When neurosurgeon and journalist Dr. Sanjay Gupta set out to write a book about pain, it wasn’t because he thought he had all the answers. This was because he was still often confused by it.
“Most of my patients come to me for pain. Headaches, back pain, neck pain, whatever it is,” he says. “If this is the majority of your professional life, you should understand it as best you can.”
His 2025 book, It Doesn’t Have to Hurt: Your Smart Guide to a Pain-Free LifeGathers the latest developments in pain science, based on his experience with patients and conversations with researchers and doctors.
What she found may challenge your own understanding of pain and also give you tools to help you feel better. there is evidenceFor example, that bus Learn Regarding pain and how it works, it “appears to provide pain relief” for people with chronic pain conditions, he says.
Gupta, who also serves as chief medical correspondent for CNN, explains what we still don’t know about pain and shares some effective new treatments. This interview has been edited for length and clarity.
it doesn’t have to hurtBy Sanjay Gupta
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In your book, you say that one of the most important developments to emerge in the treatment of pain is the fact that the brain is at the center of any pain experience. Can you tell us more about why this matters?
What I think has become clear – and I’m not the first person to say this – is the idea that if the brain Not there. Decide if you have pain, then you don’t have pain.
the brain can Too Create pain where it feels like it won’t exist. The best example of this is phantom limb pain, which has troubled people for a long time. Pain is a mysterious thing. Some people react very differently, and even the same person may react differently at different times.
Give an example of this in your book.
The story of the two Joanna’s. It so happened that I operated on two women on the same day who had essentially the same problem and were similar in terms of age and medical history.
When you walk into a patient’s room you can always tell how they are doing. I went into Joanna No. 1’s room that day (after the operation), and she already had lipstick on. Her hair was combed. He was discharged soon after. But Joanna No. 2 was miserable.
If I had operated on Joanna No. 2 a week later, she probably would have had a completely different outcome, and that was because she had less stress, had better food, and had nicer weather outside. When it comes to pain, things you don’t think matter matter a lot.
This can happen with chronic pain too, right? In some cases, doctors cannot find the underlying cause or injury. Or an injury may have occurred, but one is still experiencing severe or persistent pain.
Correct. Chronic pain is pain that lasts for at least three months. But there are also people who have pain for decades. Why this happens is still a largely unanswered question. Nothing is off limits in terms of what (could) be contributing to pain, especially when that pain becomes chronic.
You say that mindfulness therapy, like meditation and breathing exercises, can be an effective treatment in managing pain. Can you share one method and how it works?
There is one protocol in particular called MORE: Mindfulness-Oriented Recovery Enhancement. for one significant percentage For people who have chronic pain without any underlying physical problems, it can be really effective.
(practitioner) Tell:Hey, don’t just wallow in the pain, but think of a pleasant scene. It’s the idea that the toxicity of pain can somehow be cured by thinking about something far more pleasant, whatever that may be – flowers, sunsets, time with your children.
The idea that MORE can reduce pain levels for a short period of time is evidence that how much of it is happening in the brain and how much of it is under our control.
One of the surprising new developments in pain is how we deal with injuries – say, ankle sprains. For a long time, we have been told to follow the RICE acronym to reduce inflammation and heal injury. But new research suggests something else.
The acronym RICE – rest, ice, compression, elevation – all these things basically reduce inflammation.
but there was one paper What came to light a few years ago changed the thinking on this. The researchers were trying to answer the question: Who is more likely to have chronic pain? People with what demographics, what medical histories?
They found that people who had the highest levels of inflammation at the time of injury at least Possibility of chronic pain.
What you hear from pain doctors now is to lean into the pain.
The new acronym to be followed is MEAT: Movement, Exercise, Analgesia and Treatment.
Activate the joint, exercise, use pain medication if necessary, but do not use anti-inflammatory medications.
If you get active early and don’t pay as much attention to reducing inflammation, you’re less likely to have chronic pain.
It’s helpful to know that there are lots of different things to try. All you have to do is connect with the right information.
When you’re dealing with something as mysterious as pain, you should have a large menu of options to choose from. And while nothing works for everyone, there’s probably something that works for someone.
listen to podcast episodes For more pain treatment and therapy from Dr. Sanjay Gupta.
This story was edited by Malka Gharib. We’d love to hear from you. Leave us a voicemail at 202-216-9823, or email us LifeKit@npr.org.
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