Dr. Sean Mackey: Tools to Reduce & Manage Pain
ฝัง
- เผยแพร่เมื่อ 7 มิ.ย. 2024
- 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.
Thank you to our sponsors
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Dr. Sean Mackey
Stanford academic profile: stanford.io/48TgiBz
Website: drseanmackey.com
Publications: stanford.io/3U1OiHY
Lab website: stan.md/3vKrrWY
Stanford Division of Pain Medicine: stan.md/47zT9Dh
X: / drseanmackey
LinkedIn: / seancmackey
Journal Articles
Swearing as a response to pain: bit.ly/3O32Tir
Pain Mechanisms: A New Theory: bit.ly/3SiUGcq
Sex differences in pain: a brief review of clinical and experimental findings: bit.ly/3ShAebP
Diffuse noxious inhibitory controls (DNIC). I. Effects on dorsal horn convergent neurones in the rat: bit.ly/3ShFZGr
Viewing Pictures of a Romantic Partner Reduces Experimental Pain: bit.ly/3SiyNdi
Managing twin crises in chronic pain and prescription opioids: bit.ly/4aXuPht
The clinical use of mindfulness meditation for the self-regulation of chronic pain: bit.ly/3vC4ky0
Local immune response to food antigens drives meal-induced abdominal pain: go.nature.com/3TVMmAH
Effect of Electroacupuncture vs Sham Treatment on Change in Pain Severity Among Adults With Chronic Low Back Pain: bit.ly/4aQnxfz
Mindfulness-Based Stress Reduction, Cognitive Behavioral Therapy, and Acupuncture in Chronic Low Back Pain: bit.ly/3vuVBgS
Adverse Life Experiences and Brain Function: bit.ly/48WumKP
Oral Treatment With α-Lipoic Acid Improves Symptomatic Diabetic Polyneuropathy: The SYDNEY 2 trial: bit.ly/3TVMtw7
United States National Pain Strategy for Population Research: bit.ly/3U2Nrqi
Other Resources
TENS device: cle.clinic/48vzo0X
Acetyl-L-Carnitine in ALS Clinical Trial: bit.ly/47DqIUO
Empowered Relief: empoweredrelief.stanford.edu
National Pain Strategy: bit.ly/47z2Vp9
PainUSA: www.painusa.org
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, TH-cam Feedback, Sponsors, Momentous, Social Media, Neural Network Newsletter
#HubermanLab #Pain
Disclaimer: www.hubermanlab.com/disclaimer - วิทยาศาสตร์และเทคโนโลยี
I am so grateful that a humble scientist with a sincere desire to help humanity brings all these qualified professionals to his podcasts.
He needs a superhero outfit. He's gott the look and backstop and could use cold water and make people sleep.
Backstory. He has a lab.
As a Psychiatric Nurse Practitioner and Licensed Massage Therapist, I am quite naturally inclined to ask questions regarding the entire patient and not only what the patient is expressing as their primary complaint.
How I wish you could dedicate another 3 hours to this topic as it has overlap with suicide, addiction, depression, homelessness, and many others.
Another interesting topic is how we normally undermedicate acute pain which thereby leads to chronic pain.
Great topic. Eloquently broken down in layman’s terms. I am forever a fan Dr. Huberman.
In nursing school, they taught us that pain is a signal usually to something happening in the body. It's our body's way of communicating with us. The question is, are we listening. It's better to listen to your body when it whispers before it has to scream.
You needed to go to nursing school to learn that?
@@GOD999MODE chuckles no of course not. Nursing school is alot more intensive than that about various things
Im sure she didnt go to nursing school just to learn that lol @GOD999MODE
Yeah obviously
@@snarlynx1 yep
As a chronic pain patient battling with multiple syndromes, diseases and conditions, this had to be one of the most informative, compassionate podcasts I have ever watched. Although a few offered opinions/statements I don’t agree with, overall I feel you both have shown grace, wisdom and empathy. Thank you both so very much!
If you enjoyed this you should check out Dr. Rachel Zoffness! I recommend the Dolorogy episode of ologies with Allie Ward.
I appreciate this education as I lay awake struggling with chronic pain unable to sleep. I was told I was a liieing whining woman with psychosomatic pain for decades. Dx at 48 with congenital kidney disease. I was right all along. This should have been fixed long ago if only I was believed.
Hi dr andrew. I am from Ethiopia Africa. Here we follow your tools and protocols and it is changing our lifestyle for good. We would like to thank you. Keep it up 👍 we want more of your work.
Dr. Sean Mackey was such a pleasure to listen to. He brought the science, but he also brought a humble kindness and willingness to share his personal experience. I really enjoyed every minute of this episode.
In full disclosure, I wasn't very interested in this topic, so I almost skipped this discussion, but I played it in the background just for kicks and some noise, and I'm so glad I did; I learned things I didn't even know I wanted to know about. Dr Mackey so effectively communicated the information you asked him about, respectfully navigating the controversial or less 'conventional' interventions, and even in your '10-questions-in-1' ambush I MEAN format haha. I appreciated how you both intuitively knew when to pause to break something down for clarity or to back it up to recap the information presented. His long standing dedication to to improving the understanding and managing pain for all is heartening too. Good stuff.
As others have said, a series on pain and or a specific episode decoding fibromyalgia! This was incredibly insightful as a chronic pain patient at 24 years old and being told over and over again after mri's and x-rays that nothing is wrong, now I know we were never looking at the right place (my brain).
