Essentials: Control Pain & Heal Faster With Your Brain

**Andrew Huberman** (0:00)
Welcome to Huberman Lab Essentials, where we revisit past episodes for the most potent and actionable science-based tools for mental health, physical health and performance. I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. Let's continue our discussion about neuroplasticity, this incredible feature of our nervous system that allows it to change itself in response to experience, and even in ways that we consciously and deliberately decide to change it. Most people don't know how to access neuroplasticity, and so that's what this entire month of the Huberman Lab podcast has been about. We've explored neuroplasticity from a variety of different perspectives. We talked about representational plasticity. We talked about the importance of focus and reward. We talked about this amazing and somewhat surprising aspect of the vestibular system, how altering our relationship to gravity, and in addition to that, making errors as we try and learn can open up windows to plasticity, but we have not really talked so much about directing the plasticity toward particular outcomes, and thus far, we really haven't talked yet about how to undo things that we don't want. And so today, we are going to explore that aspect of neuroplasticity, and we are going to do that in the context of a very important and somewhat sensitive topic, which is pain, and in some cases, injury to the nervous system. We, as always here on this podcast, are going to discuss some of the science, we get into mechanism, but we also really get at principles. Principles are far more important than any one experiment or one description of mechanism, and certainly far more important than any one protocol, because principles allow you to think about your nervous system and work with it in ways that best serve you. So let's start our discussion about pain and the somatosensory system. The somatosensory system is, as the name implies, involved in understanding touch, physical feeling on our body. And the simplest way to think about the somatosensory system is that we have little sensors, and those sensors come in the form of neurons, nerve cells, that reside in our skin and in the deeper layers below the skin. We have some that correspond to, and we should say respond to, mechanical touch. So pressure on the top of my hand, or a pinpoint, or other sensors, for instance, respond to heat, to cold, some respond to vibration. We have a huge number of different receptors in our skin, and they take that information and send it down these wires that we call axons in the form of electrical signals to our spinal cord and then up to the brain. And within the spinal cord and brain, we have centers that interpret that information that actually makes sense of those electrical signals. And this is amazing because none of those sensors has a different unique form of information that it uses. It just sends electrical potentials into the nervous system. Pain and the sensation of pain is, believe it or not, a controversial word in the neuroscience field. People prefer to use the word nociception. Nociceptors are the sensors in the skin that detect particular types of stimuli. It actually comes from the Latin word nocera, which means to harm. And why would neuroscientists not want to talk about pain? Well, it's very subjective. It has a mental component and a physical component. We cannot say that pain is simply an attempt to avoid physical harm to the body. And here's why. They actually can be dissociated from one another. And there's a famous case that was published in the British Journal of Medicine where a construction worker, I think he fell, is how the story went. And a 14 inch nail went through his boot and up through the boot. And he was in excruciating pain, just beyond anything he'd experienced. He reported that he couldn't even move in any dimension, even a tiny bit without feeling excruciating pain. They brought him into the clinic, into the hospital. They were able to cut away the boot. And they realized that the nail had gone between two toes and it had actually not impaled the skin at all. His visual image of the nail going through his boot gave him the feeling, the legitimate feeling that he was experiencing the pain of a nail going through his foot, which is incredible because it speaks to the power of the mind in this pain scenario. And it also speaks to the power of the specificity. It's not like he thought that his foot was on fire. He thought because he saw a nail going through his foot, what it was going through his boot, but he thought it was going through his foot, that it was sharp pain of the sort that a nail would produce. It really speaks to the incredible capacity that these top down, these higher level cognitive functions have in interpreting what we're experiencing out in the periphery, even just on the basis of what we see. So why are we talking about pain during a month on neuroplasticity? Well, it turns out that the pain system offers us a number of different principles that we can leverage to A, ensure that if we are ever injured, we are able to understand the difference between injury and pain because there is a difference. That if we're ever in pain, that we can understand the difference between injury and pain. That we will be able to interpret our pain. And during the course of today's podcast, I'm going to cover protocols that help eliminate pain from both ends of the spectrum, from the periphery at the level of the injury and through these top-down mental mechanisms. Believe it or not, we're going to talk about love. A colleague of mine at Stanford, who runs a major pain clinic, is working on and has published quality peer-reviewed data on the role of love in modulating the pain response. So what we're talking about today is plasticity of perception, which has direct bearing on emotional pain and has direct bearing on trauma. So let's get started in thinking about what happens with pain. And I will tell you just now that there is a mutation, a genetic mutation in a particular sodium channel. A sodium channel is one of these little holes in neurons that allows them to fire action potentials. It's important to the function of the neuron. It's also important for the development of certain neurons. And there's a particular mutation. There are kids that are born without this sodium channel 1.7. If you want to look it up, those kids experience no pain, no pain whatsoever. And it is a terrible situation. They don't tend to live very long due to accidents. It's a really terrible and unfortunate circumstance. In fact, it's reasonable to speculate that one of the reasons, not all, but one of the reasons why people might differ in their sensitivity to pain is by way of genetic variation in how many of these sorts of receptors that they express. People who make too much of this receptor experience extreme pain from even subtle stimuli. So let's talk about some of the features of how we're built physically and how that relates to pain and how we can recover from injury. I'd like to take a quick break and thank our sponsor, 8 Sleep. 8 Sleep makes smart mattress covers with cooling, heating and sleep tracking capacity. 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