Dr. Sean Mackey

Who’s more sensitive to pain, men or women? The answer may surprise you. wapo.st/47CrdlV

Our latest paper @NatureComms reviews the relationships between sleep and pain. Research shows that poor sleep worsens pain; pain worsens sleep. Clear area for better understanding these relationships and improving care. (free download) nature.com/articles/s4385…

Just went live on The Drive with @PeterAttiaMD — we dive deep into the science and future of pain: what we know, what we get wrong, and what’s next.

🎧 Listen here: peterattiamd.com/seanmackey

#PainMedicine #PrecisionHealth #Neuroscience

This quote came from an interview, likely on the Huberman Lab Podcast (hubermanlab.com/episode/dr-sea…), where I was discussing the science of pain. Taken out of context, I understand it sounded dismissive or upsetting. We’ll do better to provide full context in the future.

Pain isn’t just signals from the body — those are nociception. Pain is how your brain interprets those signals. It’s a subjective, whole-person experience — and that’s what we treat.

In that interview, I explained the complexity of pain: how it begins as signals in the body, is shaped by processing in the spinal cord, and ultimately becomes the experience of pain in the brain.

Why does this matter? Because our treatments target different parts of this system. Take shoulder pain, for example:

NSAIDs (like ibuprofen or naproxen) act on inflammation in the shoulder, but also alter signaling in the spinal cord and brain.

Duloxetine, an FDA-approved treatment for some pain conditions, mainly affects the brain and brainstem.

Opioids do not act directly in the shoulder — they target spinal cord and brain circuits that process pain.

This framework also applies to physical rehabilitation, mind-body treatments, procedures, and more. The most effective approach often combines multiple treatments tailored to the person.

Understanding pain pathways is essential to developing safer, more effective treatments. That’s what drives our work. Our mission is to reduce pain and its impact — together, with you.

Did you know you can look up any physician to see if they've received payments from drug or medical device companies? The site is "Open Payments" (openpaymentsdata.cms.gov). It collects and publishes data on financial relationships between these companies and healthcare professionals, including payments for research, meals, travel, gifts, or speaking fees.

When controversy around opioids and pharmaceutical industry relationships arose over a decade ago, I chose to stop all consulting and financial relationships. As a result, my Open Payments reporting remains at $0 (see attached report).

I mention this because occasionally my opinions prompt accusations that I am financially influenced by industry entities. To clarify: I'm salaried by Stanford University, and I receive no additional personal compensation from federal research grants—they support research staff and project costs at Stanford.

Importantly, my decision isn't a critique of those who do engage in industry relationships. These collaborations can be valuable, helping to make products safer and more effective. I simply made a personal choice to avoid financial ties altogether.