Look into Alan Gordon, his work on chronic pain has helped me 👍🏻
I found several talks by Sean Mackey discuss fibromyalgia and I started taking what he suggested which was 1000mg BID of acetyl l carnitine (Jarrow brand) and it was IMMENSELY helpful for all my fibro chronic pain! Good luck!
You’re on the right path. Keep researching and learning more and more from people like Huberman and applying the advices and protocols to your condition.
You won’t have to keep hearing the same old doubt and gaslighting from doctors for much longer.
The more you can learn and apply from all the resources out there, the better. You got this
There was a study where blood from fibro patients was injected into mice and they developed fibro symptoms. There's more research being made and progress
You have neuroplastic pain. Look at Alan Jorden work the way out of pain
Pain management is a crucial topic. So many people are suffering physical, emotional and psychological pains of various intensities and durations, for whom the medical system fails in helping to cure or treat.
Agree
Yessss. Podcast The cure for chronic pain w Nicole Sachs is amazing
Hey Andrew, i am 36 year old (and formerly very active - much like the tennis player example mentioned here) living with degenerative disc disease, spinal stenosis and facet joint damage. Your channel has been great so far, as i have tried and failed with mindfulness approaches due to the ambiguity of their instructions. I greatly appreciate the scientific approach and information here, and would love a series on pain. Thank you for helping people
In my medical practice I see many patients that develop food sensitivity after acute gastroenteritis. Typically this is because the infection or food poisoning triggers small intestinal bacterial overgrowth or SIBO. When I do testing and treatment of SIBO, that often resolves the food sensitivities that are caused by the overgrowth in the microbiome.
Fascinating and thorough discussion on pain! Thank you! You almost discussed labor ... Haha. This is one of the experiences of my life that I find most important when it comes to learning about physical pain. My mother delivered my younger brother at home when I was 3 years old. I watched her endure it with strength, dignity and calm, but also perceived she was experiencing great pain. I also witnessed the euphoria of holding her new baby for the first time. After that, my older sister (2 years older) and I frequently reenacted childbirth whenever we played "house." It always concluded with repeating my mom's exclamations of joy: "My baby! My precious baby! Oh, my baby!"
I later grew up and delivered 6 babies of my own without any pain medication because that was what I had witnessed as a young child. I grew up believing epidurals were not needed. When I experienced labor pains for the first time, I was shocked! It was deep, burning, relentless pain. As my husband drove me to the hospital, I decided that this was too much for me and I needed an epidural, but by the time we arrived, it was nearly time to deliver! So, I had to rely on my own inner dialog to help me stay calm and not panic. With my eyes closed, I chanted in my head: Breathe slowly, you can do this, breathe breathe breathe. I stayed in control, despite some rising panic towards the moment of delivery. But, I did it! My son arrived safely.
A friend asked me the next day if I thought I'd do it again without pain meds and I admitted, I wasn't sure. But, when it came time to deliver my other babies, I referred to my mother and to my previous experiences: an epidural in a safe delivery was not really necessary. So, I forged ahead and relied on my inner dialog and calming breathing.
All 6 of my births were quite different experiences. The first one was very quick, as I already related. The second one was also quick, but I paced the room like a angry, caged tiger and didn't want anyone touching me until it was time to climb into the bed and deliver my 2nd son. My 3rd son came when the hospital was too busy to give me a room. I felt panicked that I might deliver in the lobby or then in the triage holding cubicle, so labor stopped. When I finally had a room, it took a while for it to resume, and then I needed lots of touch, long slow strokes down my arms and my head, as a calming and reassuring measure. These first 3 babies were delivered by nurse midwives who had nothing but encouragement to trust my body and trust the process. They were amazing and I felt so confident!
My 4th son was delivered by a regular OBGYN because we'd moved to a small city by then and there were no midwives. I was pressured into having an induction because I was overdue. The doctor used scare tactics (the baby is too big, it's dangerous to go overdue, the placenta starts to break down, I know what happens...) and emphatically drew the line on 3 days past my due date (highly ridiculous). I wasn't permitted any of the freedom my midwives had provided during labor, I felt stifled and powerless. He broke my water without my permission when he checked me early in the labor phase, saying it would be about 6 more hours til birth. The pain that followed was absolutely horrible and far worse than anything I'd experienced naturally! But that boy came in 45 minutes. No one assisted me. The nurse had run to get the doctor, my husband was running between my bedside and the doorway. I didn't care who was or wasn't in the room, that baby was coming out NOW. He was born onto the bed.
My 5th child was a girl (different doctor). I opted for induction so that my mother could be with me since she was visiting from overseas. (Previously, I'd gone into labor a few weeks premature while my husband was across the country at his dad's funeral -- but, even after being admitted to the hospital and progressing, labor stopped completely and I was discharged the next morning, though I had come to a moment of resignation that I would bravely deliver without him, like my pioneer mother ancestors, who had delivered in covered wagons and under trees, because at least I was in a clean hospital with a friend!) We had a very peaceful and strong labor, but transition came on like a nightmare, I very nearly couldn't keep myself from panicking even with my internal mantras. Honestly, after she was born, I could barely look at her or hold her for a bit. My feelings were hurt. I asked God if it really had to be THAT hard. I don't think it would've been naturally. Again, the induction medication process makes for a very unnatural experience in the body that is overwhelmingly painful.
My 6th child, and 5th boy, came 10 days early. It was a difficult labor (I was just about to turn 38 -- I'd had babies over a 14 year span) but my inner dialog kept me grounded and mentally pacing. "You can do this, one at a time, one contraction at a time, it's ok it's ok it's ok it's ok, you can do this..."
