Introduction to Pain Management
Dr. Sanjay Gupta, CNN’s Chief Medical Correspondent, has released his latest book, “It Doesn’t Have to Hurt,” aiming to redefine our understanding of pain. The launch coincides with a special report, “Dr. Sanjay Gupta Reports: It Doesn’t Have to Hurt,” airing at 9 p.m. ET on September 7.
Recognizing the Complexity of Pain
In one reflective moment while surrounded by advanced surgical equipment, Dr. Gupta realized that a patient’s simple expression—a frowny face—was pivotal in diagnosing his condition. With over 25 years of experience as a neurosurgeon, Dr. Gupta recognizes that pain is often the catalyst prompting patients to seek medical help.
He acknowledges the challenges posed by pain’s subjective nature, which lacks an objective measure, making it a complex phenomenon deeply embedded in human experience.
A Focus on Alternative Treatments
Dr. Gupta directed his research towards addressing an unsettling disparity: while the opioid crisis has been thoroughly documented, alternative non-opioid pain management strategies have received comparatively little attention. He believes that the overwhelming focus on opioids has overshadowed other effective treatments.
“Arrogance and greed had fueled the opioid epidemic, and for pain doctors, it left very little room for conversation about other approaches to treating pain,” he states. Gupta emphasizes that while opioids can be beneficial for some, they come with significant drawbacks, particularly in the context of chronic pain management.
The Endogenous Opioid System
The human body generates its own opioid-like substances known as endorphins, which are crucial for pain suppression, mood improvement, and memory modulation regarding painful experiences. However, reliance on opioid medication can inhibit this natural production, often exacerbating chronic pain in the long term.
The Nature of Chronic Pain
Gupta delves into identifying pain as a complex mix of physical and emotional experiences, influenced by numerous factors. He notes that pain varies greatly from person to person and can fluctuate dramatically within the same individual over time.
“Chronic pain never occurs in isolation. It almost always comes with baggage attached,” he says, emphasizing the importance of addressing both pain and its underlying psychological, social, and cultural implications.
Chronic vs. Acute Pain
While chronic pain lasts for at least three months and often extends for years, acute pain serves a protective function and is located in different brain areas. The distinction between these two forms of pain is crucial, as Gupta points out that they operate under vastly different mechanisms.
He recounts expert opinions likening chronic pain to a glitch in the nervous system, where pain signals become stuck, suggesting a memory-like residue of past traumas.
Shifts in Pain Management Practices
Dr. Gupta observes changing attitudes towards pain management. During a visit to Maimonides Medical Center in Brooklyn, a Level 1 trauma center catering to a diverse community, he noted their innovative approach to opioid use. There, opioids are regarded as a last resort, replaced by methodologies such as nerve blocks and alternative therapies like ketamine for pain relief.
Real-World Applications
One striking case involved a patient with a fractured hip who received a nerve block instead of opioids, effectively managing pain within minutes. Another patient experienced substantial pain relief through virtual reality distractions while in the emergency room.
The Prevalence of Chronic Pain
Gupta highlights that more than 51 million adults—about 21% of the U.S. population—live with chronic pain, with 17 million facing significant life restrictions due to it. Despite this alarming statistic, he stresses that chronic pain isn’t a predetermined aspect of aging and encourages readers to remain hopeful.
“There are things you can do to treat, reduce, and even prevent pain,” Gupta concludes, advocating for a proactive approach to pain management.
