Back pain during Pregnancy. Possible causes and treatments

A pregnant woman is more at risk to develop back pain

Naturally, as a woman gets pregnant her body starts gaining weight and experience changes that may result in back pain.

We will list five common causes for such pains and what can be done to improve the quality of life during those 9 precious months where women have to cope with so many life changes happening at the same time.

1- Extra weight accumulated during pregnancy is added to the spine. This extra weight causes extra strain on the spine.

2- Posture adaptation. As a result of the rapid local accumulation of weight, a posture deformation occurs to compensate for the new center of gravity of the body. Such shift causes back pain.

3- Release of the hormone Relaxin. This hormone once released loosens the spine which can be a cause of pain.

4 Stress affects everything believe it or not, including your spine.

5- Physical Changes in the uterus cause muscle interactions that cause pain.

The pain usually gets better before giving birth.

If you are looking for ways to ease the pain during these precious months, here are a few tips that can help:

1- Swim or just exercise as much as possible. It will help greatly.

2- Exercise to improve your posture. We recommend the McKenzie method among others

3- Get plenty of rest and avoid sleeping on your back

4- Shoes are important. High heels will not help

5- Compresses applied locally can help ease your pain. Use both hot and cold.

6- Meditate to release your stress and if meditation is not enough you can see a therapist. They are qualified to help you.

7- Chiro or physiotherapists may help improve your posture.

8- If the pain is serious and persistent, call your doctor.

Call our office for more information, our staff is always available to help you.

What is intermittent fasting

Neurosurgery Associates intermittent fasting

Weight control is something that most people struggle with at one point or another.

If you follow trending diets, you have probably heard about a plethora of them. Namely:

Low-carbohydrate diets such as Atkins, Duncan and South Beach.

Low-fat diets such as McDowell’s starch diet.

Crash diets such as the Beverly Hills Diet.
Detox Diets such as juice fasting.

And the low calories diets such as Nutrisystem and Weight Watchers.

The intermittent fasting diet belongs to the low calories type but the focus is more on WHEN to eat over WHAT to eat.

Neurosurgery Associates blog pictures

There are several diets that fall within the intermittent fasting branch.

However, we will focus on the 5:2 method in this article.

The method gained popularity in 2012 following to the BBC article named ‘The Power of intermittent fasting’.

And you can also watch the documentary ‘Eat, Fast and live longer’.

intermittent fasting

So what exactly is the 5:2 fasting program?

As the name suggests, for 5 days in a given week, you can have your normal calories intake and then fast for two NON-CONSECUTIVE DAYS. And during those fasting days, you can still eat one meal that consists of a maximum of 600 calories.
Track your weight and avoid endurance sports during diet days.

What is particularly interesting about intermittent fasting, is that it decreases fat while maintaining muscle mass.

A study that was published in the Journal of Translational Medicine in 2016 showed promising results

‘After 8 weeks, the 2 Way ANOVA (Time * Diet interaction) showed a decrease in fat mass in TRF compared to ND (p = 0.0448), while fat-free mass, muscle area of the arm and thigh, and maximal strength were maintained in both groups. Testosterone and insulin-like growth factor 1 decreased significantly in TRF, with no changes in ND (p = 0.0476; p = 0.0397). Adiponectin increased (p = 0.0000) in TRF while total leptin decreased (p = 0.0001), although not when adjusted for fat mass. Triiodothyronine decreased in TRF, but no significant changes were detected in thyroid-stimulating hormone, total cholesterol, high-density lipoprotein, low-density lipoprotein, or triglycerides. Resting energy expenditure was unchanged, but a significant decrease in respiratory ratio was observed in the TRF group.’

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Cervical Fusion versus Disc Replacement Surgery

Chronic neck and back pain can lead to serious health problems if they remain untreated.
When patients come to us with neck and back pain, we often discover through MRI that they suffer from
a herniated disc.

After screening the patients, we typically start with non-operative methods to relieve the suffering and
improve their posture. Such treatments include but are not limited to: physical therapy, rest,
medication, braces, and spinal injections.

When such non-operative methods are not enough to improve the health of our patients, fortunately
we can operate on the spine to improve their condition.
Two main surgical procedures are available to us.
Cervical fusion as a surgery has been used for decades. It is tested and true. It can improve patients’
quality of lives in little time.
More recently, we started offering a disc replacement surgery. Which is the latest cutting-edge
technology in treating herniated discs.
Some of the advantages of a disc replacement are there is less chance of future damage to the spine near
the herniated disc that has been repaired/replaced.
In this video, Dr. Joseph Shehadi Neurosurgeon at Neurosurgery Associates in Columbus Ohio took the
initiative of educating us on the different techniques used in treating the spine. Both nonoperative and
operative measures, as well as their particularities. All in about a minute.

