Book extract: “It doesn’t have to hurt” by Dr. Sanjay Gupta

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In his new book, “It doesn’t have to hurt: your smart guide for painless life” (Published on September 2 by Simon & Schuster), Dr. Sanjay Gupta, neurosurgeon and chief medical correspondent for CNN, written on chronic pain, and innovative techniques are now used to study and treat it.

Read an extract below, and Do not miss the interview with Jane Pauley with Dr. Gupta “CBS Sunday morning” August 31!

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“It doesn’t have to hurt: your smart guide for painless life” by Dr. Sanjay Gupta

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More than a hundred years ago, William Osler, a Canadian doctor and a founding influence on modern medicine and medical education, would have asked his students to “listen to the patient. Very often, he tells you the diagnosis”.

Today, urgent research for significant information on chronic pain has given this idea a new relevance, with impressive results. Health care providers now encourage patients to commit as partners in the processing process. Research programs now regularly include people with lived experience – patients, family members, caregivers – as members of committees who advise and lead pain studies.

Pain scientists call for a dramatic change that puts more emphasis on studies that first derive from the real pain experience of people, then follow laboratory research to develop targeted solutions for effective pain management. This reverse translational research returns the classic process of the bed bench that begins in a laboratory and ends with a clinical trial.

The reverse translational research begins with the patient’s real world experience, then tries to decipher the mechanisms by brain imaging and blood tests, correlated with the symptoms and self-assessments of the patient. Instead of the bedside bench, which was taught when I was in medical school, it was the bedside of research on the bench. Banc scientists then work with the results to find out more about basic mechanisms.

Prasad Shirvalkar, pain doctor, neuroscientist and director of the Shirvalkar laboratory of the University of California in San Francisco, used such a hybrid approach a few years ago to find the unicorn in pain science: Biomarkers objective of a subjective experience. He started by setting up electrodes in patients’ brain, to measure brain signals. He then followed the participants in the trial at home and, with the use of continuous and digital surveys, followed their pain through daily life and correlated these results with direct brain readings. The combination of laboratory surveillance and at home has led to a revolutionary series of clinical trials that have made the headlines around the world. In 2023, his team was able to directly map the chronic pain signals for the first time in history. In more recent tests, the team used electrodes located in the brain to map the unique neuronal signature of the painful experience of each participant over thousands of hours. The result was the capacity, for the first time, to create an objective measure of the subjective pain experiences of an individual patient.

In a more recent and in progress test, the cards and electrodes were used to predict a burst of pain, which was followed by the delivery of a carefully calibrated electrical impulse – deep cerebral stimulation (DBS) to interrupt the pain, reducing or even elimination completely. Predict when the pain can occur, objectively measure its severity, then inhibit it quickly is in many ways the ultimate success.

The story of Ed Mowery concerns someone who uses this remarkable processing approach, but first of all a warning. It is not currently available, or even feasible, for general use, it cannot therefore deliver the dream of a cure for chronic pain. But do Provide evidence that pain circuits in the brain are measurable and malleable. It can be targeted and treated, and we will probably see the emergence of a range of approaches that can do it without cerebral surgery.

Extract from “It’t Dues Buth” by Sanjay Gupta, MD, published by Simon & Schuster in collaboration with AARP. Copyright © 2025 by Sanjay Gupta. Reprinted with the permission of Simon & Schuster, Inc. All rights reserved.

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