Essentials: Control Pain & Heal Faster With Your Brain

Andrew Huberman frames this Essentials episode as the next step in a month-long series on neuroplasticity, the nervous system's ability to change in response to experience and, in some cases, through deliberate choice. Earlier episodes covered representational plasticity, focus and reward, the vestibular system and the role of errors in opening windows for plasticity. What had not yet been addressed, he says, is how to direct plasticity toward particular goals, and especially how to undo changes we don't want. He takes up that question through pain and injury to the nervous system, which he calls a very important and somewhat sensitive topic.

He says he will discuss mechanism but put principles first. In his view, principles let listeners reason about their own nervous systems instead of following a single fixed recipe.

Principles are far more important than any one experiment or one description of mechanism and certainly far more important than any one protocol

He links pain to neuroplasticity through one central distinction: injury and pain are not the same thing. He promises protocols that work from both ends, at the site of injury in the periphery and through top-down mental mechanisms. He mentions a Stanford colleague who runs a major pain clinic and has published peer-reviewed data on how love modulates the pain response. He also says that this "plasticity of perception" bears directly on emotional pain and trauma.

Huberman describes the somatosensory system as a set of sensors: neurons that sit in the skin and the deeper layers beneath it. Different receptors respond to mechanical touch and pressure, to heat, to cold or to vibration. They send that information as electrical signals along axons to the spinal cord and then up to the brain, where dedicated centers interpret it. He stresses that no sensor carries a unique kind of information. Each one simply sends electrical potentials into the nervous system, and the brain and spinal cord make sense of them.

He notes that many neuroscientists prefer the term nociception to "pain." Nociceptors are the skin sensors that detect particular kinds of stimuli, and he traces the word to a Latin root meaning "to harm." Researchers avoid the word "pain" because the experience is highly subjective and has both a mental and a physical component. That means pain cannot be reduced to an attempt to avoid physical harm to the body.

To show that pain and tissue damage can come apart, Huberman retells a case he attributes to the British Journal of Medicine, with some hedging about the details ("I think he fell is how the story went"). A 14-inch nail went through a construction worker's boot. The man reported excruciating pain, beyond anything he had felt before, and said he could not move even slightly without it. When clinicians cut the boot away, they found the nail had passed between two toes without piercing the skin at all.

Huberman takes two lessons from the case. The first is the power of the mind: seeing the nail produced what he calls a "legitimate feeling" of pain. The second is specificity. The man didn't feel that his foot was on fire. He felt the kind of sharp pain a nail would cause. To Huberman, this shows how much higher-level cognitive functions shape what we experience in the periphery, even based only on what we see.