Change Your Brain Every Day - "Everything You Know About Back Pain Is Wrong" – Dr. Jared Ament

Episode Date: March 9, 2026

Back pain is now one of the most common health problems in the modern world — but most people are treating it completely wrong. In this episode, Dr. Jared Ament breaks down what's really happening inside your spine, why so many people end up with chronic pain, and the everyday habits that are quietly damaging your back. From herniated discs and sciatica to posture, workouts, and when surgery is actually necessary, this conversation separates myths from medical reality.   You'll learn: The biggest mistake people make when back pain starts When pain is a warning sign — and when it isn't How to protect your spine as you age Practical strategies to stay pain-free and active long term   Whether you're an athlete, a desk worker, or someone tired of living with chronic discomfort, this episode gives you a clear roadmap to better spine health. Your back affects everything — movement, energy, sleep, even longevity. It's time to understand it. Use the code CHANGEYOURBRAIN20 at reveri.com for 20% off a yearly subscription. Thanks to our sponsors Amen Clinics: https://www.amenclinics.com BrainMD: https://brainmd.com Amen University: https://www.amenuniversity.com Change Your Brain Foundation: https://www.changeyourbrain.org Love & Logic: https://www.loveandlogic.com Follow Daniel Instagram: http://instagram.com/doc_amen TikTok: http://tiktok.com/@docamen Facebook: https://www.facebook.com/drdanielamen Follow Tana Instagram: http://instagram.com/tanaamen TikTok: http://tiktok.com/@tanaamen 📘 Get Dr. Daniel Amen's new book, "Change Your Brain, Change Your Pain" https://www.amazon.com/Change-Your-Brain-Pain-Emotional/dp/0063426706 📗 Get Tana Amen's book, "The Relentless Courage of a Scared Child" https://www.amazon.com/dp/1400220769/?bestFormat=true&k=the%20relentless%20courage%20of%20a%20scared%20child&ref_=nb_sb_ss_w_scx-ent-pd-bk-d_de_k0_1_18&crid=17LHPEFGKIT1S&sprefix=the%20relentless%20cou   

I truly believe too many people are getting operated on, and when they do get operated on, they're getting the wrong surgery. 40 years ago, when you had a bad hip or a bad knee, they put a rod through the knee, they put a rod through the hip, that joint is no longer functional. Why we're still doing that to the spine, to me, is acinine. Dr. Jared Amant is a board-certified neurosurgeon known as the anti-fusion doctor. He specializes in minimally invasive spine surgery designed to help patients avoid fusions and preserve their natural movement. Pain is a way for the body tongues is a problem. The spine needs muscular support to stay. whole we're all degenerate we're all getting older but you can slow that process down it's important to know when pain is guiding you to do something differently when it's okay to do something to

mask that pain but you can go down the rabbit hole and say oh my god i'm gonna just take pills the rest of my life and we have the opiate epidemic on our hands that's not an answer pain doesn't usually happen in isolation happens for a reason and it's important to understand it what are the biggest misconceptions patients have about back pain the biggest misconception is that Every day you are making your brain better or you are making it worse. Stay with us to learn how you can change your brain for the better every day. Your brain is your most valuable asset. It controls everything from your focus and memory to your mood and energy.

That's why I created Brain MD to give you science-backed supplements that support your brain so you can feel and perform your best every day. If you haven't tried them yet, go to BrainMD.com and use the code, podcast 20 for 20% off. Because when your brain works better, you work better. Welcome back. We are very excited today. We have a special guest, Dr. Jared D. Aymant.

He's a fellowship trained American board certified neurosurgeon, specializes in complex and minimally invasive brain and spine surgery using the latest technologies, including neuro-navigation, endoscopy, and robotics. He's also a fellow of the American College of Surgeons, and his practice focuses heavily on motion preservation. He's often referred to as the anti-fusion doctor. Want to hear more about that? He's also the first in the world to innovate and initiate the 360-degree arthroplasty trial, and when motion preservation is not feasible, he also specializes in the management of

degenerative spine diseases, brain and spine tumors, and facial and pain spasm syndromes. Dr. Oment has operated on many celebrities and professional athletes and is currently the principal investigator on several FDA clinical trials, researching to next generation of artificial disc and motion preservation technologies. So we're so excited to have you. So, and how we got introduced is I was saying, on Max Lugave's podcast, I have a new book, Change Your Brain, Change Your Pain. Yes.

And he said pain was in his brain, but also in his back. And when he saw you, he had done sort of all of the holistic healing things and they didn't work. And he has been in pain for 10 years. And he's like, you have to meet Jared. And then I got a call from Jack Domey, who used to be the CEO. of Hitachi in, you know, America. And I had done work with Jack, and Jack loves me.

And he goes, you have to meet Jared. And so we called and I invited you on the podcast. It's very nice to be here. So thank you. And our names, our last names are very, very similar. That was great. Right. It's Amen with a tea.

Amen with a tea. We may be related. And I've been thinking a lot about pain and how it, frightens people. It changes their life in a negative way. And back pain is no joke. It's miserable. I mean, it changes people's quality of life to a point that, I mean, we've seen some major adaptations that ruins people's lives. So share your journey. Share your journey into like wide neurosurgery and just let us get to know you. I like long walks on the beach. No. You know, people have asked me this before, and I don't really know how to pinpoint it other than there was one moment that my late grandmother used to say that she remembers babysitting when I was 10 or 11.