He sheds light on the main differences between cervical fusion and a disc replacement surgery.
He will be providing more educative videos that address the fascinating world of neurosurgery.

You can ask Dr. Shehadi questions by contacting him at his office or by using the contact page.

Dr. Joseph Shehadi also provides non surgical options like Regenerative Medicine and Stem Cell Therapies. To learn more, visit the Phenicell Regenerative Institute.

A lot of good information can be found on our blog. Make sure that you read all of our postings and let us know if you have any topic suggestions.

Adult Vs Pediatric Neurosurgeon. What are the differences?

At Neurosurgery Associates, patients often ask us about the main differences between an adult and a pediatric neurosurgeon.
In this short video, Dr. Joseph Shehadi, neurosurgeon specialized in the treatment of adults, tackles the subject.


He notes three major differences:
1- Patient age group.
2- Problems treated.
3- Studies and training.


1- An adult neurosurgeon will treat patients from the age of 16 years old and over, whereas a pediatric neurosurgeon takes care of patients from birth until the age of 15.

2 -Pediatric neurosurgeons take care of congenital birth defects. Some of the most common defects are:
Craniosynostosis: a birth defect in which one or more of the fibrous joints between the bones of an infant’s skull, prematurely fuses by turning into bone, thereby changing the growth pattern of the skull.
Spina Bifida also known as Myelomeningocele: a type of birth defect where the spinal column and spinal cord do not develop properly.

Adult neurosurgeons on the other hand, take care of problems that develop and occur slowly over time. Some of the most common diseases are:
Cervical degenerative disc disease: develops when one or more of the cushioning discs in the cervical spine starts to break down due to wear and tear.
Lumbar degenerative disc disease: a syndrome in which age-related wear and tear on a spinal disc causes low back pain.
Herniated discs: a problem with one of the rubbery cushions (disks) between the individual bones (vertebrae).
Spine fractures: aka compression fracture is a vertebral bone in the spine that has decreased at least 15 to 20% in height due to fracture.
Cervical or Lumbar spinal stenosis: is a narrowing of the spaces within the spine, which can put pressure on the nerves that travel through the spine.

3-Pediatric Neurosurgeons do a pediatric neurosurgical fellowship at a children’s hospital. Whereas an adult neurosurgeon has other options, such as, neuro oncology, neuro vascular or functional neurosurgery.
Dr. Joseph Shehadi chose to do neuro surgical oncology fellowship at MD Anderson Cancer Center in Houston Texas, so that he can treat patients with brain and spine tumors.
You can ask Dr. Shehadi questions by contacting him at his office or by using the contact page.

A Promising Molecule may reverse Brain Damage

There may now be a new treatment to help patients who have suffered a traumatic brain injury (TBI) or a neurological disorder.

The key to this process is a brain molecule called N-acetylaspartate (NAA), also known as the “Antifreeze” molecule, which acts on proteins that are associated with neurological problems and decline in cognitive ability.

When the brain has suffered an injury or disease, levels of NAA decrease. This lowered concentration of NAA allows amyloid-beta fibrils (ABF) to clump together, forming harmful amyloid plaques.

According to a study* by Perelman School of Medicine at the University of Pennsylvania, the addition of the amino acid NAA after a brain trauma serves as an “anti-freeze”: it pauses the clumping of the amyloid-beta fibrils (ABF).

By restoring NAA to normal levels, it was possible to “block progression of amyloid pathologies.” The study also found that adding NAA may even reverse this clumping process.

These findings have important implications for the future treatment of both brain injuries and neurological disorders

If you are experiencing symptoms of CTS or if you are suffering from any brain or spine related disorder or injury and live in the Columbus, Ohio area, contact us today to schedule your appointment with Dr. Shehadi.

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* Journal of Neurotrauma
J Neurotrauma. 2010 Jan; 27(1): 293–298.
doi: 10.1089/neu.2009.0994
PMCID: PMC2824219
PMID: 19803785
Metabolic Acetate Therapy for the Treatment of Traumatic Brain Injury
Peethambaran Arun,1 Prasanth S. Ariyannur, John R. Moffett,1 Guoqiang Xing, Kristen Hamilton, Neil E. Grunberg, John A. Ives, and Aryan M.A. Namboodiricorresponding author
Link to the study:

Overview of Neck Injuries

Neck Injury Overview, By Dr. Shehadi

Neck injuries are unfortunately very, very common.

