Dr. Sean Mackey and Dr. Andrew Huberman: Tools to Reduce and Manage Pain

Last updated: Jan 16, 2024

The video is about Dr. Andrew Huberman and Dr. Sean Mackey, a medical doctor and professor of anesthesiology and neurology at Stanford University School of Medicine, discussing pain and its origins, the critical link between physical and emotional pain, changes in the nervous system that occur when we experience pain, and methods to reduce pain safely. The methods include behavioral tools, psychological tools, nutrition supplementation, and prescription drugs. The video also touches on controversial topics such as opioids and their use to control pain. The sponsors of the podcast are Aeropress and Levels.

This video by Andrew Huberman was published on Jan 15, 2024.
Video length: 02:56:42.

 

The video is about Dr. Sean Mackey, a medical doctor and professor of anesthesiology and neurology at Stanford University School of Medicine, discussing pain and its origins.

Dr. Mackey explains that pain is a complex phenomenon that arises from interactions between the brain and the body, and can be influenced by both physical and emotional factors. He also discusses different methods to reduce pain, including behavioral and psychological tools, nutrition supplementation, and prescription drugs. The video covers topics such as the relationship between temperature and pain, the opioid crisis, and the use of opioid drugs to control pain.

The video is sponsored by Aeropress and Levels, and Betterhelp.

 

  • Dr. Sean Mackey is a medical doctor and professor of anesthesiology and neurology at Stanford University School of Medicine.
  • He treats patients and runs a laboratory, and is the chief of the division of pain medicine.
  • The podcast discusses the origins of pain, the critical link between physical and emotional pain, changes in the nervous system that occur when we experience pain, and methods to reduce pain safely.
  • The methods include behavioral tools, psychological tools, nutrition supplementation, and prescription drugs.
  • The podcast also touches on controversial topics such as opioids and their use to control pain.
  • Pain can have both nervous system and non-nervous system origins.
  • The nervous system can contribute to pain through the release of neurotransmitters such as substance P and glutamate.
  • Non-nervous system factors such as inflammation and tissue damage can also contribute to pain.
  • Pain can be acute or chronic, with chronic pain often being more difficult to treat.
  • Understanding the origins of pain is important for developing effective pain management strategies.
  • Physical pain and emotional pain are closely linked.
  • Emotional pain can exacerbate physical pain, and vice versa.
  • Changing one's perception of emotional or physical pain can often change the other.
  • Techniques such as cognitive-behavioral therapy and mindfulness meditation can help manage both physical and emotional pain.
  • Pain can cause changes in the nervous system, including increased activity in the brain and spinal cord.
  • These changes can lead to the release of neurotransmitters such as substance P and glutamate, which contribute to pain.
  • Chronic pain can lead to changes in the nervous system that persist even after the pain has subsided.
  • Understanding these changes is important for developing effective pain management strategies.
  • Techniques such as transcutaneous electrical nerve stimulation (TENS) and spinal cord stimulation (SCS) can help manage chronic pain by modulating nervous system activity.
  • Behavioral tools such as relaxation techniques and stress management can help reduce pain.
  • Psychological tools such as cognitive-behavioral therapy and mindfulness meditation can also help manage pain.
  • Nutrition supplementation, such as omega-3 fatty acids and curcumin, can help reduce inflammation and pain.
  • Prescription drugs such as opioids and non-opioid pain medications can be effective in managing pain, but must be used carefully and under medical supervision.
  • Heat and cold therapy can also be effective in managing pain, and can be used in combination with other methods.

