Episode description

Physical pain is a universal human experience. And for many of us, it’s a constant one. Roughly 20 percent of American adults — some 50 million people — suffer from a form of chronic pain. For some, that means having terrible days from time to time. For others, it means a life of constant suffering. Either way, the depth and scale of pain in our society is a massive problem.

But what if much of how we understand pain — and how to treat it — is wrong?

Rachel Zoffness is a pain psychologist at the University of California, San Francisco, School of Medicine and the author of “The Pain Management Workbook.” We tend to think of pain as a purely biomechanical phenomenon, a physical sensation rooted solely in the body. But her core argument is that pain is also produced by the mind and deeply influenced by social context. It’s a simple-sounding argument with vast implications not only for how we experience pain but also for how we treat it. She points to numerous underused tools — aside from pills and surgeries — that can help lessen our pain.

We discuss how pain serves as “the body’s warning signal”; how our mood, stress levels and social environment can amplify or dial down our pain levels; what phantom limb syndrome says about how the brain “makes pain”; how our emotions and trauma influence our pain levels; the crucial difference between “hurt” and “harm”; why studies on back pain have yielded such bewildering results; how to figure out and improve your personal “pain recipe”; the roots of our chronic pain crisis; how our health care system could be better set up to treat chronic pain; why Zoffness says, “If the brain can change, pain can change”; and more.

Mentioned:

“Sham Surgery in Orthopedics” by Adriaan Louw, Ina Diener, César Fernández-de-las-Peñas and Emilio J. Puentedura

Book Recommendations:

Why Zebras Don’t Get Ulcers by Robert M. Sapolsky

The Body Keeps the Score by Bessel van der Kolk

Pain by Patrick Wall

Thoughts? Guest suggestions? Email us at ezrakleinshow@nytimes.com.

You can find transcripts (posted midday) and more episodes of “The Ezra Klein Show” at nytimes.com/ezra-klein-podcast, and you can find Ezra on Twitter @ezraklein. Book recommendations from all our guests are listed at https://www.nytimes.com/article/ezra-klein-show-book-recs.

“The Ezra Klein Show” is produced by Emefa Agawu, Annie Galvin, Jeff Geld, Roge Karma and Kristin Lin. Fact-checking by Michelle Harris and Kate Sinclair. Mixing by Sonia Herrero and Isaac Jones. Original music by Isaac Jones. Audience strategy by Shannon Busta. The executive producer of New York Times Opinion Audio is Annie-Rose Strasser. Special thanks to Carole Sabouraud and Kristina Samulewski.

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