got Yes.

>> So, the pain is like an alarm. Ding,

ding, ding. Move. Do something.

>> That's right. Pain is is is an alarm system for in many ways. 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.

>> That's right. That's right.

>> 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.

>> Yep. And and and deciding then what your experience is going to be.

>> Got it.

>> Yeah. 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. You mean

like they're touching the dummy hand and you feel that in the hand behind you?

>> 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 hand with your hand.

Okay. 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 >> and then you pull your hand back.

>> You're like, >> right, >> it's not even your hand.

>> Well, I don't even have the dummy hand and I felt like it was coming.

>> Right.

>> Well, the mirror neurons are firing.

>> 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

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. This is so much to say new frontier in science.

>> It it it really is.

>> 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 going to pay attention to it. Right?

to it. Right?

If you have more like a structural issue, so you've got a uh 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?

>> 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.

>> Okay. And so that that that is a little different than somebody who who basically you look at them and yet 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 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 uh Rich Roll, I talked to him the other day. He he had a very significant spine problem.

>> Oh my gosh. And he did surgery where they went in the front and the back.

>> And the back. Yes. Yes. I I I uh you know, Rich is a good friend. We were

talking throughout that entire process and you know, he's a ultra man athlete.

You know, just I think he was shocked at how much his posttop recovery sort of took. Now, one thing that Rich would say

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 uh encompassed by all this baggage that we talk about.

>> Y >> 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,

this. That idea of even a guy like him, so this should, you know, he he's an ultra man. He's an athlete. He's takes

ultra man. He's an athlete. He's 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.

>> 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

something. You may need physical therapy. Um, but there's probably some

therapy. Um, 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

healing. So, what is like the top five things of baggage that you tend to see?

>> Previous history of pain, >> okay, >> is a big one. If you if you and if you've had pain in the past, then you have a relationship with pain and and for many people that amplifies a future

pain experience. depression. About 40%

pain experience. depression. About 40%

of people with chronic pain also have depression, anxiety, um 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 that was a big one. That

was a big one. And again, it's a birectional sort of relationship. Pain

worsens 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.

>> What about high levels of stress in your life? You mentioned depression, anxiety,

life? You mentioned depression, anxiety, >> um a history of pain, which I would think makes you brace more for pain.

>> That's right.

>> Um the uh not getting enough sleep, stress. Is there anything else that you

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. I I think um certainly how we move y how we nourish ourselves and how we rest okay I think are are things that are important with all chronic diseases y but

especially with pain and I think um the idea that as a general rule if you're told that you're in pain you're told to >> not move

>> to to sort of stay still >> and I think the the data is very clear on this that that's not the right answer if you have a broken foot or something like that no No one's telling you to

walk on that, but for the most part, movement is really important.

>> 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

do. And you write and unpack the meat protocol, but what is it?

>> This is an acronym.

>> Okay.

>> And it's to be sort of a a counter measure to the rice protocol if you sprain your ankle for example.

>> So, rice is rest, ice, compression, elevation. Okay, first of all,

elevation. Okay, first of all, mobilizing, which is the M and meat. Then

exercising, continuing to actually be actively moving, analesia or pain medication if you need it, and treatment such as physical therapy, things like that,

>> uh, tend to be much better in terms of preventing chronic pain. So,

it 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.

>> Why would resting develop chronic pain?

>> I I when I was working on the book, I 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

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.

>> Why? Because wouldn't you want to reduce inflammation? That's why I'm resting and

inflammation? That's why I'm resting and elevating and icing and compressing. 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 months. It's

almost like you're going to hurt a certain amount. Do you want it to hurt

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

most problematic. And what do we do when we rest and ice and compress and you elevate? You're decreasing inflammation.

elevate? You're decreasing inflammation.

And we just learned that decreasing inflammation is more likely to result in chronic pain. So, we do things cuz they

chronic pain. So, we do things cuz they feel good in the moment, but not necessarily good for us in the long term.

>> So, what is movement mean if you're hurting? Like light movement, like just

hurting? Like light movement, like just stretching it, rolling it, like that kind of thing.

>> Yeah. mostly not resting, you know, getting up and walking around. Uh going

for walks still, you know, it might hurt. Again, if it's but for most people

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

job. The body does a remarkable job of actually treating pain and treating injuries if you let it. But so much of what we do is sort of interfering with that process. We're blocking it by

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. It's going to go away forever.

pain. It's going to go away forever.