Dr. Sean Mackey: Tools to Reduce & Manage Pain - YouTube

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Introduction

  • The podcast is about Dr. Sean Mackey, a medical doctor and professor of anesthesiology and neurology at Stanford University School of Medicine.
  • Dr. Mackey treats patients and runs a laboratory, and is the chief of the division of pain medicine.
  • The podcast discusses the origins of pain, the critical link between physical and emotional pain, changes in the nervous system that occur when we experience pain, and methods to reduce pain safely.
  • The methods include behavioral tools, psychological tools, nutrition supplementation, and prescription drugs.
  • The podcast also touches on controversial topics such as opioids and their use to control pain.
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Origins of Pain

  • Pain can have both nervous system and non-nervous system origins.
  • The nervous system can contribute to pain through the release of neurotransmitters such as substance P and glutamate.
  • Non-nervous system factors such as inflammation and tissue damage can also contribute to pain.
  • Pain can be acute or chronic, with chronic pain often being more difficult to treat.
  • Understanding the origins of pain is important for developing effective pain management strategies.
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Critical Link between Physical and Emotional Pain

  • Physical pain and emotional pain are closely linked.
  • Emotional pain can exacerbate physical pain, and vice versa.
  • Changing one's perception of emotional or physical pain can often change the other.
  • Understanding the emotional aspects of pain is important for effective pain management.
  • Techniques such as cognitive-behavioral therapy and mindfulness meditation can help manage both physical and emotional pain.
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Dr. Sean Mackey: Tools to Reduce & Manage Pain - YouTube

Changes in the Nervous System when We Experience Pain

  • Pain can cause changes in the nervous system, including increased activity in the brain and spinal cord.
  • These changes can lead to the release of neurotransmitters such as substance P and glutamate, which contribute to pain.
  • Chronic pain can lead to changes in the nervous system that persist even after the pain has subsided.
  • Understanding these changes is important for developing effective pain management strategies.
  • Techniques such as transcutaneous electrical nerve stimulation (TENS) and spinal cord stimulation (SCS) can help manage chronic pain by modulating nervous system activity.
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Methods to Reduce Pain Safely

  • Behavioral tools such as relaxation techniques and stress management can help reduce pain.
  • Psychological tools such as cognitive-behavioral therapy and mindfulness meditation can also help manage pain.
  • Nutrition supplementation, such as omega-3 fatty acids and curcumin, can help reduce inflammation and pain.
  • Prescription drugs such as opioids and non-opioid pain medications can be effective in managing pain, but must be used carefully and under medical supervision.
  • Heat and cold therapy can also be effective in managing pain, and can be used in combination with other methods.
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Section 1: Introduction

  • The video is about Dr. Sean Mackey, a medical doctor and professor of anesthesiology and neurology at Stanford University School of Medicine, discussing pain and its origins.
  • The video touches on controversial topics such as opioids and their use to control pain.
  • The sponsors of the podcast are Aeropress and Levels.
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Section 2: Pain and Its Origins

  • Pain is a complex and subjective experience that serves a crucial role for all of us to keep us away from injury or harm.
  • It is both a sensory and an emotional experience.
  • Pain is incredibly individual and varies from person to person.
  • Chronic pain, which becomes persistent and affects about 100 million Americans and costs about half a trillion dollars a year in medical expenses, is an astounding problem in society.
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Section 3: Link Between Sensory and Emotional Experience

  • Every once in a while, we experience pain such as a kink in our neck or back.
  • When we experience pain, we become slightly more irritable and everything becomes more challenging.
  • Pain is as if something is nagging from the inside.
  • Pain is clearly in our brain and can be influenced by our emotions.
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Section 4: Pain and the Brain

  • Pain starts with some stimulus, such as a kink in the neck or shoulder from working out or turning the wrong way.
  • There are sensors in our skin, soft tissue, and deep tissues called noors that sense different types of stimuli.
  • Two types of nerve fibers are responsible for transmitting pain signals: Delta and C fibers.
  • Delta fibers transmit very fast and are responsible for sharp jolt of pain, while C fibers are slower and responsible for dull achy pain.
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The Electrical Signals of Pain

  • Pain is not just a sensation, but an experience created by the brain.
  • Electrical signals and impulses are transmitted from the body to the brain.
  • These signals are converted into the subjective experience of pain.
  • The brain serves many functions, including emotions, cognitions, and memory.
  • The signals coming in from the body are shaped by the brain to create the unique experience of pain.
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The Direct Linkage between Body and Action

