So let’s go through some of the common injuries that occur in the lower back I feel that these are we hear about these daily so what are those so a bulging or herniated disk we talked about that when I showed the pictorial earlier that’s very common people have bulging discs very commonly as those outer bands start to weaken that this bulge is backwards but it doesn’t necessarily have to touch the nerve when it comes out as a disc herniation then it might pinch the nerve and you get the leg pain when we’re talking about the low back another common condition more seen in elderly patients as we get older a spinal stenosis so as the earlier picture noted that you can have narrowing of the canal and we saw that video earlier very graphically showing that and when you get narrowing of the canal either it could be congenital so that’s the hereditary predisposition or it could be acquired due to the arthritis will start to close in on the canal and make it narrower in the center and and so that will give you heaviness in the legs fatigue in the legs numbness and tingling difficulty walking most patients will tell me that I can only walk a block or two and then I have to sit down for five minutes and then I can start walking again right and there’s something called the super this shopping-cart sign so when they go to the supermarket they lean on the cart that opens the canal just a little bit and their symptoms go away for that little bit of time that they’re doing that the minute they stop pushing the shopping cart they can’t walk very far again we also talked about something called vertebral fractures as well yeah and spinal tumors right so I mentioned earlier the main area for metastasis is in the mid-back the thoracic spine but it can also occur in the lumbar spine as well for example when a patient comes to me with a history of prostate cancer I want to make sure they’re not getting metastatic disease into the lower back right because it can occur there as well so as we talked about earlier if someone’s not getting better we have to dig deeper for some of these other things it’s not the common thing but it can certainly occur you don’t want to miss that right and then osteomyelitis is a infection that can occur we see it sometimes with people that have had procedures where there’s been a lot of bleeding in the procedure and bacteria can get in there and go to the spine and create an abscess or a pocket of inflammation and infection and that’s very dangerous it needs to be treated very aggressively how would you treat that well you treat it with IV intravenous antibiotics okay and you might need surgery to decompress it and wash it out as well it’s a very serious condition that could be life-threatening