I marvel at the power of the inner dialog. Not necessarily to reduce pain, but to carry on through it. I learned that relaxing and leaning into the pain let the muscles ease and allow dilation, rather than holding back and tensing up and fearing it. It feels counterintuitive to what the primal brain wants to do, but that's the key. I think it's the key to all pain. Allow it, embrace it as a teacher and a guide, learn from it, relax into it and then it will pass.
thank you so much for your advice, I'm due to march 2 and a little bit scared about pain, I've been doing excerice and now I'll start to meditate and try to take control over my body.
@@xochitlarletterojasgarcia3672 How exciting for you! Congratulations! It is interesting that I am now a mindset coach. Witnessing my mother's experience carried with me into my own births and into my mothering and now into my profession. Visualization and meditation are POWERFUL prep tools! Think back to the 1000s of mothers up your ancestral tree, whose DNA is part of yours, who successfully gave birth and so will you! They were strong and so are you. It's in your DNA!
Childbirth is 100% natural.
It is NOT a medical emergency.
Trust the process.
Believe that your body is designed for this and knows what to do.
Visualize yourself being calm and strong, listening to your body's cues.
The pain is telling you a story.
Relax into it, don't resist it.
Make it a partner. Change positions. Ask for touch/don't touch. See what works.
Create your inner dialog:
It's ok it's ok it's ok
One squeeze at a time, one at a time
The squeeze helps my baby come
You can do this/I can do this
I'm strong I'm strong I'm strong
Breathe breathe breathe
I can't wait for you to hold your beautiful child for the first time! I'd love to hear back from you how it goes!
❤
I sincerely appreciate this comment. You are a wise, strong woman
@@andreastroner3927 Thank you! ☺
I am finding this episode at the perfect time in my life. 7 years ago I got a left inguinal hernia while working. For months nobody could figure out why I would faint from pain at random times and where all this pain was coming from. I never had a bulge or anything and was told I had a paper cut sized hernia but it was the most pain I’d ever felt in my life, constantly, every day. Here I am years later, 2 left inguinal hernia repairs, 1 right inguinal, an umbilical hernia surgery to repair multiple hernias around my belly button. None of them ever bulged, not a single ultrasound or ct scan ever showed that I had a hernia. I am still in daily pain in my left groin/ testicles. I’m convinced I have another tiny hernia & I’ve been severely warned about having another groin surgery because of loss of blood flow and a possibility of losing one of my danglers down there. After seeing every surgeon in my area and being turned away I’m currently going to the Cleveland clinic and have a future appointment to deal with a nerve/ pain specialist and have been told I will likely not walk away without another surgery, probably a surgery to adjust my nerves. I’ve tried multiple rounds of all the nerve medicines they could ever think of. All of which I have some sort of reaction to either mental or physical. After all this time it’s really starting to affect my mental health as well. It’s been a tough, tough road. I wish this on nobody.
How distressing for you… I have a friend who had mesh 15 years ago for his hernia and has been in agony ever since. Finally he found a group of drs and surgeon willing to remove the mesh and repair the damage. Keep going… many of us are finding we have to challenge doctors on their practices and demand they tell us what is going wrong to cause such pain and sickness. Keep going… ask god and universe to help you find a good Dr and help you beat this. You will find a result if you do ask this.
I’m a nurse who works more in psych I’ve had major pain issues severe is arthritis in my left and right shoulder in my spine my spinal cord slightly being pressed by my vertebrae, which caused a partial loss movement in my left leg in numbness experience. A lot of pain and I do know that the doctors are afraid or very cautious of giving pain medication even if there’s over abundance of evidence, a person is suffering. I appreciate the fact you’re addressing this, a lot of people suffer unnecessarily or yuse street drugs or even consider suicide due to the ongoing pain these doctors need to be supported the CDC never said to stop using pain medication set up protocol to assist doctors but it’s easier for the doctor to have these umbrella policies inot to give pain medication or they’re highly reluctant to give pain medication. I saw one pain specialist who told me the first five minutes he doesn’t believe in pain medication, which is both an ethical and unprofessional.
I used to be on high doses for 24 yrs including compounded fentanyl lozenges for breakthru pain. I have Lupus, chronic pancreatitis from Lupus, bile duct strictures and now enlarged common bile and pancreatic ducts, a hernia, neuropathy in both feet and disk problems in my lumbar and sacral spine and a bulging disc in my neck…and Fibromyalgia. Since the CDC cracked down on pain mgmt drs, I’ve been cut down to a Burton’s patch per week and no breakthrough med. the side effects are awful and the pain is worse, I’m now in bed most days or sometimes I make it to the sofa. I don’t get to work, travel or babysit our 2 grandchildren, because of the pain and the chronic fatigue of Lupus and fibromyalgia, but also the anxiety and depression dealing with so many specialists, the worst specialist are pain Mgmt doctors. On Yelp, no one in my area gets over a 2 star review. I talk to others every month when I’m forced to go only the day this patch is due and others share the same horror stories. Massage leaves me bruised and sore for days. Physical therapy didn’t help and at 64 yo now, I’m done and just wish I could be with Jesus. I don’t understand why pain Mgmt doctors go into this line of work. Mine want to push epidurals, because they make more that way and I’ve had them on my back and neck, they didn’t work. In Bakersfield, CA we have a bad dr. reputation for all specialties. luv, we are 2 hrs from Los Angeles and after misdiagnosis on our son for 2 different diseases, he’s been to USC and UCLA. I’ve been there for 2nd opinions and found my gastroenterologist put a stent in the wrong duct. I just wish things were like they were 20 yrs ago where my PCP wrote my pain scripts and I was still able to work and take care of our 3 sons and get them to all their sports practices and games. My quality of life was much better then, thanks to pain meds. Now, I’ve been left high and dry and I know there are millions in my situation. I pray you find the help you need and deserve. God bless you. 🙏🏼❤️
Thanks so much Andrew for being a beautiful part of my love for life 🙏❤️
I originally read that as "a beautiful part of my love life " 😂
@@missjenn3963 haha 😅 well in a way that is true 😉
Thank you so much. Your videos have genuinely changed my life and how I approach it - I can't stress how important your videos have been for me in very personal terms. Simply stated, pragmatic, and non-judgemental. You probably won't see this comment, but thank you!