And somewhere along the way I had transitioned from, you know, the model cars or the model fighter planes that people put together in their kid and you can make them and build them and paint them. She remembers coming, I think she was babysitting. My parents were away. And she came to the room at like two in the morning. I was 10, two in the morning. And the light was on. And so she thought, I left it on, but she found me at my desk putting together a model of the brain. And somehow I had transitioned to that.

Where the curiosity and the intrigue came from after that, I'm not entirely sure. But I did know all along the way, even into undergrad and medical school, that neurophysiology fascinated me. I liked the abyss that was neurosurgery. It is the hardest, the most competitive, the most difficult. And it was one of those things, we didn't have all the answers. I mean, you could literally take someone's old heart out and put in a new one. And so we can't do that with the brain or the spine yet.

And I like challenges. Sometimes it's, people say, you know, neurosurgeons have God complexes. But what people don't realize is how humbling the profession can be when we really can't fix what we're hoping to be able to fix. And so that's kind of how the path started. and traditionally when you're operating on someone's back is the most common operation effusion operation? I think so. You know, statistically probably is there a lot less invasive operations regarding the spine that don't involve implants. Like someone hernia is a disc, you can do a little microdicectomy procedure, 30, 40 minutes,

just take out the disc pushing on the nerve, call it a day. But when it comes to implants and the bigger. surgeries and especially as the population is more and more active, aging better, living longer. There's a lot of degenerative disease. And at some point, a lot of, I don't know where this changed, but 30, 40 years ago, the industry pushed towards these rods and screws and they're not the stuff that you get at Home Depot, although it looks very similar. They're very fancy colored and coated in titanium and wonderful and MRI compatible now.

But it was always part of our training, you know. you were a trauma nurse, I mean, for neurosurgery, you saw brain and spine trauma. When the spine is severed in two, sure, that makes sense. You have to try to put it back together and secure it. But what didn't make sense to me was why we did that in cases where there wasn't instability. When the spine really wasn't unstable, it was just degenerative. And we felt that the degenerative changes, the arthritic changes were causing pain or neurologic problems. I did not understand the equation, why that plus that equals raw.

and screws and fixate. Like, you have a problem, and that problem is causing pain or a neurologic deficit. And somehow you go in there and take away all the compression on the nerves, you open everything up. And that's great. But what you're left with is kind of a blank space and a field. And the answer became fused because it was felt to be the safest thing to do. But rods and screws, you don't have to worry about it. The bone heals together. The nerves are safe. The spinal cord is safe. Yeah, that's not quite how it ends up most of the time. It's not. I mean, you know, neurosurgeons get a bad rap, spine surgeons in particular,

that, you know, surgery, especially back surgery, beget surgery, because it's like dominoes. It's like dominoes. No, no, my dad had it when he was 86, 87, and part of his foot was numb, and his foot was not numb, but it didn't help the backpick.

Yeah. And then I read... But many people have to have the disc above or the disc below, and then it's, I mean, the vertebra above and below. It's not... It's called adjacent segment disease. Right.

Well, then I read this study that completely changed the way I think about pain, which is, I'm 71. And 70% of people my age who have no pain at all have degenerative changes in their spine. And I'm like, okay, the MRI is what freaks people out. It's often what leads them to pain. Is there another way? Well, I always say, and this is really important, don't treat the picture, treat the patient. Now, in surgery, if there is a correlation between the picture and the patient, you usually have a better surgical result.

But often, you know, we'll see that people will come because something, you know, necessitated an image of a family doctor or someone said, we need to get this or that, and they get freaked out. And I think more surgery is being done than is necessary. And that's, you know, people always say surgeons are the hammer to the nail of the problem, right? But I truly believe too many people are getting operated on. And when they do get operated on, they're getting the wrong surgery. So you mentioned adjacent segment disease.

What is adjacent segment disease? When you, the idea of a fusion, I always use this analogy. I use it with Max Luguevares as well. And it's so, you know, a little bit redundant, but it's a good analogy. Shock absorbers on a car. If one shock absorber on the car blows and you put some duct tape around it or you put a strut and you hold it together, but it's not functioning like a normal shock absorber. What happens to the other shock absorbers in the car?

You can drive the car, but they wear out. They take its asymmetric stress on those shock absorbers. That's not how it was designed. Now, I don't know what you believe, whether it be God or nature, but the design of the spine was mobility, was movement. So when you remove that motion segment to treat a problem, you create abnormal stresses above and below it. And that's what propagates the problem.

That's why I think we're doing wrong. 40 years ago, when you had a bad hip or a bad knee, they did the same thing. They put a rod through the knee, they put a rod through the hip, got rid of pain, but it's not functional. That joint is no longer functional. So why we're still doing that to the spine, to me, is assonine. So what do you do instead? Well, the idea is motion preservation. If there's not frank instability, some major trauma, can we preserve motion?

And there are several ways to do it. But the most common one is what's called artificial disc replacement. So in front of the spine is the disc, like a shock absorber on the spine, for a car. And if we can remove, if the entire disc should be removed, because if it's a little herniation, like I talked about before, you can do a little, take the little herniation, leave the disc alone and you don't have to over-operate. But if there's enough degenerative changes, you can remove the remnant disc, especially when people are bone-on-bone, and you can put in a new disc that functions like a mechanical joint, almost exactly like a knee or a hip replacement.