They occur both in auto accidents as well as in sports injuries.

The management or treatment of a neck injury usually has four components:

Number one is rest, number two is anti-inflammatory painkillers, number three is to get an MRI of the cervical spine which helps to identify ligamentous injury and or traumatic herniated discs.

The fourth component is the usage of a hard-cervical collar for stability and comfort.

We use the best brand on the market and it is adjustable so it’s one size fits all and we can distribute them here in our office.

Fortunately, neck injuries in general, rarely ever need to have surgery.

If you are experiencing neck pain or if you are suffering from any brain or spine related disorder or injury and live in the Columbus, Ohio>area, contact us today to schedule your appointment with Dr. Shehadi.

Treatments of Concussions due to Football and other injuries

In a recent interview, we asked Neurosurgeon Dr. Joseph Shehadi to give us an overview of concussions.

Read the interview and Watch the video.

The Interviewer:

“We’re here in Columbus Ohio with doctor Joseph Shehadi, the neurosurgeon and he will be answering some of our questions today.
Our first question is about football and concussions and the injuries that are related to football.
So, doctor Joseph Shehadi Can you please enlighten us a bit about the topic?”

Dr. Shehadi

“Concussion is a very hot topic nowadays, especially with all the media frenzy and the news articles on CTE and head injuries in the NFL.
A Concussion by definition is a temporary or transient impairment of brain functions. It is usually classified as mild, moderate or severe. However, there’s some controversy as to whether loss of consciousness is necessary for the definition, whether headaches and symptoms are necessary and whether or not you have a focal neurological deficit.”

The Interviewer:

“Thank you for your clarifications, what can be the treatments for such concussions?”

Dr. Shehadi

“Well the best treatment I think for concussion is threefold:
Number one is rest

Number two is the removal from the field, which is usually temporary

Number three is a quantitative and qualitative assessment tool to define your symptoms, the resolution of your symptoms, the extent of neurological deficits and whether you’re safe to return to the field.
and for that Component here at Neurosurgery Associates, we use the latest technology, namely Clear Edge which is a complex software.

Sports, in general, are a very important part of our culture and have many benefits, such as camaraderie, hard work, etcetera. However, unfortunately, injuries occur and when they do feel confident, knowing that Associates. Because we have the latest technology and expertise and software. First in Columbus OH, to best treat the athlete And have them back on the field as safely and as soon as possible “

What is Spinal Decompression?

Explained by Neurosurgeon Dr. Joseph Shehadi from Neurosurgery Associates in Columbus Ohio.

Patients often come to us with low back pain, they frequently get diagnosed with what they call lumbar spinal stenosis.
MRI of the lumbar spine is typically needed to make the diagnosis properly of lumbar spinal stenosis.

Stenosis is a medical term that means narrowing. Which means to your spinal cord and or that your nerve roots are being compressed. Compressing your nerves causes pain.

So the treatment for spinal stenosis as always begins conservatively. Conservative treatment includes anti-inflammatory painkillers, outpatient physical therapy, sometimes a lumbar spinal brace which we provide here at this office and at times patients go for epidural steroid injections.

The steroid injections are optional, not mandatory if and when any or all of these conservative treatment measures fail then you become a good surgical candidate.

Surgical treatment options include lumbar decompression with or without spinal instrumentation. the key component is lumbar spinal decompression which means taking pressure off the spinal canal, spinal cord and nerve roots which are being compressed. Because compressed nerves are what causes the pain.

So in the simple sense, all you need to do is take the pressure off of these nerves. so lumbar laminectomies have been done for decades with high success rates. More recently doctors including myself offer spinal instrumentation and spinal instrumentation is a medical term for screws and rods that provide stability.

Both surgical options, a decompressive laminectomy with or without instrumented fusion and stabilization with screws and rods have very good success rates.

Feel free to contact our office for an in-person live consultation to learn more about lumbar spinal stenosis and how to feel better. Thank you.

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Carpal Tunnel Syndrome – Causes, Symptoms, & Treatment

What is carpal tunnel syndrome?

Carpal Tunnel Syndrome - Causes, Symptoms, & TreatmentCarpal tunnel syndrome (CTS) is the compression of the median nerve at the carpal tunnel in the wrist. The median nerve runs through the thumb, index finger, middle finger, and half of the ring finger closest to the middle finger. Read more

Are You Doing These 3 Things To Your Neck?

It’s alarming but true that some common, everyday actions can be bad for your neck—especially if they’re done frequently. Working to break these common habits can do a world of good for your neck health, preventing pain and stiffness. Read more