This discussion is as valuable, perhaps more valuable, than a quarter semester of university classes on the topic. I learned do much. It ties and knits together bits of intel that I've gathered for the last 3 years and elaborates, expands on, and educates on each bit. I can only imagine what an hour of this man's time would cost as an expert, so I' appreciative the generosity of his willingness to share. Equally grateful to receive it on this 'free" platform. I will listen again to be sure. Thank you.
Thank you Dr. Huberman, team, sponsors and supporters ☀ THANK YOU DR. SEAN MACKEY.
My comment is late and this podcast is a few weeks old but I wanted to point out that some forms of massage therapy are incredibly effective for pain and quality of life management.
I have been doing massage for 26 years and teaching it for 17 years and I can speak to this reliably.
I am aware that massage was one of the first medical practices, going back over 5000 years worldwide, for managing pain and was taught and practiced by physicians.
Neuromuscular therapy in particular is incredibly effective.
I do realize that when you were referring to massage as temporary in its benefits, you may have been referring to what people might think of as spa massage or basic relaxation massage.
But the type of massage I do and teach, which in some ways is similar to some aspects of physical therapy, has garnered reliable and long-term benefits for my clients over the years.
As I say, this comment comes too late in the timeline of your podcasts, but I figured I would nevertheless throw in my two cents in support of the effectiveness of well performed, skilled and educated massage therapists.
I can attest to the benefits of right massage. I have had chronic neck pain for 25+ years and have seen innumerable doctors and have tried probably every modality to manage the pain. I kept telling doctors and surgeons that I believe it's my muscles that are protecting my spine but have never been heard. Until recently. I was introduced to a massage therapist who works in a chiropractic office. He has been practicing for 24 years and is well educated with the human body and all its connected parts. It took time to get time with him, most likely because others are benefiting from his "ways". After all these years, I am finally getting some relief, albeit temporary, it's a godsend. I stopped going to the chiro and have the massage therapist come to my home. I'm still seeking solutions, ( wherefore my presence here listening to Huberman and his knowledgeable expertise ) as I know pain can also run deep into the psyche.
Sharing a poem I wrote couple years ago. It's called: HEALING.....Healing comes in many forms. Wounds inflicted leaving torn. Many people in various distress. Living life in a mess. Seeking a cure, that is pure. Soothing when it arrives. Remedies help you be alive. Whole and blemish free, we all want to be but not easily. Promises medicines bring, cost expensive worse than sting. Lots of choices to make, can be overwhelming to take. Restoration back to normal be, able to function fully. Health so valuable it's true. Take good care of the person that's you.
I love that they touched on the edge cases of prescribing benzos for ppl with chronic pain. Among other things have generalised anxiety disorder and panic disorder. With the very bad chronic pain i have i have wide variety of medication which include benzos which absolutely help when im having bad flare ups that can cause anxiety/panic attacks.
Love as an analgesic: what a novel concept! Thank you professor Huberman for the discussion today. Knowledge is power resonates the most after listening to this episode. We all deal with pain, and understanding the physiological aspects definitely empowers one to manage pain and/or eventually heal. Immense gratitude to both of you. What I love about your conversations with other great minds is the little nuggets of wisdom that spontaneously come about. And there are always so many! So grateful to you.
Early 50's male patient was eating a lot of onions. One evening, he took a soup from the fridge and ate it without heating it up. Same night round 4:00 am he woke up with extreme stomach pain, vomiting and diarrhea which triggered a 911 call and ended up in ER. After some painkillers, bloodwork, ultrasound and CT scan, he was released for further follow-up. Pain decreased but whenever he ate something, felt like an iron ball in his stomach. This lasted for a month till his follow-up appointment, which showed up helicobacter pylori positive and immediate treatment with antibiotics fixed the pain.
I appreciated hearing about Dr. Mackey's whole patient approach to care. He sounds like a very good doctor. Which leads me to a small portion of the conversation that I think necessitates further discussion: how does one find a good doctor? How should we define the term "good doctor"? I have some of my own thoughts on this topic, but would love to hear from others.
Thank you Dr. Huberman for your continued faithfulness in making information and research accessible to anyone. I am sure it can be time consuming and maybe even frustrating at times. But I want to encourage you that what you do matters.
took 5 minute break from work this morning to come say thank you Andrew Huberman. you have been a great mentor to me and I appreciate you taking the time to share your thoughts and experience. I feel very grateful
As someone experiencing Long Covid for a year, I wish I had listened to this episode before it all started. However, this made me consolidate what I've learned independently, after multiple doctor visits, and sleepless nights. I hope clinicians are better trained regarding pain, and so are we all to cope better with it. We can retrain our brains and manage this inevitable side of life. Thank you, Dr. Mackey, and our beloved Andrew Hubermann.