  • The idea of a direct linkage between the body and action is incorrect.
  • The biomedical model still perpetuates this idea of a one-to-one relationship.
  • Humans tend to project their own experiences of pain onto others.
  • Chronic pain is often viewed as an invisible disease.
  • People with chronic pain may not have something outwardly visible that they're experiencing.
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The Invisible Disease of Chronic Pain

  • Chronic pain is often viewed as an invisible disease.
  • People with chronic pain may not have something outwardly visible that they're experiencing.
  • Conditions like fibromyalgia may not be visible but cause chronic pain.
  • People with chronic pain may not have a legitimate pain, but it is real.
  • People with chronic pain may not have a visible injury or condition, but they are in pain.
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The Pain Pathway in the Brain

  • There is no dedicated set of areas in the brain that represent pain.
  • People experiencing the same thing differently according to a mysterious mechanism in the brain.
  • There is no pain center in the brain that can be knocked out.
  • Pain is a conserved phenomenon and is not a simple phenomenon.
  • Knocking out one pathway going to the brain will still result in pain.
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The Pain Matrix

  • The pain Matrix was a concept that represented areas of the brain that subserved different functions.
  • The concept of the pain Matrix has evolved over time as new regions of the brain have been identified to contribute to the experience of pain.
  • There is a conserved set of distributed regions that do represent the experience of pain.
  • Technically, nonsteroidal anti-inflammatory drugs (NSAIDs) are not analgesics, they are anti-inflammatory drugs.
  • Anti-hyperalgesic drugs reduce some of the sensitization in the periphery and in the spinal cord and brain.
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NSAIDs and Anti-Hyperalgesic Drugs

  • NSAIDs like ibuprofen and naproxen are anti-inflammatory drugs that do not act as analgesics.
  • Anti-hyperalgesic drugs like NSAIDs reduce some of the sensitization in the periphery and in the spinal cord and brain.
  • In a normal situation, taking an NSAID like ibuprofen does not reduce pain.
  • The increase in pain in a general area is an adaptive response that raises the question of the threshold for treating pain.
  • The inflammation is part of the healing process, and pain is subjective and different between individuals.
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Threshold for Pain Treatment

  • The threshold for pain treatment is when it is impacting the individual's quality of life and ability to perform daily activities.
  • The decision to take medication for pain should be based on the individual's quality of life and ability to perform daily activities.
  • There is a lot of controversy in the space regarding the use of medication for pain.
  • NSAIDs like ibuprofen, acetaminophen, naproxen, and nefenopam are commonly used for pain relief.
  • Toral or ketorolac is another anti-hyperalgesic drug used for pain relief.
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Over-the-Counter Pain Relievers

  • Two over-the-counter pain relievers are ibuprofen and napasin.
  • Tylenol has a slightly different mechanism of injury but is still considered a general class of pain relievers.
  • Aspirin is not considered an insulin-like substance.
  • Aspirin reduces inflammation and is anti-hyperalgesic.
  • It is important to not rely on potent opioids for pain relief.
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Professional Sports and Healing

  • Professional teams and athletes often use peptides to accelerate healing.
  • Corticosteroid injections and painkiller injections are commonly used in professional sports.
  • These injections are not without risks and should be used with caution.
  • For everyday people, it is important to seek medical attention for acute injuries.
  • It is important to understand the mechanism of action of pain relievers to use them safely and effectively.
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Inflammation and Cortisol

  • Inflammation is a natural response to injury and serves an important biological role.
  • Cortisol is a hormone that helps restore normal functioning after an injury.
  • It is important to balance the use of pain relievers with the need for normal healing.
  • Taking too much pain relief medication can delay the healing process.
  • Establishing a baseline for normal functioning can help determine the appropriate amount of pain relief medication to take.
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Determining Normal Functioning

