Tools to Reduce & Manage Pain | Dr. Sean Mackey

Andrew Huberman

Jan 15, 2024

Episode description

In this episode, my guest is Dr. Sean Mackey, M.D., Ph.D., Chief of the Division of Pain Medicine and Professor of Anesthesiology, Perioperative and Pain Medicine and Neurology at Stanford University School of Medicine. His clinical and research efforts focus on using advanced neurosciences, patient outcomes, biomarkers and informatics to treat pain.

We discuss what pain is at the level of the body and mind, pain thresholds, and the various causes of pain. We also discuss effective protocols for controlling and reducing pain, including the use of heat and cold, acupuncture, chiropractic, physical therapy, nutrition, and supplementation.

We also discuss how pain is influenced by our emotions, stress and memories, and practical tools to control one’s psychological perception of pain.

And we discuss pain medications, including the controversial use of opioids and the opioid crisis.

This episode will help people understand, manage, and control their pain as well as the pain of others.

Read the episode show notes: https://go.hubermanlab.com/ZrPX7fZ

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*Dr. Sean Mackey*
Stanford academic profile: https://stanford.io/48TgiBz
Website: https://drseanmackey.com
Publications: https://stanford.io/3U1OiHY
Lab website: https://stan.md/3vKrrWY
Stanford Division of Pain Medicine: https://stan.md/47zT9Dh
X: https://twitter.com/DrSeanMackey
LinkedIn: https://www.linkedin.com/in/seancmackey

*Timestamps*
00:00:00 Dr. Sean Mackey
00:02:11 Sponsors: AeroPress, Levels & BetterHelp
00:06:13 Pain, Unique Experiences, Chronic Pain
00:13:05 Pain & the Brain
00:16:15 Treating Pain, Medications: NSAIDs & Analgesics
00:22:46 Inflammation, Pain & Recovery; Ibuprofen, Naprosyn & Aspirin
00:28:51 Sponsor: AG1
00:30:19 Caffeine, NSAIDs, Tylenol
00:32:34 Pain & Touch, Gate Control Theory
00:38:56 Pain Threshold, Gender
00:44:53 Pain in Children, Pain Modulation (Pain Inhibits Pain)
00:53:20 Tool: Heat, Cold & Pain; Changing Pain Threshold
00:59:53 Sponsor: InsideTracker
01:00:54 Tools: Psychology, Mindfulness-Based Stress Reduction, Catastrophizing
01:08:29 Tool: Hurt vs. Harmed?, Chronic Pain
01:12:38 Emotional Pain, Anger, Medication
01:20:43 Tool: Nutrition & Pain; Food Sensitization & Elimination Diets
01:28:45 Visceral Pain; Back, Chest & Abdominal Pain
01:34:02 Referenced Pain, Neuropathic Pain; Stress, Memory & Psychological Pain
01:40:23 Romantic Love & Pain, Addiction
01:48:57 Endogenous & Exogenous Opioids, Morphine
01:53:17 Opioid Crisis, Prescribing Physicians
02:02:21 Opioids & Fentanyl; Morphine, Oxycontin, Methadone
02:07:44 Kratom, Cannabis, CBD & Pain; Drug Schedules
02:18:12 Pain Management Therapies, Acupuncture
02:22:19 Finding Reliable Physicians, Acupuncturist
02:26:36 Chiropractic & Pain Treatment; Chronic Pain & Activity
02:31:35 Physical Therapy & Chronic Pain; Tool: Pacing
02:36:35 Supplements: Acetyl-L-Carnitine, Alpha Lipoic Acid, Vitamin C, Creatine
02:42:25 Pain Management, Cognitive Behavioral Therapy (CBT), Biofeedback
02:48:32 National Pain Strategy, National Pain Care Act
02:54:05 Zero-Cost Support, Spotify & Apple Reviews, YouTube Feedback, Sponsors, Momentous, Social Media, Neural Network Newsletter

Disclaimer & Disclosures: https://www.hubermanlab.com/disclaimer

Mindsip insights from this episode:

Utilize Acetyl-L-carnitine and Alpha-lipoic acid for nerve pain relief

Over-the-counter supplements like Acetyl-L-carnitine and Alpha-lipoic acid have been shown in studies to be effective for neuropathic pain by improving mitochondrial health and modulating nerve channels.

#pain

#supplement

Implement pacing to manage chronic pain recovery

To overcome the roller coaster of good and bad days with chronic pain, use 'pacing' by setting small, consistent daily activity goals and avoiding the urge to overdo it on good days.

#pain

#recovery

Activate love's power to alleviate pain

Viewing a picture of a romantic partner can significantly reduce pain by activating the brain's reward and addiction circuits, a different mechanism than simple distraction.

#pain

#relationships

Recognize food poisoning's link to chronic pain sensitivity

A gut infection like food poisoning can alter your system, creating a long-term sensitivity to certain foods, like the onion family (FODMAPs), that can trigger severe, delayed pain.

#digestion

#pain

Express anger to alleviate pain amplification

Data suggests that 'anger in'—a boiling, simmering, unexpressed anger—is worse for pain amplification than 'anger out,' which is expressive.

#emotion

#pain

Differentiate between hurt and harm in pain management

A critical concept in pain management is understanding the distinction between feeling hurt, which may not be damaging, and being harmed, which indicates true tissue injury.

#pain

Utilize conditioned pain modulation to inhibit original pain signals

Engaging a painful stimulus in a different location from the primary pain can activate a brainstem circuit that descends to the spinal cord and inhibits the original pain signal, a phenomenon called conditioned pain modulation.

#pain

Avoid NSAIDs to promote natural healing processes

While non-steroidal anti-inflammatory drugs (NSAIDs) can help with pain, research shows that by blocking inflammation, they may also delay the body's natural healing process, such as in fracture repair.