Neurosurgeon’s Protocol to Feel Better Now: The Best Ways to Heal Your Body & Live Pain Free
In this episode of The Mel Robbins Podcast, neurosurgeon Sanjay Gupta examines chronic pain, which affects over 50 million adults in the United States. He explains how chronic pain differs from acute pain, persisting beyond the original injury and often disrupting daily activities, relationships, and work life. Gupta explores the complex relationship between pain perception and factors such as mood, stress, and sleep.
The discussion covers both traditional and alternative approaches to pain management. Gupta introduces the MEAT protocol as an alternative to the conventional RICE method for injury treatment, and describes how mind-body interventions like meditation and virtual reality have helped patients manage their pain. He also shares practical strategies for identifying pain triggers and patterns through journaling, while emphasizing the role of lifestyle factors in pain management.
This is a preview of the Shortform summary of the Oct 16, 2025 episode of the The Mel Robbins Podcast
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Understanding the Nature and Scope of Chronic Pain
Sanjay Gupta explores the widespread impact of chronic pain in the United States, affecting over 50 million adults. He explains that chronic pain persists without an ongoing injury, typically lasting for three months of daily pain or six months of intermittent pain. For approximately 17 million people, this condition severely disrupts daily activities, relationships, and work life. Gupta shares personal observations of how chronic pain can "hijack" an individual's identity, as witnessed with his wife and mother, noting it's now the fastest-growing health condition in the United States.
Mind-Body Pain Connection and Relief
Gupta, along with other experts, describes pain as a complex experience shaped by multiple factors including mood, stress, sleep, and past experiences. The brain plays a crucial role in pain perception, with chronic pain operating like a continuous memory loop. Various mind-body interventions have shown promising results: virtual reality has reduced knee pain in patients, and meditation has demonstrated significant pain reduction comparable to medication. Gupta shares how his initially skeptical wife found such relief through meditation and movement that she eventually participated in a triathlon.
Non-medical Approaches and Lifestyle Changes
Gupta introduces the MEAT protocol (mobilizing, exercising, analgesia if necessary, and treatment) as an alternative to the traditional RICE method for injury treatment. He emphasizes that gentle movement after injury can promote healing and prevent chronic pain development. For managing ongoing chronic pain, Gupta recommends maintaining a detailed pain journal to identify triggers and patterns. He stresses the importance of addressing lifestyle factors such as sleep quality, stress levels, and mood, which can significantly impact pain perception and management.
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Counterarguments
- While Gupta highlights the role of the brain in pain perception, it's important to note that pain is not solely a product of the brain; it can also be a symptom of underlying physiological issues that should not be overlooked.
- The efficacy of mind-body interventions like virtual reality and meditation may vary widely among individuals, and while promising, they may not be universally effective or accessible to all patients with chronic pain.
- The MEAT protocol, while potentially beneficial, may not be suitable for all types of injuries or patients, and the recommendation to mobilize after an injury should be approached with caution and tailored to individual circumstances.
- The suggestion to maintain a detailed pain journal, though helpful for some, may be burdensome or impractical for others, especially those with cognitive difficulties or severe pain that impedes their ability to record such details.
- Emphasizing lifestyle changes and non-medical approaches may inadvertently minimize the experiences of those who do not find relief through these methods, and it could be perceived as placing the onus of managing pain solely on the individual without acknowledging the need for professional medical intervention in many cases.
- The claim that chronic pain is the fastest-growing health condition in the United States may require further context, as it could be influenced by factors such as increased awareness, better reporting, or changes in diagnostic criteria, rather than an actual increase in prevalence.
Actionables
- You can integrate micro-movements into your daily routine to potentially alleviate pain and improve mobility. Start by setting a timer every hour to remind you to do a simple range of motion exercises, like neck rolls or ankle circles, which can be done even while seated at a desk. This habit can promote gentle movement throughout the day, which may help in preventing the onset of chronic pain by keeping the body active and the joints lubricated.
- Develop a personalized relaxation playlist to help manage stress and improve your mood, potentially reducing pain perception. Curate a selection of music, nature sounds, or guided imagery that you find soothing and allocate time each day to listen, especially during periods of high stress or when experiencing pain. This strategy leverages the connection between stress, mood, and pain by using auditory stimuli to foster a calming environment for the mind and body.