  • As a physician, determining normal functioning is complex and nuanced.
  • NSAIDs, IBuprofen, and napins are commonly used pain relievers.
  • Research has shown that blocking inflammation can delay the healing process.
  • It is important to balance the use of pain relievers with the need for normal healing.
  • As a patient, it is important to work with a healthcare provider to determine the appropriate amount of pain relief medication to take.
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Sleep and Healing

  • Sleep is important for healing and recovery.
  • Taking an insomnia medication can help with sleep and engagement with what needs to be done.
  • The lowest dose of the medication should be taken to avoid adverse effects.
  • NAD (Nicotinamide adenine dinucleotide) should be taken no more than once every six hours.
  • There is individual variability around the effectiveness of insomnia medications like ibuprofen and napasin.
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Pain Management

  • Reducing pain through medication can have negative consequences.
  • There is a need for more data on the healing message and its impact on pain management.
  • Some orthopedic surgeons prefer people not to be on insomnia medications after surgery.
  • Individual variability around the effectiveness of insomnia medications like ibuprofen and napasin.
  • Aspirin can benefit heart health and can be used to manage pain in some instances.
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Individual Person and Gut Health

  • Baby aspirin can act as an antiplatelet agent and help with heart health.
  • Different mechanisms of action at different doses of aspirin.
  • Gut health is critical for proper brain functioning.
  • Taking a vitamin mineral probiotic drink like ag1 can ensure adequate intake of vitamins and minerals and support gut health.
  • Ag1 contains adaptogens, probiotics, prebiotics, and critical micronutrients that are hard to get from Whole Foods or in sufficient quantities.
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Over-the-Counter Treatments for Pain

  • Caffeine can be used effectively for headaches, migraines, and can help potentiate the analgesic response of some people.
  • Tylenol (acetaminophen) is safe on the stomach, but it's important not to exceed 4,000 milligrams or four grams per day in divided doses.
  • NSAIDs (nonsteroidal anti-inflammatory drugs) like naproxen and ibuprofen can be effective for pain, but they can be irritating on the stomach.
  • There are versions of NSAIDs that are Cox 2 inhibitors, which are very selective and less irritating on the stomach.
  • It's important to talk with a clinician if you have problems with NSAIDs and their GI issues.
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Mechanical Interventions for Pain

  • Manual stimulation or rubbing around the area of pain can contribute to the activation of a neural pathway that reduces pain through legitimate neural inhibition.
  • Massage above or below the sight of pain can also be effective in reducing pain.
  • Acupuncture can also be used as a mechanical intervention for pain.
  • Heat and cold can also be used to reduce pain.
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Section 1: Pain and its Origins

  • Pain is a complex experience that can have both physical and emotional components.
  • Studies have shown that swearing can reduce pain better than non-explicit methods.
  • Rubbing or shaking the affected area can also reduce pain by activating touch fibers.
  • The real mechanism of action for pain relief is taking place in the spinal cord, not just the periphery.
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Section 2: Neuromodulation and Pain Relief

  • Neuromodulation is a technique used to change the signals in the spinal cord, reducing noxious signals coming in.
  • Activating touch fibers through rubbing or shaking can also be a form of neuromodulation.
  • Kissing an injured area can also provide pain relief by activating touch fibers and reducing pain through positive emotional salience.
  • The TENS device is a device that takes advantage of the body's nervous system to provide pain relief through transcutaneous electrical neurostimulation.
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Section 3: Pain Thresholds and Context

  • Pain thresholds can vary depending on the context and the individual's emotional state.
  • Adrenaline and epinephrine can increase an individual's pain threshold.
  • People have different pain thresholds and pain responses, which can affect how they experience pain.
  • Defining pain threshold can be difficult and depends on how it is measured.
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Section 4: Controversial Topics in Pain Management

  • Opioids are a controversial topic in pain management due to their addictive nature and potential for misuse.
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Pain Threshold

