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Dr. Sean Mackey: Tools to Reduce & Manage Pain
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399,489 Views • Jan 15, 2024 • Click to toggle off description
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: twitter.com/DrSeanMackey
LinkedIn: www.linkedin.com/in/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, YouTube Feedback, Sponsors, Momentous, Social Media, Neural Network Newsletter

#HubermanLab #Pain

Disclaimer: www.hubermanlab.com/disclaimer
Metadata And Engagement

Views : 399,489
Genre: Science & Technology
Date of upload: Jan 15, 2024 ^^


Rating : 4.944 (81/5,685 LTDR)
RYD date created : 2024-05-13T00:22:25.980568Z
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YouTube Comments - 734 Comments

Top Comments of this video!! :3

@metemad

3 months ago

I am so grateful that a humble scientist with a sincere desire to help humanity brings all these qualified professionals to his podcasts.

129 |

@memastarful

3 months ago

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.

266 |

@michelesnyder8920

3 months ago

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!

29 |

@emranmufti3339

3 months ago

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.

61 |

@dawnhughes9942

3 months ago

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.

22 |

@brookewright1069

3 months ago

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.

68 |

@watashiwamillo

3 months ago

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.

57 |

@pattyborn4548

3 months ago

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.

2 |

@GOD999MODE

3 months ago

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.

29 |

@jordanclark4944

3 months ago

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).

84 |

@tawnigrubaugh9343

1 month ago

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.

6 |

@cordellsenior9935

2 months ago

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.

1 |

@kahlagerard2021

2 weeks ago

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 .

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@bartstienen4161

3 months ago

Thanks so much Andrew for being a beautiful part of my love for life 🙏❤️

19 |

@Austin-ys3zr

2 months ago

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.

4 |

@MichelleCox.Mindset

3 months ago

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.

12 |

@shirintobie-paul3501

3 months ago

Thank you Dr. Huberman, team, sponsors and supporters ☀ THANK YOU DR. SEAN MACKEY.

3 |

@late-.-6278

3 months ago

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.

5 |

@biggbbear6300

3 months ago

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.

6 |

@HealthyCare-fi6mv

2 months ago

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!

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