How much does age play a role in in this? A lot. > A lot but you know young people have their share of that problem — what’s young, what’s young — young you know someone like you someone know — under under what under fifty — oh Under sixty. — under sixty — Yeah those patients develop disc herniations which is kind of a young person problem versus generally those over 60 over 65 developed more deformity or change in the shape of the spine. > And why do people what why does your back hurt in the morning something sometimes usually you’re kind of stiff and then by the end of the day it’s a little bit better? > Okay so that’s that’s a tricky answer okay so bear with me. — okay — So as you lose height okay various parts of the spine have to adjust specifically there is joints that bind all of your bones in the spine and then in the back but they’re called facet joints. Now with time those facet joints they have to sort of accommodate a change in the position of the spine and they sort of destroy some cartilage and they kind of Bend then they change. Well whenever anything changes in the human body you can my body produces a certain reaction, now you can call it arthritis but an intermediate stage to arthritis is essentially just joint stretch which body does not like, and whenever that happens it sort of makes it whatever it can to stop the motion of those segments. Now when you wake up in the morning after you get up from a nice comfortable bed those joints have not really seen the body weight and they’re in that least stretched position. Now you stand up and you ask your body to do things so you ask those joints to sort of open up and move the way that a normal person would expect, well that initial stage involves stretching of the joint capsules and that’s frequently what produces sort of like this flexed for posture in the morning and the lower morning back pain. Now that being said a late night pain or for some of us an early morning pain that we you know, those of us that get up really early, can be a sign of inflammation as well and actually one of the things I ask my patients is do you have night pain and if the answer is yes to me that implies that there is a strong inflammatory component to their problem.