Check out podcast episodes on long Covid recovery on The Cure for Chronic Pain.
Yessss. Nicole Sachs podcast The cure for chronic pain has several episodes on "long covid"
I love that food intolerance/gut issues and the body's response are discussed. Through elimination diets over the past 10 years, I have figured out that if I eat any cream, butter fat, or anything high in saturated fat, I get extreme joint pain in main joints exactly 27 hours later and erythema nodosum on my legs. Would love to join a study where saturated fat and inflammatory response is measured.
my spouse also gets pain from saturated fat meals.
By far the best podcast given by Dr. Huberman. I have so much respect for doctors such as Dr. Mackey who help the public understand such an important topic. I learned so much these three hours. Thank you! 🙏
As an ER doctor, I wish I could have chimed in here a few times. I spend all day treating pain in kids and adults. The one thing I know for sure, the farmer/rancher pain scale is drastically different than the city boy pain scale.
Yes but when a teeny tiny Indian girl comes in basically blind from pain after a fall off a horse and being dragged, (while roping sheep mind you. she's ignored as making a fuss... low and behold 10 years later, the migraines have never stopped...
Sorry... just a bit salty... I basically had to be dragged to the hospital by family to then get there and be told I was making a fuss, made to wait 8 hours in excruciating conditions only to be discharged with a basic xray and told to drink water.... I would have been better off finishing off the sheep, getting some ice on my head, and going to bed!
I hope you're an empathetic ER doctor and help people with pain instead of judging them and thinking they're exaggerating their pain. I've heard several ER doctors don't give opioids for severe pain anymore.
I really appreciate this one, thank you Dr Mackey and Huberman Labs. I turned 40 at the end of last year and missed playing competitive sports since I spent the last 10 years raising 3 wonderful children. I signed up for soccer and in the first game, I ruptured my Achilles tendon. I'm a healthy guy, cardio, kettlebell exercises, even cold plunges, however, this injury and it happening right as I try to do something I love was a 2 fold blow. The realization that I would need surgery and a long recovery was bad, but the emotional anchor of 'I cannot do the things I used to be able to do' is now sitting heavy on my mind. Getting old sucks. Midsubstance Speedbridge implant.
This channel makes me better for my patients every single week. Thank you both for your contributions to science!
⭐️⭐️⭐️⭐️⭐️
What an excellent discussion. Thank you for making this information accessible and easy to understand. It covers a wide range on the topic, and very educational. It teaches empathy and understanding. Thank you again for your down to earth delivery.
Thank you for inspiring my interest in science. Reading 'I contain Multitudes' because it was recommended on a recent podcast. Dr Sean Mackey is a fantastic guest as he explains things so clearly. I would be interested in a podcast about skin conditions.
I am very thrilled to hear this further discussion and interest in kratom. I am a 56 year old woman with a genetic mitochondrial disease (LHON-plus). I do not drink alcohol, smoke or eat a lot of junk food, fast food etc and I take good care of myself. I have a small farm. I am active with my grandkids and animals. I could not do all that without kratom. Period. I found it 6 years ago and it changed my life. I was bedridden and on 12 rx drugs. I was able to come off all of them. Kratom helps me in so many ways. Relaxes smooth muscles, gives me energy and cognitive help, reduces pain, regulates my body temp, helps my mood, and more. I could ramble on and on about how it helps me. I did a ton of research myself, digging deep into the alkaloids and their benefits. I am anxious to see you do more research and I’m hoping it will be a bit more positive now than before. I’m at least glad you are open to it. 😀 thank you!
My wife and I have had the same experience, better then any pharmaceutical, I guess that's why they want to control it.
Thank you! So informative, and despite the complexity of the topics, you and your guests make it so clear and understandable for us . I really enjoy your podcasts, and I have learned so much! Thank you for all you do🙏
Such a beautiful discussion with a such a kind and professional man, in a non-dogmatic and compassionate way. Thank you for this gem!
Mahalo for opening these nuanced complex individualized conversations to the zeitgeist, opening the approaches and break down barriers the management and approach to pain and overall healing. The goggles and paradigms are shifting: comprehensive functionality.
Great way to start the morning, thank you for all you do sir
Amazing! Thank you for bringing us the Phenomenal Dr. Sean Mackey.
I live with more than five decades of complex chronic pain and this has been the absolute best summary of pain, approaches and treatments. Also, I value that dogma was mostly absent in this summary and even though I don’t quite agree with everything discussed (remember I have 24/7 clinical experience over 5 decades when I say this) I’m pleased that this kind of information is available to the public .
Several surgeries in the past and waiting to have three now. 4 tears in my shoulder, knee replacement, and surgery on my patella.
Very helpful thank you!
Thank you both. As a person in chronic pain, I learned a few things. Lots of new words for my vocabulary. MBRS sounds like a good technique. I have asked many doctors the question, what is pain? The answer Dr. Mackey gave was the best I have heard recently.
Fantastic episode! I appreciate the discussion about emotional pain; I have had fibromyalgia for ten years and always maintained the primary causes have been traumas (early and mid-life experiences). The evolving knowledge of chronic pain has been truly life-changing. It has empowered me to explore and discover what works best for me, with therapy playing a crucial role in pain reduction.
I’ve read that there can be a lasting impact of prolonged childhood traumas on the brain. Still, I like to remain optimistic that chronic pain won't be a lifelong struggle, especially if love becomes a significant source of relief… something to look forward to. Although I'm not sure I could dedicate 80% of my mental time and energy to another person right now, it seems daunting!
