本期节目邀请了斯坦福大学医学院麻醉学、围手术期和疼痛医学以及神经学教授兼疼痛医学部主任肖恩·麦凯博士（Sean Mackey, M.D., Ph.D.）作为嘉宾，深入探讨了疼痛的本质、疼痛阈值以及各种疼痛原因。节目还涵盖了控制和减轻疼痛的有效方案，包括热疗、冷疗、针灸、脊椎按摩、物理治疗、营养和补充剂。此外，节目还讨论了情绪、压力和记忆如何影响疼痛，以及控制个人对疼痛的心理感知的实用工具。最后，节目还探讨了止痛药，包括备受争议的阿片类药物的使用和阿片类药物危机。

🤔 **疼痛的本质：** 疼痛是身体和大脑之间复杂的互动过程，它是一种保护机制，提醒我们身体可能受到伤害。疼痛感知因人而异，与个体生理、心理和社会因素有关。

🧠 **疼痛与大脑：** 疼痛信号通过神经系统传到大脑，大脑会解读这些信号并产生疼痛感。疼痛的强度和持续时间会受到情绪、压力、记忆等因素的影响。

🧰 **疼痛管理工具：** 除了药物治疗外，还有许多非药物治疗方法可以有效控制和减轻疼痛，包括热疗、冷疗、针灸、脊椎按摩、物理治疗、营养和补充剂等。这些方法可以调节身体的生理反应，减轻疼痛信号的传递，并改善心理状态。

💊 **阿片类药物：** 阿片类药物是强效止痛药，但长期使用会产生依赖性，并可能导致药物滥用和成瘾。因此，需谨慎使用阿片类药物，并寻求专业医师的指导。

💪 **心理治疗：** 心理治疗可以帮助患者改变对疼痛的认知和行为模式，减轻心理压力，提高疼痛管理能力。常用的心理治疗方法包括认知行为疗法、正念减压等。

🤝 **全方位管理：** 疼痛管理是一个综合性的过程，需要结合药物治疗、非药物治疗和心理治疗等多种方法，才能取得最佳效果。患者需要积极配合医师的治疗方案，并采取积极的生活方式，改善疼痛状况。

🙏 **寻求帮助：** 如果你正在经历疼痛，请不要犹豫，寻求专业的医疗帮助。医生会根据你的具体情况，制定个性化的治疗方案，帮助你控制和减轻疼痛。

🧠 **科学与人文：** 理解疼痛的本质，掌握有效的疼痛管理方法，需要科学与人文精神的结合。我们应该关注疼痛的生理机制，同时也要重视心理因素和社会因素的影响。只有这样，才能更好地应对疼痛，提高生活质量。

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.

For show notes, including referenced articles and additional resources, please visit hubermanlab.com.

Use Ask Huberman Lab, our new AI-powered platform, for a summary, clips, and insights from this episode.

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Timestamps

(00:00:00) Dr. Sean Mackey

(00:02:28) Sponsors: LMNT & Waking Up

(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

(00:27:51) 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

(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

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