Sanjay Gupta Takes a Fresh Look at Pain and the Brain

What he found turned some conventional wisdom on its head

Susan Moeller

Updated August 05, 2025

Dr. Sanjay Gupta posing for a photo on a blank background

Sanjay Gupta, M.D.

Credit: CNN

The secret to overcoming pain, even chronic pain, has been with you all along.

That’s the premise of It Doesn’t Have to Hurt: Your Smart Guide to a Pain-Free Life, a new book by neurosurgeon Sanjay Gupta, M.D., that focuses on the brain — the control center for pain. Armed with better brain health, and a familiarity with mindfulness techniques and the latest findings about pain treatment, you can redirect and manage your pain, sometimes even skipping surgery or addictive drugs, he writes.

“Pain really cannot exist unless the brain decides it should exist,” says Gupta, a faculty member at Emory University School of Medicine in Atlanta as well as a bestselling author, host of the podcast Chasing Life, and the Emmy-award winning chief medical correspondent for CNN. He refers to pain as “a warning signal on the dashboard.” But the warning signal’s not the problem; it’s telling you something else is going on.

Let’s say you slam your finger in the door. Whether your brain registers the injury as pain depends on all kinds of factors, ranging from your health to your mood to the weather, Gupta says. “And I think even more surprising is that the brain can create pain when nothing has happened and can even create pain in a place of the body, like an amputated limb, that doesn't even exist anymore.”

Gupta’s book, coming out in September, explores tactics that we can use to help our brains and bodies build pain defenses. His research took him from university lab researchers to alternative treatment practitioners to doctors and patients, leaving even him surprised at the complexities of the brain’s relationship with pain.

Here are five findings that surprised Gupta and made him feel hopeful.

1. A healthy brain deals better with pain.

With a couple of additions, the same brain health tips he talks about in Staying Sharp and in his 2021 book, Keep Sharp: Build A Better Brain at Any Age, can help keep pain at bay. Gupta offers seven “reset strategies for pain-smart living,” including regular exercise; good sleep habits; healthy eating; socialization; “minding your brain” through techniques like mindfulness and psychotherapy; “befriending your body” via massage and traditional healing approaches, such as acupuncture; and learning to savor life’s positive experiences.

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He points to isolation as a risk for chronic pain. If you already have an unhealthy brain because you lack social connections or have “toxic influences in your life, it's likely to make the pain worse,” he says.

But if, for example, you redirect the brain with positive thoughts or controlled breathing, “there is … less bandwidth to devote to pain,” he says. Gupta tested mindfulness himself by working with clinical researcher and psychotherapist Eric Garland, a professor at the University of California San Diego. Focusing on his breath, Gupta was able to overcome the sensation of heat filaments of 122 degrees Fahrenheit. His pain scores dropped 35 percent when he practiced mindful breathing, and he didn’t even feel the last pulses of heat, he says.

2. Sleep and pain are a two-way street.

While we think of pain as a sleep disrupter, people who get poor sleep are more likely to have chronic pain, research shows. He offers several techniques for addressing sleep problems: Ditch the screens at night, keep the bedroom at a cool temperature (about 65 degrees), keep a regular sleep schedule, and try controlled breathing — breathe in for a count of four, then breathe out for a count of eight — for as long as you need to. Controlled breathing targets the vagus nerve, which carries signals from your brain to your heart and your gut, controlling everything from your heart rate to your digestion, he writes.

3. Pain is created in many parts of the brain.

“There’s no single center of pain in the brain,” Gupta says. Just as with music, the brain registers pain using several different areas, he says. He cites research at the University of California San Francisco where researchers used probes in a patient’s brain to correlate waves of pain with brain waves. That allowed them to try and predict where to stimulate the brain to block or interrupt the pain. As he writes in the book, while this research is in the early stages, and deep brain stimulation (DBS) might not be a solution for everyone, it unexpectedly proved it’s possible to “see” pain in someone's brain, measure it and interrupt it. And, because everyone has unique pain signatures, the work could lead to individualized treatments, he says.

4. We’ve been treating some pain wrong.

Much of pain treatment has focused on reducing inflammation using RICE: rest, ice, compression, elevation. But inflammation may trigger the release of healing agents, Gupta writes. In one study, he says, people who developed chronic pain (lasting three to six months) actually had low levels of inflammation at the time of the injury. That means, Gupta says, that “all the things that we have conventionally been taught to do, which is to reduce blood flow and thus reduce the inflammatory mediators that go to the site of injury, that's not a good thing when it comes to chronic pain.” Today, doctors are trying a different tack, when appropriate: MEAT — movement and exercise, analgesia if needed and treatment, he says.

5. We are making progress on pain.

The book cover of Sanjay Gupta, M.D.'s new book, "It Doesn't Have to Hurt: Your Smart Guide to a Pain-Free Life"

"It Doesn’t Have to Hurt: Your Smart Guide to a Pain-Free Life" by Sanjay Gupta, M.D.

Simon & Schuster

There are some encouraging signs that we are learning better techniques to overcome chronic pain to be able to avoid surgery or addictive opioids, Gupta says. He bases his optimism on developments like the U.S. Food and Drug Administration’s approval of the first new type of painkiller in 25 years — suzetrigine, a non-addictive, non-sedative pain medication; experiments like opioid-free emergency rooms; and the inclusion of patients and a broader swath of the population in pain research. It’s important, also, that mainstream medicine has begun to consider techniques like mindfulness as legit, not just “woo-woo,” as he says.

“We know chronic pain hardly ever occurs in isolation. It comes with baggage,” he says. “That baggage needs to be addressed as much as the pain itself. And that’s happening.”

It Doesn’t Have to Hurt: Your Smart Guide to a Pain-Free Life can be found at the AARP Bookstore.