Now, there are others. It's gotten even more advanced. We do something nowadays called the Tops procedure, which is an artificial facet replacement, which is the back part of the spine. Oh, interesting. And that was developed in Israel, which is close and dear to my heart. And so I have no financial interest in the company, which I did, but I don't have any interest in the company. But I have extreme interest in the science. And I was part of the original FDA trial as an investigator. So I have the luxury of seeing patients with seven or eight years of follow-up where this has really only been in the U.S. about two years. And it's incredible what these new technologies are now doing for people because artificial disc is a little bit more nuanced. This, the artificial facet literally treats patients

that only had fusion as an option. That was the only other option. Most of the time there's a little bit of a slip in the spine, not frankly unstable, but there's a slip, significant degenerate disease. The facets grow and become really arthritic and they push into the nerve canal. So when you see people as I get older and they're like, after 10 minutes, they call it a shopping car. sign. They have to lean over a shopping cart to relieve their foot or they have to take a break. Five minutes, then it becomes two minutes or it becomes less and less mobility. That's called neurogenic clotication, like cloticatory symptoms in the leg. It's very common to see people like that who've got these growing, gnarly looking facet joints in the back of their spine that push

into the nerves. In the past, getting rid of those facets makes the spine unstable. So when you have instability, you fuse. In this case, an artificial facet replacement allows us to decompress all the nerves, give people their mobility back without fusion. And so you take those facets off and then you replace them with this device. With the artificial. Correct. Yeah. Wow. I'm feeling like I need an appointment. Well, talk a little bit about your history. My back's a mess. We have a case. This is far of your life, right? We have that. We have that. We have a we have a real live patient. So I'm a mess.

I mean, I've been highly active my whole life, martial arts, CrossFit, the whole thing. And then I hurt myself pretty badly about five years ago. It was sort of a combination of things.

I had a hysterectomy, which weakened my core and didn't take the time off that I probably shouldn't, should have. And then went back and I felt something in my back. And I'm like,

well, I feel how many times from those sports, you know? But then I fell. And so it's sort of the three things, happened very close together and I don't know which one was the worst of it. But the bottom line is all of a sudden I couldn't walk up my stairs. I mean, I could not walk. I was just in tears. I've never

called pain that bad. So people I know that have back pain will tell you they've never had pain that bad in their life. So the next thing I know, I'm like crying, I can't walk up my stairs. We're looking for houses with elevators. Like I, it was bad. And so I go to the doctor and get an MRI and the facets are a mess. My disc at L2 at L2 is gone. He said it's crushed. It's just gone. And he said it's bone on bone.

And so he said he wanted to do a fusion. And I said, is fusion the only option? He said, yes, it's the only option. And he was going to put a cage. He's going to infuse it.

He's going to fuse it. Yeah, it's cage. But he's going to fuse it. When people say cage, it's like a, think it with like a wedge, the spacer. So he's going to fuse it.

But I'm like, but it's already bone on bone. I don't know. I didn't want to do it because I've seen so many of them go bad. Plus I have scoliosis. I had mild scoliosis, which I feel like is a little worse now. And I'm like, what's going to happen if I have scoliosis and you do this? I don't know.

Just in my head, I'm like I just had. It's worse. I felt like it was going to be worse. So I just didn't want to do it. So I've done everything that I have. A normal consult when we're done here. The table, we'll do an exam. It's perfect.

Yeah. So I had an epidural. And I've helped for months. No, it helped for probably a year and a half. Great. And, but in that year and a half, I really worked on getting my core strong. I started doing Pilates. I started doing just, I started very small.

But now I'm doing strength training, not CrossFit ever again, but I'm doing strength training. I'm doing Pilates. I'm walking. I couldn't walk for 15, 20 minutes. Yeah. So I mean, I love Pilates, by the way. Love Pilates.

I wanted to take two steps back because you said something that run true to me. Martial arts. Which martial art? So I have a black belt in Taekwondo and a black belt, a second degree black belt in Kempo karate. Very nice. So my first job was when I was 16 teaching martial arts. I had in Shodokan.

I grew up in a dojo. That was my life. And I got depressed when I had to give it up. Because you know that rush, that intensity, that there's no therapy like beating the heck out of big padded guys. There's just nothing like it. I know I grew up in a dojo. My sense was like my second father. Yes.

Yes. I grew up as a young kid. I started six. First job at 16. And I only really stopped training like that when I left for medical school. but I always kept training. So I was in Israel. I trained with the Israeli military

as part of their teaching unit. And so I continued it and it's a huge passion. But it's... So you understand. But I understand what it's like to not be able to do something like that. So I got really depressed because not just the...

It wasn't just the pain. The pain was bad and that made me depressed. And it wasn't just the feeling older because of the pain. That made me feel depressed. But giving up the things you love. Absolutely. And that just...

That still gets to me sometimes. So, I mean, I'm active now. So I'm okay. but it's hard. Adaptations can be good. They can also be extremely depressing. And one of the things, I mean, you and I had spoken when you asked me, what's my goal? My goal is trying to make people more aware.

So there's better choices so that you don't have to adapt so much that your quality of life, the things that give you joy, have to be changed. And so I always say people, I want to get you back to the highest functional quality of life possible, not a Band-Aid. Let's figure out a solution so you can do all the things you want to do. And patients always ask when they're doing well. They know there was another part of my story. I was a sommelier.

I was in the wine business before. I put myself through college by learning wine. But anyways, but they always know, somehow they find out or it's posts or something about my wine collection and all this stuff. And can I get you a bottle of wine? I said, you know what? The only thanks I ever would love to receive would be a picture of you doing something incredibly active or whatever it is that gives you that feeling that you had,

that we both had in martial arts. And it's true, because that, to me, is the greatest joy of what we're doing. Yeah. We're both, we're trying to help people. We're trying to make better decisions. Make people whole again. Make them feel whole again.