- Create a sleep sanctuary to enhance sleep quality, which can influence pain management. Invest in blackout curtains, comfortable bedding, and a white noise machine to create an optimal sleep environment. Additionally, establish a bedtime routine that might include light stretching or reading to signal to your body that it's time to wind down. Improving sleep hygiene can have a positive impact on pain levels by allowing the body to rest and recover more effectively.
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Understanding the Nature and Scope of Chronic Pain
Sanjay Gupta shines a light on the pervasiveness and complexity of chronic pain, which affects a significant portion of the U.S. adult population.
Chronic Pain Impacts 50 Million U.S. Adults
Gupta explains that chronic pain is a common affliction in the United States, with between one in five and one in four adults dealing with it, equating to over 50 million individuals. Chronic pain is defined as pain that endures without an ongoing injury or cause, typically classified as chronic if experienced every day for three months or every other day for six months.
Chronic Pain Endures Without Injury or Cause, Often for Months or Years
Some suffer from chronic pain without a structural, anatomical issue, or injury, such as Rich Roll, who dealt with chronic pain for 13 years. This demonstrates how chronic pain can persist for extended periods, sometimes even without a clear cause.
Chronic Pain Impacts Daily Life in Various Forms
For an estimated 17 million people, chronic pain severely disrupts their normal life, impacting their jobs, education, and relationships. Pain can interfere with sleep and poor sleep can, in turn, exacerbate pain, creating a bi-directional relationship.
Gupta shares personal experiences, noting how chronic pain can "hijack" an individual's life and identity, as seen in his wife and mother. He notes that it changes their personalities and can be so pervasive that it affects their ability to perform simple tasks, like turning doorknobs. When his wife was asked to show where it hurt, she indicated her entire body, emphasizing how all-consuming chronic pain can be.
Mo ...
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Understanding the Nature and Scope of Chronic Pain
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Counterarguments
- Chronic pain prevalence rates can vary depending on the criteria used for diagnosis and reporting, which might lead to different interpretations of its pervasiveness.
- The definition of chronic pain as enduring without an ongoing injury or cause may be too broad, as some chronic pain can have identifiable sources that are difficult to treat or diagnose.
- The impact of chronic pain on daily life, while significant, can vary greatly among individuals, and some may find ways to manage their pain effectively without severe disruption to their lives.
- The notion that chronic pain can "hijack" an individual's life, while true for some, may not reflect the experiences of all individuals with chronic pain, some of whom maintain a strong sense of identity and purpose despite their condition.
- The journey to finding effective treatment for chronic pain is indeed challenging, but there are also many cases where individuals find successful management strategies, including non-pharmacological approaches, which are not mentioned in the text. ...
Actionables
- You can create a pain awareness journal to track your daily experiences with discomfort, noting activities that exacerbate or alleviate your pain. By documenting your pain levels, triggers, and the effectiveness of various coping strategies over time, you'll have a personalized record that can inform your conversations with healthcare providers and help you identify patterns that may be contributing to your chronic pain.
- Start a mini-meditation routine each morning to potentially reduce the perception of pain. Even five minutes of focused breathing or guided meditation can help manage stress levels, which are often linked to the intensity of chronic pain. Apps like Calm or Headspace offer short meditation sessions that can fit into a busy schedule.
- Engage in low-impact physi ...
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Mind-Body Pain Connection and Relief
Pain: A Complex Experience Beyond Just Sensation
Brain's Role in Pain Perception Influenced by Mood, Stress, Sleep, Past Experiences
Sanjay Gupta, alongside other experts, explains that pain is not just a physical sensation but a complex experience that reflects our integrated body system. It is influenced by mood, stress, sleep quality, past experiences with pain, and possible histories of depression or anxiety.
The brain's role in pain perception is crucial, as it determines whether we experience pain. Gupta states, "'Chronic pain hardly ever occurs in isolation. It always comes with baggage attached,'" referencing the influence of psychological factors on pain. Chronic pain can be seen as a continuous memory loop in the brain, persisting without a current reason.