I’d suspect similar for myself 😀 thanks for sharing
I’m in the same situation. I’ve been following Dr. Howard Schubiner work for the last 5 years. He seems so genuine and dedicated to resolving chronic pain. Google his name and you’ll find his work, podcasts he’s done and he sees patients too!
I’d suggest reading dr sarno’s “healing back pain” really insightful info illuminating psychosomatic pain, ie. How internalized trauma/grief/stress can manifest as chronic physical pain.
As a back pain sufferer for over 27 years I’ve read Sarnos book and totally get the concept but could never seem to get it to work for me .
As an engineer I have a deep appreciation for taking complex and challenging subjects and making them easy to understand. Thank you Andrew for always doing that and to both of you for this topic.
My sister has, I believe it is called, chronic pain syndrome for a number of years. Have you or people you research with regarding pain had any experience with that? Any papers or research that could be useful?
Thank you again for all the effort you put into these.
Thank you soooooo much for this Dr. Mackey! As a chronic pain sufferer, I appreciate the very thorough and supportive way you educate about pain - more people need to be educated on what pain actually is!
💯💯💯💯💯💯
I really enjoyed this information. I am going to listen to it again. Dr. Sean did a great job of making such a complex topic understandable.
As a young clinical professional I am totally in love with this podcast.
I am always amazed and inspired to learn and do deeper research after listening.
I fcan't believe all of this information you have spread out over the years is for free. We must be all so grateful and thankful for all what you've been doing and are doing for the broader society. And especially in these times, we need more people like you. So you've been one of my biggest inspiration throughout the last year, guiding me through my recovery. And I cannot say how much I thank you. This podcast has totally come in the perfect time point again. I've been dealing with a lot of chronic pain after my COVID vaccine and lumbar puncture. And now I also feel that I have this variable artery disease. So it's great to hear all of this knowledge for free and how you can try to better yourself and manage your pain threshold. Thank you for what you do. And most important, thank you for your interest in saving and helping humanity.
He makes a lot of sense. The pain mgmt I have to go see has it completely backwards. I have to do the physical therapy FIRST before getting the pre requisite MRI to even get in to see pain mgmt. I can't do any activity without a pain flare.
Dr. Andrew, Thank you for another wonderful and informative episode. This is particularly interesting to me as I’ve been dealing with the onset of some chronic pain for the last year or so. I have been working on lifestyle modifications and natural remedies first before resorting to any prescription drugs. I appreciate that you covered a broad spectrum of pain relief techniques and not just the common pharmaceuticals. Thank you for your “labor of love” in producing these podcasts. They are a treasure trove of great information and your show notes are incredible. Thank you for connecting cutting edge research institutions with the general public. ♥️
Listening on podcast. Not even at half, but from a girl with ankylosis spondilitis, you cant understand how these it is helpful
I’ve used almost all these techniques to reduce pain due to an autoimmune condition. Great work, doc. Please do an episode on AUTOIMMUNE DISEASES.
Re: Pain inhibits pain: I’m an Aesthetician and I have a huge brazilian wax following. People frequently comment that the experience was considerably less painful than waxing experiences done elsewhere. While I have 20 years of experience and several other techniques, the hilarious thing I do that helps the most, is I literally smack the skin gently several times after each pull of the wax. At fist clients are a bit surprised, but they understand almost immediately that the smacking distracts the nerve endings and the sensation of the hair being pulled by the root dies down.😅😂😊
Hi Andrew. Great podcast. It might be interesting to maybe do a series on pain? Or maybe have several guests on the show? People who come to mind are Lorimer Moseley and Howard Schubiner. Would really love to see them on the podcast, as they have valuable insights and contributions regarding pain.
I agree, they would be interesting to have on this podcast!
Yes! They would be excellent guests!
I agree, I'd love some kind of series on pain as well!
Yes these two suggestions are phenomenal! Please consider. I know I’ve been requesting Dr.Howard Schubiner to your podcast since the first IG live you did on pain. I also recommend him often to Arm Chair Experts podcast. It’s so important to have their work, experience and research in the mix of discussion as Luke was said in this interview we are in a public health crisis!
I just sent in same. Also Nicole Sachs podcast The cure for chronic pain. The curable app. Dr schubiner!!! I was a patient of the original Dr John Sarno
What a great guest and topic. I’m newly diagnosed with fibromyalgia, rheumatoid arthritis and neuropathy. I’m currently on LDN and wish you could have asked about low dose naltrexone. I feel like it’s helping me. My dream life has come alive and my sleep has been improving. As a recovering heroin addict (10 years in) I am super interested in how long term opioid use and then the abrupt change in those receptors due to abstinence affects the brain. I think you said you’re doing a podcast on addiction and I look forward to hearing it. You’re definitely helping me in my journey Andrew and I thank you for pieceing out the science in ways I can understand and implement in my day to day life!
I agree. LDN is game changer for many patients, it's unfortunate that it's not more widely discussed and prescribed.
We need a IBS (Irritable Bowel Syndrome) podcast. Dr. Sean Mackey related his personal story about the condition. It affects millions of individuals and Stanford has competent researchers such as Dr. Linda Ánh Vân Nguyễn MD
I found this episode absolutely delightful. It's informative, it's well-spoken, it's deeply scientific, and I loved every second of it. Dr. Mackey is a pleasure to listen to!
Such a good topic. You are a blessing to this world Andrew Huberman.