Yeah. Yeah, that makes sense. The best gift is to see them happy. Living. Doing what they love. What did the biggest misconceptions patients have about back pain? I think the biggest misconception is that,

you can bandaid the solution away, that you, that it, or that it happens in isolation, because people do talk to me a lot about how their back pain is affected the rest of their life, their work, their family life, their sexual health. And so the misconception is that it's sort of, you're in a silo and it's just back pain, but usually it affects much more than that. And then the other thing is that all these injections and things that people do, again, pain is a way that the body telling us there's a problem. I'm not saying more surgery. You're case, you know, Pilates core strengthening. The spine needs muscular support to stay whole, to degenerate slower. We all degenerate life. We're all getting older. But you can slow that process

down. And so I think that it's important to know when pain is guiding you to do something differently, when it's okay to do something to mask that pain. But I mean, we say masking pain, you can go down the rabbit hole and say, oh my God, I'm going to just take pills the rest of my life. And we have the opiate epidemic on our hands. Right? That's not. an answer. It's not, no. Right? And so even an injection, I think, is great to try if an injection, if we know structurally you're okay, structurally you're safe, you're not at risk of a neurologic injury because that's back pain can be, you're on the precipice of that. So I think an injection is fine to take down that inflammation to allow you to do things like Pilates and therapy and

rebuild the core. Yeah. So for me, I was doing it, I was only doing it as a temporary fix so that I could see, can I do, can I avoid surgery by getting strong? It wasn't for me to keep doing the injections. No, but that's a perfect example of what made sense. But there are some people that live in, they're so afraid of surgery or they can't do anything if they don't get their injection every six weeks. And again, on some levels, especially if you have so many comorbidities that you're not a good candidate for surgery, you should never consider surgery. You have high risk factors. Sure, you do everything you can. I just think it's very important we know that pain doesn't usually happen in isolation. It happens for a reason.

And it's important to understand it. And at what point, Tanna's the first person who turned me on to John Sarno's work. Okay. That pain often is repressed rage or it's repressed emotions. And there's one study I talk about in my new book where they looked at conservative treatment versus back surgery. Same outcome, 21 times. fewer side effects. And if 70% of people my age have abnormal backs who have no pain at all, and pain often gets stuck in the brain, in the circuitry of the brain where it's either the

feeling pathway or the suffering pathway or the calming pathway are not functioning right. I mean, I like the idea of, all right, let's get your brain as healthy as it can be and see. But as Max had said, he'd tried all those things. And the minimally invasive procedure, is that an accurate way to call it? Depends on the surgery. Not all the surgeries we do are minimally invasive. There may be more cutting edge or novel, but not necessarily minimally invasive. But if that surgery helped him and it helped.

Jack, it's like, oh, well, you have to pay attention. Yeah, because I think it depends on the injury. I mean, Sarno's work really helped me as far as managing my pain. It didn't change my injury. My injury was my injury, and you can't say that to someone who's a quadriplegic, who's right? Yeah, I think you have to be careful because those studies also, first of all, I know that study didn't look at motion preservation technology.

It looked at other back surgeries, which we've already kind of talked about and established as fundamentally flawed, in my opinion. But it's a little bit of the chicken versus the egg sort of situation because there are situations where I completely agree that you could have an okay looking spine, but the pain is out of proportion and a lot of that is brain health, brain mediated. Or it could be the reverse and you can have a real problem. Your foot stops working. You lose continents. You can't control your bowel or bladder function. This is a neurologic issue.

And this whole pathway then affects your brain's perception of quality of life. And we know that pain and stress and cortisol levels affect neuroplasticity and neurogenesis. So it can go either way. And I just think, again, my preference. And the more pain you're in, the more it activates those circuits in your brain. And that gets stuck. So it's like a cycle. So if you think of phantom limb pain.

I mean, obviously, it's not in your limb that's not there. It got stuck in the processing centers. But I will say that that work, where it helped me is my back injury was real. It's a real injury. But where the work helped me is I'm very tight. I mean, there's a reason I practice martial arts and CrossFit and not, you know, I wasn't doing yoga. It's because my brain is very intense and I'm just a very high, strong kind of person. That's where that work helped me.

It was getting that the intensity, like noticing how that was affecting my pain. That was affecting my pain and making my pain worse. So I can make my pain worse or I can make my pain better. As I preface the conversation, too much surgery is likely being done. And the goal for me, especially when talking to people like you, is if we're going to do the surgery, let's do it for the right reasons. Let's do the right one. So how do you, as a neurosurgeon, when you assess someone, go, okay, this person's likely to have a really good outcome and this person not so much? I mean, I can take you through like 18 years of figuring it out and training.

And I mean, I'm always evolving. And we're using the tools that we have to help. When I say that, I mean like AI and different algorithms and predictive models, which we didn't used to have. So part of it's just training and learning and figuring out, you know, part of it's the training. Part of it is anecdotal what you do in your practice. And you kind of grow from that.

I was very fortunate. I had mentors who are arguably the leaders, you know, and pioneers in motion preservation. So they allowed me to think outside the box. I think it's just a combination of good common sense, good training, and then objective tools and measures that we now have available and even more coming online, like AI. So for a lot of you have, you were mentioning in the introduction, the 360 trial that we started, this 360 trial, it's not about, you know, in the olden days, I was like, you, you put put a radiograph on a screen and you look at things.