  • Pain threshold is the stimulus intensity that results in the onset of the experience of pain.
  • The first onset of pain is when the stimulus becomes the perception of pain.
  • Fast fibers (A-delta fibers) are responsible for the fast perception of pain.
  • Slow fibers (C-fibers) are responsible for the slow perception of pain and are more emotionally charged.
  • C-fibers converge on more emotional regions in the brain that are conveying an unpleasantness to the experience.
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Pain Thresholds in Men and Women

  • On average, men have higher pain thresholds to things like heat stimulus than women.
  • The difference in pain thresholds between men and women is small and highly variable.
  • Individual variability within men and women is much greater than the difference between men and women.
  • There are plenty of women on the pain threshold curve that have much greater heat thresholds than men.
  • The difference in pain thresholds between men and women is even closer and tighter than the difference in height between men and women.
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Pain Threshold and Adaptive Role of Pain

  • A lower pain threshold can serve a more adaptive function, such as fewer injuries.
  • The tough part is a subjective label and it gets into the implications of what we mean by "tougher."
  • People are not averages, and individual variability within men and women is much greater than the difference between men and women.
  • Individual variability within men and women is much greater than the difference between men and women.
  • The distribution of the curves highly overlaps, meaning the individual variability within men and women is much greater than the difference between men and women.
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Pain Threshold and Emotional Regions in the Brain

  • C-fibers converge on more emotional regions in the brain that are conveying an unpleasantness to the experience.
  • The emotional regions in the brain are more sensitive to pain.
  • The emotional regions in the brain are more sensitive to pain.
  • The emotional regions in the brain are more sensitive to pain.
  • The emotional regions in the brain are more sensitive to pain.
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The Role of the Brain in Pain

  • The brain plays a critical role in processing pain signals.
  • The brain is shaped by beliefs, expectations, anxiety, and early life experiences.
  • Increased anxiety can increase perceived pain.
  • Pediatric pain research is limited, but experiments have shown that parental cues can affect a child's perception of pain.
  • It is important to find a balance between making light of pain and ignoring a loved one's painful issue.
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Anecdote about Parental Response to Pain

  • The speaker observed that children and friends who cried in pain or complained of pain were often told to "suck it up" or "come on, just be okay."
  • One friend's father slapped his crying brother across the face and told him not to do it again, compounding the lesson about the saw.
  • This response is now considered abusive parenting by today's standards.
  • The speaker's mother responded similarly to children hurting themselves, especially boys.
  • The speaker finds this interesting because it highlights the importance of interpreting our own pain and understanding how we react to children in pain.
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Conditioned Pain Modulation

  • Conditioned pain modulation is a neuroscience concept that pain inhibits pain.
  • When a person experiences pain, their brain releases signals that inhibit pain in other areas of the body.
  • This phenomenon is known as "pain inhibits pain."
  • Conditioned pain modulation is an example of how the brain can regulate pain.
  • The speaker suggests that this concept can be applied to understanding how we interpret our own pain and how we respond to children in pain.
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The Phenomenon of Pain Inhibition

  • The phenomenon of pain inhibition is described by Lars in the late 70s in rodent models.
  • When a noxious stimulus is engaged at a site distal from the primary pain, it engages a brain stem circuit that has descending pathways to the spinal cord.
  • This phenomenon is called diffuse noxious inhibitory control or denck, and it works by inhibiting pain.
  • Higher brain centers also contribute to this phenomenon.
  • Conditioned pain modulation (CPM) is a human version of this phenomenon, where the brain learns to inhibit pain in response to a conditioned stimulus.
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Therapeutic Heat and Cold

  • Therapeutic heat and cold are used to treat injuries such as bruises, breaks, and sprains.
  • Cold is heavily debated in the world of sport physio, with some people claiming it creates a sludging of fluids trying to head in and out of the injury.
  • Heat allows for the inclusion and removal of waste products, which can help ameliorate pain.
  • When applied correctly, cold can reduce inflammation and slow the number of signals coming up, ultimately reducing pain.
  • Heat increases blood flow, which can also help ameliorate pain.
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Contemporary Controversies