>> Well, you know what's interesting is that if I think about this in a common sense standpoint, if I am feeling stiff, if I sit, I'm going to get stiffer.

>> I know, right?

>> If I stretch Yes. 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

are tight. And so stretching kind of blows when you first do it first thing in the morning because 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

loosen up. And that's kind of what you're talking about, isn't it?

>> That That's right. People who are moving into older age, they're just constantly moving, they are far less likely to have chronic pain.

>> How can you start to retrain your brain to experience pain differently? Because

I feel smarter. I feel like I'm getting this. you you're going to be the best

this. you 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 >> Doesn'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

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?

>> 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.

>> Well, that may be your mom, not mine.

>> I'm I'm kidding, mom. Mom, she watches your show. So, I got to say this.

your show. So, I got to say this.

>> We love you. You did a great job, Mom.

Um, that's going to cause you you a lot of pain. He was just kidding. Can you

of pain. He was just kidding. Can you

give me some examples of what you've seen that have a correlation to when people's pain spikes?

>> Yeah. So, you know, sometimes it can be um 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?

Be 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.

>> I you I think the 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

about this. I'm not the first by any means. guys like John Sarno, people have

means. guys like John Sarno, 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

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 you know, 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

virtual reality. I would say look at the data. I mean, I'm not just telling you

data. I mean, I'm not just telling you this. Um, and I was a skeptic of this,

this. Um, 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

changes. We now know meditation objectively and measurably changes your brain. It causes thickening in certain

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 you don't have to go to

your reach. I you don't have to go to some fancy clinic to be able to do a lot of this.

>> You know, so many people deal with back pain. Are there things that you found in

pain. Are there things that you found in all this research that are kind of top of the list to lessen back pain? Dr.

Gupta I >> if if you've you know, again, get get it checked out. I mean, I I evaluate a lot

checked out. I mean, I 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 the back is something that I think a lot of people will rest in in response to pain.

>> Um 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 I'm going to hurt, you know, my back hurts.

I'm 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 or actually

get mobile, you are probably going to actually help relieve your pain. Think

about recruiting those those healing molecules to actually go to the site of your your pain and help chill out those no receptors, decrease the amount of transmission going to your brain, and

you know, help you feel better.

>> What about the person that's scared to?

You know what I'm saying? Because I

think when you're in pain, because I I immed like you're right because if you think about how stiff most of us are in the morning, a little bit of stretching, like it loosens things up, but if you're

in chronic pain, I think there's a fear that you're going to 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 ha yoga class or rolling out a mat and doing a gentle stretching routine or going for a walk.

>> Yeah.

>> What would you say to somebody who's scared or afraid they're just going to make it worse?

>> Uh, first thing I would say is I understand. I I get that. That is a

understand. I I get that. That is a common way of thinking. Um, we looked at some studies that 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 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 you know

lying in bed or or resting all the time.

So it is an important conversation to have. But I think people often assume

have. But I think people often assume because pain is an alarm system that if I'm hurting that there's something wrong.

>> Yes, of course.

>> But at some point with chronic pain, it's not that there's anything wrong anymore. Maybe it's a glitch in the

anymore. Maybe it's a glitch in the central nervous system. Maybe it's some repressed sort of thing, you know, like Bessel Vanderolk talks about, but it's not a structural problem in your back.

You should move. 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 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."

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.

>> You do.

>> 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 gota you gota you got to stop letting the glitch in your mind from preventing you from doing these simple things.

>> Yeah, I 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

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

we evolved. You know, the idea that pain would come and stay.

>> I I think 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 it and elevate and and don't move and rest and 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 um exercise. Even

movement. Think about um exercise. Even

>> I have TMJ, but I didn't even consider that chronic pain. Right.

>> It bothered me so much I actually got surgery on the joint 20 years ago. But

as I'm sitting here, >> did that help?

>> Oh, it helped a lot. But so did the fact that I wear the bike guard, but I'm also hearing you talk and I'm like, well, actually, the 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. But it used to lock

Sanjay >> really.

>> And and you know, I'm I'm about to turn you into our personal team doctor here and ask you a bunch of questions. Okay.

>> But you know the NIH says more than 10 million people in the US live with jaw pain.