Then it went to the digital computer and we start measuring things on the digital computer. And now I'm like, you know, you could put a line here and you measure it. It's three millimeters or someone can take two millimeters. It's too subjective. It's too inaccurate. And so now we have anybody who's enrolled in our trial, their images gets fed into this AI algorithm. So it's objective.

It's the same AI tool being used over and over and over and over again in learning. But at least we know that we're not the ones making these measurements. And that's helping us with predictive analytics to say these. patients are better candidates versus not. So it's, I mean, you have to be open to using these tools. There are people that are just very set on their ways and they're not. And that's why they keep putting rods and screws in the back. I mean, on my, on Instagram, I, you know, the anti-fusion doctor, but I always say,

all my hashtags, I say for a reason. That's not marketing. I don't make money off of it. It's what I feel is stop the, hashtag stop the madness. Hashtag, motion preservation surgery. Because it doesn't make sense in nine out of ten cases. And in the, God forbid, the one case of a bad car accident with the spine, severed, yes, it makes sense. I still fuse in those cases. So interesting. I don't know why it didn't

make sense to you even intuitively, right? Because you're a martial artist. Just, yeah, it's because you're martial artist. Nothing about it made sense to me. So I have a thing for martial artist. It's because you're a martial artist. It's because you were a martial artist. We speak a different language. So I tried to get him into it. It was a me funny story. I tried to get him, I'm like, we need to do something together. So he's very yin and Barry Yang. Like we balance each other out. Sure. Let's do something together. So I get him to go with me and he got through his first belt test and we were in New York and he's like, I'm not going to go back. And I'm like, why? And he goes, because I just realized I'm walking down the street thinking,

I know how to break that guy's arm. I'm like, I know, right? You can break his neck too. He's like, no. Knowing doesn't mean you have to do. It's the same as in surgery. Just because you can do something. Right. You should. What if the key to overcoming your pain isn't just in your body, but in your brain. My new book, Change Your Brain, Change Your Pain, offers strategies I've used with thousands of patients to break free from physical and emotional pain and reclaim focus, energy, and peace. Healing is possible, and it starts with your brain. Pre-order my new book now and receive special bonus gifts that change your brain, change your pain book, I was named after my grandfather, and he was my best friend growing up, and he was the kindest person.

That's you. And, yeah, I got, I didn't get my business sense from, I got that from my father, who was not kind. You want to hear something even crazier? My middle name is Daniel. Oh, that's so funny. So if you look at our names, we spelled it out. That is funny. It's really, really funny.

what are some of the most practical things you can tell people from your experience, helping them manage their pain? I think Tanna mentioned some of the things. I mean, there's often many ways. It's often multifaceted. And the first important step is one diagnosing the source of the problem. If possible, diagnose the source of the pain. Secondarily, figure out if it's a pain due to,

arthritis, degenerative things that don't put you at risk for neurologic dysfunction. Because if you can take that off the table, like in your case, take it off the table. Then I would say, then you have, the world is your oyster. And I would say, pain's coming from somewhere, coming for a reason, but it's not necessarily dangerous at the moment. So therefore, if it's not dangerous, I can do things like. That's the practical approach. The corral area is if we go down that, you know, diagnostic pathway and they say there is

impending risk here and we have to be cognizant of it, then that's something we have to either intervene or monitor more closely. So practically speaking, it's those two pathways. And then if you pick the pathway of conservative care because you can and it's safe to do so, then we mentioned some already, but there's a plethora of things that are available. I mean, Max talked about it, you know, in his book, on his show, you know, there are a lot of things. I mean, people, I just have a patient tomorrow, also very big online presence. And she's talking about exosomes and stings. And stem cells and traveling to a different country. Mark Hyman talks about, you know, his...

Oh, I've done all of that. His fiasco going down to Mexico and, you know, stem cells and everything happened, and then a major infection in his spine. There are certain things that you can do that are... I didn't love that about Mark. Mark and I wrote a book together. Oh, Mark.

The Daniel plant. And so Mark Hyman talks about it. Yeah, I've been so disappointed in stem cells. The exosomes actually helped me a little bit. Exosomes are good. But doing the whole big, you know, expensive stem cell thing, I was very hopeful. It didn't really work. The stem cell, I've been disappointed as well.

I think stem cell technology is coming. I think it's just not here yet and to the level we want. I have seen people that have had some interesting relief with amniotic or placental grafting and some neuroregenesis, but the truth of the matter is a lot of the times these stem cells that we're injecting, we just don't know what they do. We think they're going to be like PRP that you take from your own body and put into a joint and it's lubricating, but stem cells in PRP are different. And stem cells, unfortunately, can sometimes have a mind of their own. And we have not figured out a good way to control, hey, you stem cell, please regrow this person's disc for me, because that would be cutting edge

and that would be amazing. We don't have that ability. I have taken care of patients who went somewhere, got stem cells injected. The stem cells wreaked havoc on their spine, just eight up parts of the spine. And we had to reconstruct the entire, with rods and screws, have to reconstruct the entire spine. Now, I'm not bashing them because I think there'll be a time we'll have more scientific capabilities around that technology,

but it's just not here yet. Spine health is central to overall health. But people don't think about that. So how do they take care of their spines? They don't. Yeah, it's interesting. I mean, people don't think, like I often say,

nobody really cares about their brain because you can't see it. You can see the wrinkles in your skin or the fat around your belly. You do something when you're unhappy with it, because most people never look at their brain, they don't care. And I think that's even more so true for the spine. I mean, when I take care of athletes, it's always fascinating to me that they walk into the office

and they look like an incredible Hulk. And you take a picture of their brain and they've got lesions everywhere. Spine looks like a 90-year-old, you know, grandmother's spine with complete arthritic changes. Look, plastic surgeon, have a better sales pitch than we do because they're dealing with things that people see. And it's hard for us to say, we want to help. We want to, you know, this is important for your overall neurological health.

