When neurosurgeon and journalist Sanjay Gupta decided to write a book about pain, it was out of curiosity rather than certainty. Most of his patients seek him for pain—headaches, back pain, neck pain—and he wanted to understand that experience better. His 2025 book, It Doesn’t Have to Hurt: Your Smart Guide to a Pain-Free Life, draws on recent pain science, clinical care, and conversations with researchers and clinicians. One notable finding: for some people with chronic pain, simply learning about how pain works can reduce their symptoms.
Gupta, who is also CNN’s chief medical correspondent, stresses that the brain is central to any pain experience. If the brain does not register pain, you do not feel it; conversely, the brain can create pain without an obvious physical cause, as with phantom limb pain. People differ widely in pain sensitivity, and even the same person can react differently at different times.
He illustrates this with a pair of patients—both named Joanna—who had similar problems and the same operation on the same day. One was up, dressed, and discharged the next day; the other was miserable. Small factors such as stress, sleep, nutrition, or weather can meaningfully change pain outcomes. “Things you don’t think matter can matter a whole lot when it comes to pain,” he says.
Chronic pain, typically defined as pain that persists at least three months, remains poorly understood. For some people it lasts decades, and why it becomes chronic for some but not others is largely unanswered. Biological, psychological, and social factors can all contribute, and nothing should be ruled out when searching for causes or solutions.
Among nonpharmacologic approaches, mindfulness-based therapies show promise. Gupta highlights Mindfulness-Oriented Recovery Enhancement (MORE), a structured program that trains people to shift attention away from pain toward pleasant experiences—sunsets, flowers, time with loved ones—so the pain’s intensity and “toxicity” lessen. The effectiveness of these interventions underscores how much pain is processed in the brain and how, to some degree, it can be influenced by attention and interpretation.
Gupta also points out a changing approach to treating acute injuries. The long-standing RICE model—rest, ice, compression, elevation—aims to suppress inflammation, but some evidence suggests early inflammation after injury may reduce the risk of chronic pain. That has encouraged a shift toward MEAT: movement, exercise, analgesia, and treatment—promoting early mobilization and appropriate pain control rather than immediately shutting down inflammation.
His practical takeaway: keep a broad menu of options. Pain is complex and individual, so a range of treatments increases the chance of finding something that helps. Nothing works for everyone, but something may work for almost anyone.
This interview has been edited for length and clarity. For more details and treatments, listen to the podcast episode of this interview. This story was edited by Malaka Gharib.