Dr. Gottlieb tell us what the difference is between something that’s acute or chronic when it comes to back pain so in general when we’re referring to acute back pain we’re talking about something that’s been present for six weeks or less and chronic back pain is generally more than 12 weeks and then there’s sort of that that middle ground of subacute where it’s between about a month and a half in three months gotcha and is the the treatment plan similar to both well it would be it would be similar if you had somebody who came in with sub acute or chronic back pain that had not undergone any treatment but if you have someone that’s had back pain for about a month and a half they haven’t done anything if it’s not gotten worse I would still generally start them off with a conservative measures if there was any reason to believe that they do have a more complicated problem then we wouldn’t necessarily have them wait the four to six weeks before getting the imaging we might initiate workup at that point gotcha so in general not well not necessarily an acute pain can turn into a chronic pain at some point if not treated correctly at that moment is that a common thing it’s actually quite common and and its really related to how we tend to deal with pain if something hurts we tend to not move we tend to try to protect that area and what happens very often with the back is you have a sprain or a strain and it hurts to move so we move a little bit less and then we get stiffer and then we try to move and that’s that hurts so we become stiffer and eventually people will come in and say my gosh I I can’t bend over more than a few inches because when I do my back hurts and that’s really a decompensation so the injury may have been relatively mild but the degree to which they’ve gotten worsen has been related to their black of activity the lack of movement and and then it does go from being a relatively straightforward simple acute back pain to something which can take a bit longer to recover from