You know, and I always tell people, back, you mentioned back pain and what's the global picture and spine health and overhealth. I mean, there are so many things that how your brain, your spine's like the highway, right, for information to go back and forth, tune from the brain for the rest of the body. If you don't take care of that highway. Yes. So how would people take care of? stretching, strength training.

One of the most, people always say core, right? Core exercises, but people think that means going to the gym and doing a bunch of crunches. That's not true. Core actually means the musculature, like the multifidus, longissimus, QLs, the muscles around the spine. Not the pretty stuff we see on the exterior, but actually the stuff that when I go in and I'm operating, we're actually looking, dissecting, being very meticulous about putting back together, not cutting through.

So those are the things. Those are the core that's required. And so it's much more involved. Isn't it true that a lot of people who are ripped don't actually have strength in some of those. They don't have a core. They're ripped because they're working on all the things that will make them look ripped.

Right. But the core, you see all the, with the A-PAC and all these things, but they go to one Pilates class and they're dying. Right. So that was sort of, I was really into that when I was younger, but I don't think I had a strong core. And this is not a huge, I mean, I'm a big proponent of Pilates, but you know, why do I put people to Pilates?

Because it's one of those things that really works on core. when we do with a lot of adolescents with scoliosis, one of the best things I put them in very early is Pilates because it works on the central core around the spine. The spine needs muscular support to remain strong and intact and stable. And when the spine is and moving and mobility, that's hence motion preservation pitch that I'm giving, because when you have mobility in the spine

and strength in those movements, then you have a slower degenerative process. Now, like all of us, we're fighting genetics. There are some people that are genetically predisposed to accelerated arthritic conditions or things like ankylospondylitis, dish diffuse adepathic skeletal hypersosis. There are certain things that life is unfair and we have to deal with, you know, what we're dealt, what we're given and we deal with it. But in general, there are a lot of healthy ways to keep our spine better longer.

Yeah, well, one of our kids actually said, If you could give me any advice, what would you give me? I'm like, well, besides all the normal advice that we give our kids, protect your spine and your joints. Protect your spine and your joints. Like, we already talk about the brain all the time, but it's like, no one thinks about it. And I'm like, after being hurt, if you want something to age you really fast, hurt your joints and especially your spine. Absolutely. So some exercises for the kind of core you're talking about.

Yeah, sure. So, you know, I always tell people compound exercises. So the movements that are not just one isolating certain areas. Like functional. Functional compound movements where you're balancing or doing a plank but lifting one leg in the air and you're alternating. Those are the type of movements that are better for internal core strengthening. So I like an ab roller because I feel like I'm working my back, my chest, my... At the end of the day, something's better than nothing.

I mean, but look, and I talked to Max at length about this, it's not just the exercises. I think, you know, Max is onto something when it comes to his, you know, healthy eating, you know. Anti-inflammatory. This is not a, I mean, people joke about it. There's a lot of influencers online. There's all these products out there. But the truth of the matter is, especially in the Western diet, and again, this is, I've learned a lot from Max. And it's funny how he became my patient and friend.

And we just celebrate our one-year anniversary together. And we had a cigar. It's like the worst thing we could have been doing together. But it was funny. But we enjoy it. Don't get me started. I'm lying. No, no.

Celebrating with ways to hurt you. Exactly. But it's important because. we know that the spine and the brain can go under significant oxidative stress and inflammatory stress, and some of that comes from what we eat. So healthy eating, avoiding ultra-processed foods, all of that really matters. Inflammation is a cornerstone of disease. So here's a great point that people don't realize.

When you eat poorly or you have pain or something's bothering you or you're, or you're stressed at work, all of these signals in some way can affect the HPA access, right? So your cortisol, your cortisol levels go up. What happens when your cortisol levels go up? I mean, in the short run, it's actually good for you. Fight or flight, it's great for adaptation. Right. Right.

Memory consolidation is actually really good. But the data is very clear that over two weeks of elevated cortisol levels in the brain and the spine causes a reduction in BD and F, right? Brain-derived neurotropic factor. and that can happen from eating poorly. Right. Right. You can actually see hypercortosillemia and reduce BDNF in the brain and the spine.

What does that do? It causes structural deterioration. Isn't that interesting? Of the spine and the brain. But the flip side of that is an anti-inflammatory diet and moderate exercise help to boost BDNF, right? Correct. So it keeps your brain younger. And the spine.

People don't, people talk a lot about the brain health and don't get me wrong. I'm a neurosurgeon. I still operate in the brain health. brain, brain health is critical, but why does BDNAF and why do those signaling pathways matter for the spine, the highway, right? They'll go back and forth to and from the brain to the rest of the body, is because there are still structural things in the spine like microglia or oligodendrocytes. Oligendrocytes are required to produce myelin, right, to have transmission in the sheath in white matter sheets. And those things become structurally incompetent or deteriorate when you have

high inflammatory stresses. That come, again, diet can cause that, good or bad. Pain, good or bad. Both of those factors. Not sleeping. Sleep. But if you're in pain, you don't sleep well. And then people start with sleeping. The pillows.

I've been through 80 pillows as well. We've all gone through it. He's like, where are you in there? It's like a fort every night. My wife is the same way. It's unbelievable. But I've got my lumber pillow. I've got my, like, my wedgions.