  • There are contemporary controversies over the mechanisms of pain inhibition, which need to be sorted out.
  • The use of heat and cold for therapeutic purposes is still a topic of debate in the medical community.
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Conclusion

  • Pain inhibition is a real phenomenon that has been observed in both rodent models and humans.
  • Therapeutic heat and cold can be effective in treating injuries and reducing pain, but their use is still a topic of debate.
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Section 1: Understanding Pain

  • Pain is a complex experience that involves both physical and emotional components.
  • Changes in the nervous system occur when we experience pain, leading to a reduction in pain perception.
  • There is individual variability in how people respond to heat and cold, and it's important to take care when using cold packs.
  • The specifics of cold exposure, such as duration and temperature, can affect pain perception and threshold.
  • Regular exposure to pain, in a safe way, can potentially raise pain threshold through habituation.
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Section 2: Deliberate Cold Exposure

  • Deliberate cold exposure, such as cold showers or ice baths, can be painful but can also numb the area.
  • It's possible to raise pain threshold through regular exposure to cold, but it's important to do it safely.
  • Cross-modality changes in pain thresholds, such as changes in heat thresholds or pressure, are possible with cold exposure.
  • Cognitive control and training are important factors in changing pain thresholds.
  • Experiments have shown that cognitive manipulations, such as the presence of an attractive person, can affect pain thresholds.
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Section 3: Movement and Exercise

  • Movement and exercise can change pain thresholds over time.
  • Increased inhibitory tone through exercise can lead to a reduction in pain perception.
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Section 4: Nutrition and Personalized Platforms

  • A personalized nutrition platform, such as Insid Tracker, can analyze data from blood samples to provide personalized recommendations for nutrition.
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Section 1: Understanding Pain

  • Pain is a complex experience that can be physical or emotional.
  • The nervous system undergoes changes when we experience pain.
  • Pain can have a significant impact on our immediate and long-term health.
  • Many blood tests only provide information about metabolic factors, lipids, and hormones but do not provide specific directives for managing pain.
  • Insid Tracker is a personalized platform that allows users to see the levels of all metabolic factors, lipids, hormones, etc., and provides specific directives for managing pain.
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Section 2: Mindfulness and Pain Management

  • Mindfulness is the idea of whether or not under conditions of stress or pain, the most adaptive mindset is to think about something else and distract oneself from the pain or to go into the pain and realize it is not as bad.
  • Attentional distraction is a technique that works by distracting oneself from the thing that is causing pain.
  • Attentional distraction engages specific brain networks, including the prefrontal cortex and the singulate cortex.
  • Distraction can reduce pain significantly, but it may not completely eliminate it.
  • Sleep is a big issue for people with chronic pain, and attentional distraction works well during the daytime but may not be effective at night when people are trying to get into a relaxed state and fall asleep.
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Section 3: Meeting the Pain

  • Meeting the pain involves addressing it from a non-judgmental, accepting manner.
  • John Kabat-Zinn originally developed mindfulness-based stress reduction, which has been shown to work well for people with low back pain.
  • Recent studies have shown that mindfulness-based stress reduction also works for managing pain.
  • Meeting the pain involves noting its presence without judging it or putting a value on it.
  • Meeting the pain can help people develop a more adaptive mindset and manage pain more effectively.
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Section 4: Nutrition Supplementation and Prescription Drugs

  • Nutrition supplementation and prescription drugs can be effective tools for managing pain.
  • Behavioral tools and psychological modifications can also be helpful in managing pain.
  • It is important to work with a healthcare professional to determine the best approach for managing pain.
  • Opioids are a controversial topic in pain management, and their use should be carefully considered and monitored.
  • It is important to consider all available options and work with a healthcare professional to develop a personalized pain management plan.
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Introduction