>> I think when you look at temporal mandibular joints so this this joint is >> that what TMJ is?

>> TMJ exactly temporal mandibular joint.

>> Awful literally.

>> Yes.

>> But you know for 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

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

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 uh are driving chronic disease drive chronic

pain. So, you know, getting to the root

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.

>> Um you're you 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,

jaw, right? I want to fix my pain. So,

I'm seeing a psychologist.

>> I love this paradigm shift that you would go work on your mindset.

>> Yeah.

>> And work on your stress levels.

>> Yes.

>> And work on your resilience. And that

would >> cure your jaw pain.

>> Yeah. Or or greatly mitigate it. I mean,

none of this stuff has gotten much attention, you know? It it that that's the thing is that people wonder why the these pains are increasing and why they're lasting longer. And I think it's because one of the fundamental things

driving it has not really been addressed. We want the home runs. We

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.

>> So I got to get back to work. I got to go do that thing.

>> I got a podcast to do. 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

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.

>> I would love for you to read the dedication of this book.

>> For my three daughters, Sage, Sky, and Sole, every word in this book is for you. One of our greatest fears is seeing

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

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

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.

>> How has Rebecca's journey impacted you?

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 um you know, I'm I've been a doctor for a long time. And I think um 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

tough. But I think at the same time, you know, I think our greatest joys sometimes, Mel, 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.

>> How long did it take?

>> 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, is this is just a thing that'll go away in a little bit. And

>> she couldn't turn the door knobs, you know, with her 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

immeasurable, right? You don't understand. Or I'd say, "Point to where

understand. Or I'd say, "Point to where it hurts." And I remember she would she

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."

>> And and I think that was probably, you know, three or four year journey in some ways. Keep in mind, you know, the way

ways. Keep in mind, you know, 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.

>> Yeah. Yeah. And you need to give it months to see if it'll work, right? So

it's not a fail fast sort of model.

>> Yeah.

>> 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

something else. So you know that we probably went through that cycle four or five times, six months a pop, and then now she's on nomads. 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.

>> Yeah. 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 that really galvanize the natural intelligence and desire of your body to heal and to be painfree,

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.

>> Well, um I I really appreciate that, Mel, especially coming from you. It's

it's it's um you know, you write books as you well know and um you know, you you spent three years I spent three years working on the book and you you I was dreaming about it at some points,

you know, just it 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 would probably would have been, you know, this thick, you know, >> we wouldn't have read it much smaller.

>> So I wanted just kidding. But on the other hand, I wanted to put things in the book that you can't just easily go and Google.

>> Yes.

>> 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 it's powerful stuff. It's

for you. It's it's powerful stuff. It's

powerful for me. You know, I will I 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.

>> She's a lawyer. Former lawyer lawyer.

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, um, but I did it with her.

you know. So, um, 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 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 uh pain

movement. You know, my wife's uh 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 um there's all

single movement. And um 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

TNF blocker. Let's try this particular pain medication. Let's try this

pain medication. Let's try this autoimmune therapy. How about hum? Have

autoimmune therapy. How about hum? Have

you done that?" Which we greatly appreciated all that. She was still in pain, though. So, you know, it's it was

pain, though. So, you know, it's it was the baggage that was not getting addressed. And I felt helpless at times

addressed. And I felt helpless at times to try and help her. But but the idea that that ultimately, you know, 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. So, it's

me. So, it's >> well, 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?

>> It's it's it's really hard, Mel. It's

it's um you know, 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 is 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. 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.

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.

>> Well, one of the biggest things that I'm taking away from this is that like if you're in pain, if 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

your life. And I feel like every one of us have been told the opposite.

>> I know.

>> And so that in and of itself is life-changing. If the person listening

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?

>> I 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

complicated. There's all these different things that are sort of associated with it. So starting to really understand

it. So starting to really understand your pain. And when I say understand it,

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

the pain? Can you identify that? Like

really really use as many adjectives as you can to to to 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. Um

if you do have some of these things that we are not in any porative 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. 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.

>> 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.

>> Dr. 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.

Well, I believe you. I'm so excited.

Thank you. Thank you. Thank you for being here.

>> What a pleasure. Thanks for having me, Mel.

>> 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. I

there's no doubt that if you put to use everything that you just learned today, you are going to feel better. You're

going to be happier. I'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. And prioritizing your

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.

And 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. All

righty. Here 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.