I'm trying to not take this personally that you're creating a major bear. carrier. Tell us a story that has inspired you the most. Well, this isn't recent, but I can tell you during some of the hardest times in residency during training as a neurosurgeon, which is not the easiest thing to get through. We often joked in the trenches that it was like the Navy Seals of Medicine. Yeah. I mean, I witnessed it. 30, 40 hours shifts. Literally would, I witnessed two neurosurgeons collapse on the floor. This was back before they put the regulations in for the 80 hours I was before their 80 hours too. And then when they put the 80 hours in, the only exception was to neurosurgery.

Right. And so we were, I was 40 pounds overweight eating whatever on the go from the nursing station. I blamed you guys. Yeah, they feed us. If you were nice. If you were nice, they'd feed us and we were on the go. If you weren't nice, we were going to wake you up in the middle of the night. Yes.

For coli sort of. See, she gets it. Or Tylenol. Yeah, exactly. But. Why are you looking to me like that? That's how we, that's how we were nice to us. That's how it was.

I was always nice to nurses. I figured that out at her own. Yes. During the hardest of times, I do remember, and it's interesting because I didn't really go into this subspecialty of neurosurgery, but it was a functional neurosurgery case where the patient suffered from essential tremor. And I think she was a musician. It may have been a different case, but the test that we were doing in the, and this is a live,

awake brain surgery. I'm using microscopic electrodes deep into the brain. And her hand was shaking and she couldn't drink a cup of water. And that was what we were doing. We were giving her a cup of water. And I just remember a moment during residency, we're all exhausted. None of us want to be there. In these cases for residents tend to be pretty boring.

It's not open brain surgery. It's all microscopic. You can't see anything. We're like, come we please go home. And if you say that, of course, you're kicked out and not back. And I remember they did the, we implanted the electrode. and they turned it on. Yep.

And she did this and drank the water and started to cry. It's the coolest thing ever. And the entire OAR started to cry. And at that moment, it didn't matter how tired we were, we knew why we were there, what we were learning to be able to do to help people. It is so cool. So I worked from Medtronic for a while.

Yeah. And that was my therapy, was deep brain stimulation. It was just the coolest thing. Yeah. And now, I mean, now they're doing it with ultrasound and it's an incredible kind of evolution. but the ability to affect someone's quality of life. While they're in surgery, while they're actually.

It was a sort of monumental shift because it went from being, why the heck are we here at the moment to an aha moment. Yeah, it's pretty awesome. Yeah. I had one of those cases where I thought she had Alzheimer's disease because she almost burned down her house. And then I scanned her and I'm like, she doesn't have the pattern. Her emotional brand was way too busy.

You could see the inflammation. her thalamus and her basal ganglia and put her on well butron and within three weeks she's teaching cooking classes on the ward i mean it's like the movie awakenings yeah she just woke up but you know that's interesting because you know neuropsychiatric disorders there's some crossover here because when you talk about pain you talk about HP access cortisol we also know that extended cortisol extended pain and pain is mediated through like ventromed medial ventral lateral part of the thalamus and then branches out, we know that you can actually see changes, early dementia, increased tau proteins with prolonged elevated cortisol levels. And so there is

a crossover here in terms of the neurosurgery psychiatry, neuropsychiatry, because pain, hypercordidolemia can cause neuropsychiatric problems as well. Yeah, and Sarno's idea of repressed rage causes tension and that increased muscle tension increases pain. You're not going to lie,

I do love rage journaling. That's not what? I love rage journaling. Yeah, I have found it so helpful. We have a niece. We have a niece who had complex regional pain center which is a disaster.

It was terrible. I've seen that. If you looked at her brain, it's on fire. One of the hardest things we have to deal with. Oh, my God. Learning not to be afraid of the pain. And Simbalta was just transformational for her.

Now she's on the track team. She's running. Yeah, she was one of the good cases. Well, when we're done here off the record, I'm going to pick your brain a little bit about CRPS because it was pretty rough. It is, I think all surgeons secretly are very afraid. It's terrifying. Because when we intervene and that happens,

we feel very paralyzed, no pun intended, about what we can do next for this patient. Yeah. Because there's like, I mean, people have pain management and ketamine boot camps and all these things. It was pretty scary. Yeah. We didn't think she's going to get better. Yeah. That doesn't surprise me.

What advice would you give to other doctors who want to push the boundaries of traditional practice and adopt newer evidence-based methods, having been brutal. I was what to say. Likewise. Look, as you know, we become a little bit of a target. I would say make sure you've got lizard skin, you know, thick, thick skin. Don't be afraid. Just be prepared. I'm still a target. I mean, this 360 arthroplasty trial that I'm running, you know, there are groups that think I'm at the cutting edge of the next coming of spine surgery. And there are groups of Bleeding edge too. Yeah, I think I am absolutely crazy.

And, you know, I just, I'm going to, along those lines, I want to tell a quick story. A shout out to one of my mentors, Dr. Pat Johnson, who's very famous cowboy neurosurgeon at Cedars. And I trained with him. I still work with him. I met him. Yeah. At Dr. Phylls. Yeah.

Yeah. Yes. So I know the relation there. And so I was his fellow and we still do research together. We still get together for dinner. and he was a very important mentor. And we were at a conference together. And this kind of goes along with your questions.

We were at a conference together and there was maybe, I don't know, 1,000, 2,000 neurosurgeons, just neurosurgeons, not spine only, just neurosurgeons in the room. And I got up and gave a talk presenting our early results on this. And people were like, this is crazy. You are nuts. You're hoping yourself up to liability. And I said, okay, but thank you for the feedback.