  • The video is about Dr. Sean Mackey, a medical doctor and professor of anesthesiology and neurology at Stanford University School of Medicine, discussing pain and its origins, the critical link between physical and emotional pain, changes in the nervous system that occur when we experience pain, and methods to reduce pain safely.
  • Dr. Mackey discusses mindfulness-based stress reduction (MBSR) as an effective tool for managing pain, anxiety, depression, and other conditions.
  • He emphasizes the importance of understanding the difference between being hurt and being injured, and recognizing when pain is reporting an injury versus when it is just reporting a temporary sensation.
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Mindfulness-Based Stress Reduction (MBSR)

  • MBSR is a non-judgmental acceptance of pain, which has been shown effective for anxiety, depression, and pain.
  • It is a great skill to learn with no side effects and takes a little bit of time to learn.
  • Some people find it effective and helpful for pain management.
  • It is important to understand that some of these things work for some people and some of the time.
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Cognitive Behavioral Therapy (CBT)

  • CBT is a direct cognitive reframing about the meaning of pain.
  • It is a foundation for something called cognitive behavioral therapy.
  • Different neural circuits are engaged with different approaches.
  • Research is going to figure out which approach works for which person under which circumstance.
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Understanding the Difference Between Being Hurt and Being Injured

  • Knowing the difference between being hurt and being injured is important.
  • It is a key moment for people to recognize when pain is reporting an injury versus when it is just reporting a temporary sensation.
  • It is important to understand the distinction between hurt versus harm versus harm.
  • Emotional pain is also important to consider.
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Conclusion

  • Dr. Mackey's tips for pain management include understanding the distinction between hurt versus harm versus harm.
  • Emotional pain is also important to consider.
  • Recognizing when pain is reporting an injury versus when it is just reporting a temporary sensation is important.
  • MBSR is a non-judgmental acceptance of pain that has been shown effective for anxiety, depression, and pain.
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Section 1: Understanding Pain

  • Pain is a complex and multifaceted experience that can be difficult to define and measure.
  • Chronic pain conditions often require more than a 45-minute or 60-minute education session to address.
  • The distinction between hurt and harm is critical for people to understand, as it helps them determine whether their pain is a medical issue that needs attention.
  • The complexity of pain comes from the fact that it can be both physical and psychological in nature.
  • Emotional pain is often related to physical pain, and it is important to validate the fact that emotional pain is a valid form of pain.
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Section 2: Addressing Fear and Anxiety

  • Fear and anxiety can exacerbate pain and make it more difficult to manage.
  • It is important to address fear and anxiety in people with chronic pain conditions.
  • Educating people about the distinction between hurt and harm can help alleviate fear and anxiety related to pain.
  • Addressing fear and anxiety can improve a person's quality of life and ability to manage their pain.
  • It is important to approach the management of pain in a holistic and comprehensive way, taking into account both physical and psychological factors.
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Section 3: The Psychology of Pain

  • Psychiatry has established thresholds for normal and abnormal functioning, but these thresholds may not be applicable to pain.
  • It is important to take into account the level of emotional pain when treating patients with chronic pain conditions.
  • Gauging someone's psychological pain can be done through their vocalization of their pain, as well as their overall management of their life, including sleep, nutrition, and relationships.
  • It is important to approach the management of pain from a psychological perspective, as emotional pain can be a significant factor in a person's overall pain experience.
  • It is important to recognize that pain is a complex and multifaceted experience, and that a comprehensive approach to pain management is necessary to address both physical and psychological factors.
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Section 4: Tools to Reduce and Manage Pain

  • Behavioral tools, such as cognitive-behavioral therapy, can be effective in managing pain.
  • Psychological tools, such as mindfulness and relaxation techniques, can also be helpful in managing pain.
  • Nutrition supplementation, such as omega-3 fatty acids and vitamin D, may have anti-inflammatory effects and help manage pain.
  • Prescription drugs, such as opioids and nonsteroidal anti-inflammatory drugs (NSAIDs), can be effective in managing pain, but they should be used with caution and under the guidance of a healthcare professional.
  • It is important to approach the management of pain with a holistic and comprehensive perspective, taking into account both physical and psychological factors.
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Section 1: Pain as a Sensory and Emotional Experience