Neuroplasticity allows the brain to change due to focused attention on pain, which can reinforce this memory loop. Areas of the brain involved in the emotion and memory, such as the amygdala and hippocampus, can amplify the perception of pain based on past experiences. The prefrontal cortex, which influences judgment, is often smaller in chronic pain patients, affecting their decision-making abilities.
Recognizing Mind-Body Connection in Pain Management Beyond Physical Symptoms
Meditation, Virtual Reality, and Mind-Body Interventions Reduce Pain Perception
Discussions surrounding mind-body interventions highlight their effectiveness in pain management. For example, virtual reality has been shown to significantly reduce a patient's knee pain by simulating a calming environment. This suggests that non-physical interventions can activate the body's endogenous opioid system, reducing stress and promoting the release of feel-good hormones.
Sanjay Gupta and Mel Robbins explore the concept that the mind, not the area of pain, is where pain is experienced. They touch upon condition-related stresses, such as TMJ, where psychological factors, like stress, increase chronic pain.
Robbins discusses breaking the memory loop of pain as a treatment approach. Gupta believes that chronic pain confuses many because it persists without active harm occurring in the body, and his observations suggest that movement and exercise are beneficial once it's confirmed that nothing is continuously acti ...
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Mind-Body Pain Connection and Relief
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Clarifications
- Neuroplasticity is the brain's ability to reorganize itself by forming new neural connections throughout life. This process allows the brain to adapt to experiences, learn new information, and recover from injuries. Neuroplasticity plays a crucial role in changing the brain's structure and function in response to focused attention, such as in chronic pain conditions. By understanding neuroplasticity, researchers and healthcare professionals can explore interventions that harness the brain's adaptive capabilities for pain management.
- The endogenous opioid system is a network in the body that produces natural pain-relieving chemicals called endorphins. These endorphins bind to opioid receptors in the brain and spinal cord, reducing pain signals and promoting feelings of well-being. Activating this system through interventions like meditation or virtual reality can help manage pain by harnessing the body's natural pain relief mechanisms. Understanding and utilizing the endogenous opioid system is a key aspect of non-pharmacological approaches to pain management.
- In chronic pain, a continuous memory loop refers to the brain's tendency to retain pain signals even after the initial cause of pain has resolved. This loop can be reinforced by neuroplasticity, where the brain changes in response to persistent pain signals. Past experiences, emotions, and memories can amplify the perception of pain, creating a cycle that sustains the sensation of pain without a current physical trigger. This phenomenon highlights the complex interplay between psychological factors and the brain's processing of pain signals in chronic pain conditions.
- In pain perception, the amygdala processes emotions related to pain, influencing its intensity. The hippocampus stores memories associated with pain, affecting how we perceive and react to it. The prefrontal cortex plays a role in judgment and decision-making related to pain management strategies. These brain areas interact to shape our overall experience of pain.
- Pain is a complex experience involving both physical sensations and the brain's interpretation of those signals. The brain processes and interprets pain signals, and factors like mood, stress, and past experiences can influence how pain is perceived. This means that pain is not solely a result of physical damage in a specific area but is also influenced by psychological and emotional factors. The mind-body connection in pain perception highlights that the brain plays a significant role in how pain is experienced and managed.
- Temporomandibular joint (TMJ) disorders can lead to chronic pain in the jaw joint and muscles controlling jaw movement. Stress and anxiety are known to exacerbate TMJ symptoms, causing increased pain and discomfort. Psychological factors like stress can contribute to the development and persistence of TMJ-related chronic pain. Managing stress and ...
Counterarguments
- While neuroplasticity can reinforce pain, it can also be harnessed to diminish pain through positive changes and learning, suggesting that the relationship between neuroplasticity and pain is not solely negative.
- The size of the prefrontal cortex and its correlation with pain perception is complex and not fully understood; other factors may also contribute to the changes in the prefrontal cortex size and decision-making abilities in chronic pain patients.
- The effectiveness of mind-body interventions like meditation and virtual reality can vary greatly among individuals, and more research is needed to understand the mechanisms and to identify for whom these interventions are most effective.
