What Medicine Gets Wrong About Pain with Dr. Rachel Zoffness

Dr. Rachel Zoffness is a pain psychologist and assistant clinical professor at UCSF and Stanford, and she came on to do something I desperately needed, explain what I actually did not learn in medical school about pain, which turns out to be most of it. The thing I absorbed is apparently what 96% of medical schools teach as their entire compulsory pain curriculum, and it's missing about two-thirds of the actual story because pain is not made in your skin, it's constructed by your brain, which means it is always biopsychosocial: biological inputs, psychological inputs, and social inputs, and you cannot treat chronic pain by ignoring any of them.

We go through the tale of two nails, why Usain Bolt's S-curved spine and unequal leg length are a really compelling argument against doing back surgery before you've exhausted every other option, how loneliness chemically amplifies pain the way social connection suppresses it, what central sensitization actually is and why chronic pain patients are not imagining anything, and how "pain as the fifth vital sign" was literally a big pharma campaign to sell OxyContin that caused enormous damage to how medicine prescribes opioids. Kristin also gets a professional consult on being a Highly Sensitive Person, which Rachel frames as being a more accurate seismograph than other people.

Takeaways:

• A nociceptor is not a pain receptor
• The "tale of two nails" proves that hurt and harm are not the same thing
• Chronic pain is a disease of the central nervous system
• Loneliness is a direct pain amplifier
• "Pain is the fifth vital sign" was a big pharma invention

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The Zoffness Team

Pain Science and Education

Tell Me Where It Hurts

zoffness.com

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