  • Pain is a sensory and emotional experience.
  • It is important to treat the whole person when caring for someone in pain.
  • Pain can be amplified by factors such as anxiety and depression.
  • Anger can be a significant factor in pain amplification and treatment response.
  • Anger can be expressed in different ways, such as anger in versus anger out.
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Section 2: Understanding Anger and Its Effects on Pain

  • Anger can be directed at someone external or contained inside.
  • Anger can be expressed outwardly or contained inside.
  • Anger can be worse than other emotions such as sadness or fear.
  • Anger can be a predictor of poor treatment response in pain management.
  • Anger can be broken down into different categories, such as anger in versus anger out.
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Section 3: Treating the Whole Person in Pain Management

  • It is important to treat the whole person when caring for someone in pain.
  • Treating the whole person involves looking at physical, psychological, and social functioning.
  • Education, pain psychology, physical therapy, and rehabilitative approaches can be used to treat pain.
  • There are over 200 medications available for pain, but only a few are FDA approved specifically for pain.
  • Medications for pain are often borrowed or stolen from other fields, such as psychiatry and neurology.
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Section 4: Addressing Pain Amplification Factors

  • Anxiety and depression can amplify pain and worsen treatment response.
  • Anger can be a significant predictor factor in pain amplification and treatment response.
  • It is important to address the root causes of pain amplification factors.
  • Treating the whole person can help address pain amplification factors.
  • It is important to use evidence-based treatments for pain management.
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Section 1: Understanding Pain

  • Pain is a complex phenomenon that involves both physical and emotional components.
  • It is better to treat pain holistically, addressing all the components at once, rather than focusing solely on psychological or physical aspects.
  • Dr. Sean Mackey, a medical doctor and professor of anesthesiology and neurology at Stanford University School of Medicine, discusses the critical link between physical and emotional pain.
  • Changes in the nervous system occur when we experience pain, which can be influenced by factors such as stress and sleep.
  • There are various methods to reduce pain safely, including behavioral tools, psychological tools, nutrition supplementation, and prescription drugs.
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Section 2: Nutrition and Pain

  • Nutrition plays a critical role in local or whole body pain.
  • Healthy eating, anti-inflammatory diets, and avoiding trigger foods can help manage pain.
  • Identifying triggers and using a journal can help people build foods back into their diet and improve their quality of life.
  • The quality of nutrition matters, but defining what quality nutrition is can be difficult and individualized.
  • Physicians may not always be equipped to help people identify and address their specific pain triggers.
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Section 3: Personal Story

  • Dr. Mackey shares his personal story of developing chronic abdominal pain after a food poisoning incident.
  • He found that identifying and avoiding trigger foods, such as onions and their family, helped manage his pain and improve his quality of life.
  • His experience highlights the importance of identifying and addressing pain triggers for individuals seeking relief.
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Section 4: Conclusion

  • Treating pain holistically and addressing all components, including nutrition, can lead to better results.
  • Identifying triggers and using a journal can help people manage their pain and improve their quality of life.
  • Physicians may not always be equipped to help people identify and address their specific pain triggers.
  • Dr. Mackey's personal story highlights the importance of identifying and addressing pain triggers for individuals seeking relief.
  • The role of nutrition in local or whole body pain is critical and continues to be an area of research and discovery.
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Section 1: Elimination Diets

  • Elimination diets are a method to reduce pain by restricting the number of foods people eat to a limited number of basic things.
  • This method can help build things in and explore what triggers the pain or what removes the pain.
  • There is no other way to eliminate pain other than through this method.
  • Onions may trigger a particular neurochemical or immune pathway, but there is no knowledge of why onions would create that kind of gut pain.
  • The Onion example is a case in particular, but it is not meant to be extrapolated too broadly.
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