- The comparison of meditation to medication in terms of pain relief may oversimplify the issue, as medication can provide immediate and sometimes more predictable relief for certain types of pain, which meditation may not.
- The claim that pain is experienced in the mind and not just the area of pain might be an oversimplification, as it does not fully account for the complex interactions between the nervous system and the site of injury or disease.
- Stress and psychological factors are indeed linked to chronic pain, but this does not mean that all chronic pain can be managed or alleviated solely through psychological interventions; some chronic pain conditions require medical or interventional treatment.
- The narrative that breaking the memory loop of pain can serve as a treatment approach may not be applicable to all types of pain or all pat ...
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Non-medical Approaches and Lifestyle Changes to Manage Pain
Sanjay Gupta discusses non-medical strategies and lifestyle adjustments that can help with the management of both acute injuries and chronic pain by focusing on enhancing the body's natural healing response and addressing overarching lifestyle factors.
Rice Method for Acute Injuries May Elevate Chronic Pain Risk
Gentle Movement and Exercise Promote Healing and Prevent Chronic Pain
Sanjay Gupta introduces the MEAT protocol (mobilizing, exercising, analgesia if necessary, and treatment) as an alternative to the traditionally used RICE protocol (rest, ice, compression, elevation) for treating injuries. He suggests that mobilizing and exercising may prevent chronic pain more effectively than RICE. Mobilizing after an injury, like a sprained ankle, allows the body to send healing molecules to the site, and not resting excessively doesn't interfere with this natural process. Movement recruits these molecules, decreases nociceptor activity, and reduces pain transmission to the brain. For non-structural back pain, activities like walking can be beneficial, and Gupta stresses that movement isn't likely to cause further damage if structural issues are ruled out.
Managing Chronic Pain Through Lifestyle: Sleep, Stress, Mood
Pain Journals: Identifying Triggers and Patterns for Better Management
Chronic pain can be intensely fluctuating, influenced by aspects like sleep and stress levels. Gupta stresses addressing 'baggage' such as poor sleep, stress, and mood disorders in managing chronic pain because these can worsen the pain experience. It’s crucial to focus on non-medical interventions like improving sleep, which can help reduce pain scores.
Discussing his wife's journey with chronic pain, Gupta notes the success in focusing on movement and other non-medical inte ...
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Non-medical Approaches and Lifestyle Changes to Manage Pain
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Counterarguments
- While the MEAT protocol may be beneficial for some, the RICE protocol is still widely recommended by many healthcare professionals for initial injury management, especially within the first 48 hours, to reduce swelling and pain.
- Mobilizing too soon after an injury could potentially lead to increased inflammation or exacerbate the injury in some cases, depending on the type and severity of the injury.
- Exercise and movement are generally beneficial but should be approached with caution and personalized to the individual's condition; what works for one person may not be suitable for another.
- The effectiveness of walking for non-structural back pain may not apply to all individuals, and some may require a more structured physical therapy program.
- The assertion that movement is unlikely to cause further damage if structural issues are ruled out may be overly simplistic, as there could be other non-structural factors that could be aggravated by movement.
- The impact of sleep, stress, and mood on chronic pain is complex, and while addressing these factors can help, it may not be sufficient for pain management for everyone.
- Pain journals are useful tools, but they may not be helpful for all patients, especially those with cognitive impairments or who are not inclined towards introspection or journaling.
- The recommendation for detailed descriptions and drawings in a pain journal may not be pra ...
Actionables
- You can create a "movement menu" with a variety of low-impact activities to choose from after an injury. Start by listing activities like gentle yoga, swimming, or tai chi, and rotate through them to keep your body moving without overexerting the injured area. This approach ensures you're mobilizing and exercising in a way that's enjoyable and sustainable, which can aid in recovery and pain management.
- Develop a bedtime routine that promotes quality sleep to support pain management. This might include setting a consistent sleep schedule, creating a relaxing pre-sleep ritual like reading or taking a warm bath, and optimizing your sleep environment by investing in a comfortable mattress and blackout curtains. Good sleep hygiene can help mitigate the impact of stress and poor sleep on chronic pain.
- Use a mobile app to track your pain, sl ...
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