CNN’s Chief Medical Correspondent, Sanjay Gupta, recalls a childhood incident when he accidentally impaled himself on a wrought iron fence at age 12. He was running through his neighborhood and, on a whim, attempted to jump over a fence he typically avoided. Unfortunately, he didn’t clear it.
“One of the spikes caught my side, going in from the back and out the front,” Gupta shares. “Fortunately, it only pierced the skin instead of hitting the chest or abdomen, which would have been far worse—it was a classic in-and-out injury.”
He was stuck there for several minutes until his mother arrived to free him. Interestingly, he now recalls experiencing an odd sense of euphoria during the incident, which he attributes to the body’s natural pain relief mechanisms. “For some individuals, the body reacts intensely — producing lots of endorphins,” he explains. “So, you might find yourself laughing despite a terrible injury, which is quite a protective response, I guess. But not everyone experiences it like that.”
In his latest book, It Doesn’t Have to Hurt: Your Smart Guide to a Pain-Free Life, Gupta explores the nature of pain, its causes, and the medications available for treatment. He also reflects on techniques to mentally reduce some types of pain through distraction and meditation.
“When people experience pain, they often fixate on a specific sensation. Shifting their attention away from that can be really beneficial,” he notes. “The goal is to help someone reduce their pain score from unbearable to nothing during meditation sessions. It’s like the brain can learn to manage pain in a different way.”
Interview Highlights
On the brain’s errors in processing pain
He cites phantom limb pain as a prime example — an amputated limb may still hurt. “This revelation about the brain has propelled much understanding of its role in pain,” he states. “If the brain decides what pain is, can it also produce pain? And the answer seems to be yes.”
He also points out referred pain where, say, a heart attack might cause pain in the jaw instead of the chest, which can be confusing. Sometimes the brain just gets stuck in a loop, replaying pain signals continuously, leading to chronic pain. “Those are just some examples of how the brain misinterprets signals related to pain,” he adds.
On how pleasure can reshape the brain
Gupta finds it intriguing to consider the body’s endogenous opioid system — essentially our internal morphine-like substance. “This system can be activated in various ways,” he explains. “For instance, by practicing active gratitude. Instead of just feeling grateful for an ice cream cone, really savoring it—enjoying every bit—can activate this opioid system. It’s a fascinating mechanism.”
On opioid medications versus natural opioids
“Many medical techniques actually draw inspiration from our bodies. Your own opioid system is incredibly responsive, turning on and off as needed,” Gupta states. This means that, unlike synthetic opioids, the body’s natural pain relief can disappear quickly. “If this system didn’t exist, childbirth would probably be a one-time ordeal for women! Those natural opioids ease pain and enhance mood.”
On inflammation’s role
“Inflammation often gets a bad reputation,” he says. “Take a sprained ankle, for instance; people see it swollen and red and want to get rid of that. But inflammation serves a genuine purpose—it protects the injury and promotes healing.” He points out that everyone’s pain threshold is different. “Some may feel compelled to take anti-inflammatories thinking they’re harmful, but I encourage a different perspective: that inflammation is part of how your body works as it should.”
On a new FDA-approved non-opioid pain medication
The medication, called Suzetrigine, has an interesting backstory. Researchers became intrigued by circus performers in Karachi, Pakistan, who could endure discomfort in remarkable ways — like walking on hot coals without pain. This observation led scientists to identify specific genetic markers over many years, culminating in an oral drug designed to target pain effectively but not eliminate it altogether. “Pain has its uses; it can keep you safe and impart valuable lessons,” Gupta succinctly states.
On cannabis for pain
Going into his research, Gupta hoped to discover solid evidence for using cannabis for various pains, but he wasn’t as impressed as he thought he would be. “Collecting quality data is challenging with this substance given its classification,” he says. However, he adds that the best available studies indicate that around a third of users might find it effective, particularly for neuropathic pain, while two-thirds may not benefit at all, leaving uncertainty regarding the factors that differentiate responses.
