Tools to Reduce & Manage Pain | Dr. Sean Mackey

**Andrew Huberman** (0:00)
Welcome to the Huberman Lab podcast, where we discuss science and science-based tools for everyday life.
I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. My guest today is Dr. Sean Mackey. Dr. Sean Mackey is a medical doctor, that is, he treats patients, as well as a PhD, meaning he runs a laboratory. He is the chief of the Division of Pain Medicine and a professor of both anesthesiology and neurology at Stanford University School of Medicine. Today we discuss, what is pain? Most of us are familiar with the notion of pain from having a physical injury or some sort of chronic pain or a headache. Today, Dr. Mackey makes clear what the origins of pain are, both in the nervous system and outside the nervous system, that is, the interactions between the brain and the body that give rise to this thing that we call pain. Indeed, we discuss the critical link between physical pain and emotional pain and how altering one's perception of emotional or physical pain can often change the other. We also discuss some of the changes in the nervous system that occur when we experience pain and how that can give rise to chronic pain. We also, of course, cover different methods to reduce pain safely, and those methods include behavioral tools, psychological tools, nutrition, supplementation, and of course, prescription drugs. We discuss the intimate relationship between temperature, that is heat and cold, and pain, and pain relief. So if you're interested in the use of heat or cold to modulate pain, that conversation ought to be of interest as well. We also touch on some highly controversial topics such as opioids. Opioids are a substance that your body naturally makes, but of course, many people are familiar with exogenous opioids, that is opioids that are available as drugs and the so-called opioid crisis. Dr. Mackey makes very clear which specific clinical circumstances warrant the use of exogenous opioids, with of course a warning about their potent addictive potential. And we get into a bit of discussion about where the opioid crisis and the use of opioid drugs to control pain is and is going. Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford. It is however part of my desire and effort to bring zero cost to consumer information about science and science related tools to the general public. In keeping with that theme, I'd like to thank the sponsors of today's podcast. Our first sponsor is AeroPress. AeroPress is similar to a French press for making coffee, but is in fact a much better way to make coffee. The AeroPress was developed by Alan Adler, who is an engineer at Stanford. I knew of Alan because I used to see him in my hometown of Palo Alto test flying the so-called Aerobee Frisbee. So he was sort of famous around my town as this brilliant engineer that would create these unusual products. So when I heard about the AeroPress, I got it. I tried it and I absolutely loved it because it does indeed create the best tasting cup of coffee or loose leaf tea. With AeroPress, you can brew an incredible tasting coffee or tea and clean up the whole process in less than two minutes. The key thing to know about the AeroPress is that it's not just some trivial variation on the French press. That shortened brewing time that the AeroPress uses really changes the flavor of your cup of coffee or tea. It makes it exceptionally smooth. If you'd like to try AeroPress, you can go to aeropress.com/huberman. That's aeropress.com/huberman to get 20% off any AeroPress coffee maker. AeroPress ships anywhere in the USA, Canada and over 60 other countries around the world. Again, that's aeropress.com/huberman to get 20% off. Today's episode is also brought to us by Levels. Levels is a program that lets you see how different foods and activities impacts your blood glucose levels using a continuous glucose monitor. One of the most important factors impacting your energy levels as well as your immediate and long-term health are your blood glucose levels, sometimes referred to as your blood sugar levels. To maintain mental and physical energy and focus, you want your blood glucose levels to be relatively stable throughout the day. Levels makes it extremely easy to determine how specific foods and food combinations, meal timing, exercise and sleep work alone and in combination to impact your blood glucose levels. I started using levels about two years ago and find it to be immensely beneficial. It's helped me better arrange what I eat, when I eat, when to exercise and my sleep patterns. So if you're interested in learning more about levels and trying a CGM yourself, go to levels.link slash Huberman. Levels has launched a new CGM sensor that is smaller and has even better tracking than the previous versions. Right now, they are also offering an additional two free months of membership. Again, that's levels.link, L-I-N-K slash Huberman. Today's episode is also brought to us by BetterHelp. BetterHelp offers professional therapy with a licensed therapist carried out online. I've been going to therapy for well over 30 years. Initially, I didn't have a choice. It was a condition of being allowed to stay in school, but pretty soon, I realized that therapy is extremely valuable. In fact, I consider doing regular therapy just as important as getting regular exercise, including cardiovascular exercise and resistance training, which of course I also do every week. The reason I know therapy is so valuable is that if you can find a therapist with whom you can develop a really good rapport, you not only get terrific support for some of the challenges in your life, but you also can derive tremendous insights from that therapy. Insights that can allow you to better not just your emotional life and your relationship life, but of course also the relationship to yourself and to your professional life, to all sorts of career goals. In fact, I see therapy is one of the key components for meshing together all aspects of one's life and being able to really direct one's focus and attention toward what really matters. With better help, they make it extremely easy to find a therapist that's ideal for your needs, your life circumstances, and that can match to your schedule in a very convenient way. If you'd like to try better help, go to betterhelp.com/huberman to get 10% off your first month. Again, that's betterhelp.com/huberman.