This was fascinating, informative, and insightful for my context at the moment. It seems there have been so many 'scientific' discoveries in the last decades that back up ancient intuitive/empirical knowledge, and refine some of the earlier research into the PINE system as it relates to pain. And I appreciate that you've lifted up the 'free' program Dr. Mackey & partner are creating: more democratization of knowledge and tools seems like it can only lead to better outcomes for more people, so that is a true public service. Just discovered the podcast and am consistently impressed by the credibility of guests and quality of conversations.
So glad to hear this being talked about on a large platform! I’ve made a lot of progress with reducing my chronic pain through pain reprocessing therapy.
This was a great podcast! I really appreciated his insight to the other side of opioids and recognizing that it wasn’t/isn’t always about monetary gain for doctors. He really brought back in the human element to a difficult topic that tends to be forgotten. Thanks for opening my eyes to a different perspective ❤
This was a very very interesting discussion. Thank you so much Dr's! WOW! Hearing about Dr Mackey and his partner's work - this makes the future hopeful. Incredible that this will be for free for anyone who can access this information. I am not American so this is great!
I really really appreciate this podcast. I’m a retired registered nurse. I did hospice care. I loved how he included methadone in the pain medication list. I love how he differentiated between chiropractic and acupuncture and I was glued to the whole thing. Thank you again Dr. Huberman.
Wonderful episode. I had chronic pain for many years and I have bipolar disorder. One of the key ways I manage my situation is through nutrition that I inadvertently discovered on my own but has since been validated by many examples. Please put more research into understanding the role that nutrition has to play in our health and ability to function in this modern world.
Please consider an episode about Fascia?
I m stoked to be one of the 2% who know that pain inhibits pain. Or, to be precise, acute pain shifts focus from the chronic one. And I first heard about this in House MD (he hits himself to diminish the intensity of his chronic leg pain), which is, in my book, one of the best doctor series of all time.
As someone who has been struggling with chronic pain for my 30 years of living, this was very helpful
Im so sorry
I am going to share an experience of having toothache and was given highest legal dose opium
Then found a GP - antibiotic - no pain
I'm wondering what this says about standards treatment
And I understand that injuries are on another level shoulder pain could be gall bladder issues
Thank you for bringing such valuable science based knowledge and resources to your listeners FOR FREE! This discussion with Dr. Mackey was so thoughtful and thorough. I was seriously excited to learn about the pain signals I experience on a cellular level and learn about all the practical ways I could use to help manage them better.
After the oral health episode, I absorbed the densely packed alcohol podcast and now this comprehensive conversation with Dr. Mackey. What a gift - my family and I will be referencing useful excerpts for years to come. Much gratitude to you for sharing your passion project with all of us. Looking forward to continued learning from the Huberman Lab.
A few follow up Qs:
- what does the intersection of nutrition and pain management look like? Anti-inflammatory diet plus??? Is this completely individual or are there some basic rules on what to avoid?
- hormones/ hormonal shifts and pain?
Really great episode, thank you both so much! As for "going into the pain" - I benefited from this approach during my third trimester of pregnancy. I used to have unbelievable leg cramps at night (not only in my calf but the whole leg). The first few times it happened I thought my leg would explode and so would I. Over time I learned to calm myself down and "ride the wave". It made tremendous difference for me and probably also prepared me mentally for the labor.
Simply brilliant!
Thank you both very much. As a physical therapist this information is crucial to the preocess of health!
I am so grateful for this episode and learnt so much! Leaving with chronic pain can be discouraging. Thank you Huberman for inviting Dr. Mackey, both of you are extremely generous human beings. I hope that his platform will be made available internationally as pain, opioids and others are sadly a universal problem now.
Some gems I enjoyed ‘’pain inhibits pain’’, 100%, the study on pain and love was very interesting :) I like that there were many concrete advice, the pacing was one of them because when you feel good, you feel invincible and forget about your pain but you end up paying for it. Also his simplification of the 6 catergories of solutions is great.
I would love if you would invite Dr. Howard Schubiner one day, that would be a very interesting exchange about the specific psychological side of pain.
Amazing work as usual Huberman, bless you
🙏
I'm an internal medicine physician, and I agree with Dr Mackey, and really appreciate Dr Huberman having him on. This was a great discussion of the complexities and challenges of pain and pain control. I especially appreciate and agree with what he had to say about acupuncture, chiropractic, and Physical and Occupational Therapy. Great episode.
Great episode. Thank you for your hard work and for choosing these great topics 🔝 🌹
As someone struggling w post Covid neuropathic pain, I greatly appreciated this episode. Thank you to both doctors. I’ve done Empowered Relief and it is helpful. I’m still learning and have hope I can turn this around.
Goodluck
Loved listening to this talk, understanding chronic pain was crucial to me, specially the part where everybody experiences pain in different ways, we tend to minimize based on our experiences and listening to this talk gave me a completely different insight on how to understand people's pain and to understand their and our individual needs on the subject. Super informative, someone very close to me suffers from chronic pain and this talk completely blew my mind for understanding and helping him cope better, and for me to see that hurt and harm difference, completely crucial. Many thanks, huge fan, love your work and your easy scientific approach for me to understand. Congrats!😊
Thank you Dr. Mackey and Dr. Huberman!!
As someone who also suffered from severe, chronic abdominal pain I wanted to share my story as well. I also tried the low FODMAP diet and while I saw minor improvements, the only thing that really stopped my pain was pain reprocessing therapy. For me it was more of the emotional response to the sensations, stressful life events, and fear of food was driving my pain persistence. I’m not trying to invalidate his experience that he bravely shared but I did want to share an alternative solution to the low FODMAP diet. That diet doesn’t work for everyone but that isn’t the ONLY course of action as he suggested.