I mean, this, and then, interestingly, Pat Johnson was talking next. And he got up. And you've met him. He's quite the character. And he says, you know, I know we're on a clock, but I'm Pat, this is what he says. I'm Pat Johnson. So I'm going to take the liberty to stop this right now. And I, and the moderators are looking at what is going on, right? We have people to. He's like, no, no, sorry, we're taking a break. And he says, I want to ask the audience a question. Because, you know, Jared was my, fellow. And while I think that he's on the cutting edge and he pushes the limits, I actually applaud him for what he's doing. But I want to just, I want to canvas the audience. How many people in this room do this type of surgery that he's talking about? Five percent put up the hand.

He said, okay. If you were the patient, how many people would consider it? 95% put up their hand. And I was a little, I was touched. I was a little emotional because Pat Johnson doesn't always go out on a limb for someone. And he did for me at that moment. But it also showed something that there's this disconnect between what you're trying to accomplish and what the convention is and what the standards are. And so for someone who wants to kind of be at the cutting edge, just understand that. And if you truly believe in it, you're doing it ethically. You're doing it the right way. You want to do right by people. It doesn't mean you're not going to be a target. So like I said, just you're absolutely going to be a target. And that's normal.

Normal. So that's the thing to remember. Have you read Thomas Cune's book? Oh, you should. No. It's called The Structure of Scientific Revolution. It was written in 1962. Dr. Cune is a medical historian.

And he talks about the six stages of scientific revolution. And the first one's normal science, fusion, in this case. The second stage is somebody notices a problem. The outcomes aren't quite what they should be. The third stage is the status quo to protect the money. They see the problem too, but they make small incremental changes. So as a psychiatrist, we have six versions of the DSM. And DSM-5 is virtually the same as three.

It really hasn't involved in 45 years. It's the same document. Like, stop it. So interesting. The fourth stage is somebody comes up with a new mousetrap. So looking at the brain in my case or a new way to do surgery in your case. And stage five is the most consistent of all the stages. It's the rejection.

And it's brutal. And it was Max Planck, the Nobel Prize winning physicist said, new progress in science happens through funerals. It doesn't happen because people see the light. It's because people die. And the new generation grows up wanting something more effective. So we're falling on the sword for everyone else. Stage six is the acceptance. And I would argue, you're already between five and six. And so, you know, I mean, I have to survive. You have to live long enough to see the new generation.

And you see, if I would have known that early on when people were calling me a snake oil salesman, even though snake oil is 23% omega-3 fatty acids, just saying. When it used to hurt my feelings, it's now I just don't pay attention to them. It's like, well, if you're not looking at the brain and you think you can do this by just talking to people, God bless you. You're stupid. Yeah. Trying to get better at paying less attention. But I'm doing, look, I'm trying to do it.

I'm still young. Yeah. I'm trying to do it right. And it's just, no, it's normal. And you do what works. And one of his players, one of his NFL players, so they only go after the guy with the ball. Yes. Yeah. Makes sense.

So. That makes sense. Anyways, we've enjoyed this very much. What else do you think people should know? Like, you know, what I'm taken away from this is. is there are a number of things I should look into before I just do a fusion that my surgeon recommended.

Well, and when I'm taking weight in this is I've always known, I may not get out of having surgery, but there are other options to fusion that are probably going to be more effective for me. Yeah. So because I just, that was a hard know for me, just knowing what I know. So that's actually exciting for me to know that when I get to that point, when I know that I'm starting to lose function.

Because I do. I wake up in the middle of night sometimes have to stand up because my foot is starting to, you know, cramp up. Okay. So now maybe I won't be so scared. Yeah. I mean, surgery is not always the answer. And I'm really not saying that. And I think you guys know it's really just about knowing there are other options.

And sometimes there are better options that just aren't as accepted for a variety of reasons. I mean, the crazy thing also is, even around artificial disc technology, especially in the lumbar spine, And someone said to me, insurance companies love this. They're also money driven, right? It's experimental still. I said, you know, we have 20 years of data, some randomized controlled trials included, with over 1,000 peer-reviewed publications. And you guys are calling this experimental, but you'll let me fuse a person's entire spine together and pay for that.

Do you know how many things in medicine we do with less data, quote-unquote experimental or off-label or what? But so there are some, I think, nefarious kind of insidious factors going on here that I'm not privy to. And so it's frustrating, but I think thankfully, we'll continue to push and hopefully prevail. We'll push. Yeah, we'll push. How can people find out more about you, your practice? Where can they follow you online? Yeah.

I'm online. So Dr. Jared Amant. to A. M-E-N-T. At Dr. Jared Ahmed for Instagram. My office, my practice with my partner, Amir Vokshur, who's also another cutting-edge, amazing person who's helped me, who's given me the support to kind of do what I do. It's called NSG, Neurosurgery and Spine Group. We have an office in Santa Monica.

We have an office in the Valley. The website is www. nsg-la-la.com. But, yeah, I mean, you can reach. I try really hard to answer anyone who reaches out online and give them some personal feedback. It's hard to give medical advice online. I try very hard not to do that. But I will certainly always try to help guide people

and along the path to making better decisions around their brain and spine health. People come to Amen clinics from all over the world for answers with 11 clinics and major hubs. Atlanta, Chicago, Dallas, D.C., L.A., Miami, New York, Orange County, Seattle, San Francisco, and Scottsdale. Expert brain care is closer than you think.

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