Look at Dr John E Sarno and his work on pain
I have a follow up question/request. Can you do a deeper dive on ‘Neuroplastic pain’? That is, the brain misinterpreting good inputs from the body as a pain signal? I think there’s a lot of us that would benefit from that. Your podcasts are so valuable to those of us that struggle understanding these complex issues. Thank you so much for your service to us.
I am very enlightened about how we react to what surrounds us and how it impacts our very intelligent bodies. Thanks, Prof.
Awesome. Thank you. Reprogramming from childhood is a significant life-long undertaking to say the least. It is always something to be ongaurd for accidentally regressing back into those un-useful coping strategies. Once the neural highway is built it seems to be there waiting to be used. It's like I've learned my value based on childhood experiences and it is so difficult to change that... Okay, I am lovable and since I exist I have innate value. Now walk it ❤.
Thank you for this podcast. I am in a chronic pain experience for the last 6 years.
Thanks Andrew!
Thank you
Dr. Mackey
I'm inspired by this discussion.
Personal and work experience has afforded me so much. It's my desire to make all of this information available to anyone in need.
Such great resources as Biomodulation therapy and TENS unit. Recognizing pain as pain and nothing else is so needed universally. I appreciate all your efforts!
As someone preparing for labour and reading about hypnobirthing I found this episode very educational. Will test out soon if framing pain as discomfort that hurts but does not harm, distraction hacks and mindfulness practices will help me!
I was uninterested in the topic but listened anyway and learned a LOT! It was a fascinating discussion. Thank you for all that you do!
Thank you Dr. Huberman, another fantastic episode!😊
Love your podcast and the way these and other discussions help me keep an open and flexible mind!
Other than autoimmune issues, which I'm sure are linked to unattended stressors as a kid, I also experience arrhythmic/tachy heart beats. Been going on since my early thirties though a health professional did pick up an "extra" beat in my twenties.
God bless my little heart, it's in perfect shape as far as we've seen, but the communication is wacky.
It comes and goes, sometimes irritating, sometimes extremely painful, inducing light-headedness and more recently nausea.
Docs finally put me on beta-blocker which induced asthma problems, and now a calcium channel blocker.
As I write this getting ready for work, my heart is chatting away out of sync.
Apparently, blood work is good for minerals and any issues, but now I have to be mindful of supplements because of the blocker anyway.
Afib and aflutter is what we see when it's really jammed up; rate so far as high as 180, normal rate is 70-80's.
No alcohol (recovered 17 years), no smoking, new to psychotherapy, more doc appointments to come.
Any ideas?
Thank youuuu Dr. Mackey 🧠🙌🏽💜.
It’s not until we, as a collective, begin to recognize and really understand there is NO distinction between mental/emotional and physical pain that we can really start to move the needle towards making long lasting changes in the mental health realm.
Been watching/ listening fora few months now! For the first time since high school I’m taking notes and enjoying being a student 🤙
I can’t wait to listen after so many overnight travels I developed this pain and sometimes tingling on my left thumb if I stretch my left shoulder This is good timing
Thank you for addressing relevant topics
I had that several years ago and got relief with a physical therapist. I had a pinched nerve behind my scapula. It hurt when she found it, but was an immediate relief. Hope you feel better!
@@witchywoman703 Wow, that's awesome to hear that you found relief with the physical therapist! Thank you so much for the well wishes, I really appreciate it. Fingers crossed for a similarly positive outcome on my end too!
Thank you so much!! I sent this to my sister who has chronic pain. I was able to listen to whole podcast while cleaning. I hope she will give it a listen. I appreciate you!!
Suggest your sister listen to podcast The cure for chronic pain , Nicole Sachs. It saved me
Thanks for another effective and informative video, pain in any form can be debilitating but shouldn't dictate how you live your life. I try not to take medications unless specifically prescribed but have had a few adverse reactions so avoid them whenever possible.
Would you please make an episode on Asthma? You're the only podcast that I listen on health & I always learn something new. Thanks.
What an amazing episode! 🔥
Thank you very much for this! ❤
¡Hola Profe!What an important subject. As a migraine sufferer , I am always interested not only in prevention,but also in different approaches in pain management.Thank You for all Your hard work.
Thank you so much for talking about this. This is such an important topic and many people and medical professionals can be informed and hopefully better help their patients.
That’s exactly correct. I can get through the day, go to the gym to workout, golf, walk, bike ride, cook and bake, paint, needlepoint or knit BUT when I lay down and am still my hips hurt, my lower back hurts to the point that I cannot get comfortable enough to sleep. It’s not my mattress by the way. Sometimes it’s really bad and I just sleep short bits at a time and only because I’m exhausted. I’ve been told it is arthritis and at some point a hip replacement. I worry about taking pain medicine and usually don’t unless it’s really, really bad.
Thank you so much for sharing this information. What a beautiful gift!
Great episode discussing a holistic approach to pain and treatment! I utilize a mindfulness approach with my clients - I’m a huge advocate for enhancing the mind-body connection.
I was listening to your podcast with David goggins. I was in the way to the gym, where I had told myself “ I won’t do cardio”. Naturally, listening to Goggins made me re evaluate my decision. I did not initially want to do this cardio session, but I am now doing it.
My Question:
Can the area that controls will power grow if, I didn’t want to do it, but then changed my mind.
To refine this,
Do you have to not want to do the activity while you’re doing the activity?