What are some of the things that can be done for someone who has a short arse because again it is so common it is very common and certainly there are different types of arthritis and so having some blood work can sometimes be helpful sometimes having some imaging like x-rays can be helpful and certainly using the help of a specialist such as a Rheumatologist who specializes in these kind of conditions as well as autoimmune conditions is very helpful in kind of getting a sense of disease management and pain management let’s talk more about those imaging tests we have a graphic that’s gonna show us a few of them I know you mentioned x-rays we also have magnetic resonance imaging can you talk about MRIs and ultrasounds yes so cat scans MRIs ultrasounds are all additional types of imaging that sometimes require prior authorizations from insurance companies so they’re not always covered and certainly a lot of times the specialists do use these modalities to get a sense of what’s going on in the joint and the least invasive way possible and so a lot of times a Rheumatologist who specializes in joints may try and investigate the cause of an arthritis and they may or may not refer a patient to an orthopedic surgeon who may do different types of interventions for the joints and utilize these kind of imaging studies to help guide the treatments dr. Sharma how often do you get a patient with back pain and one of the things that you actually prescribe is exercise and a change in diet yes so that is something that we do prescribe commonly certainly in medicine we’ve moved away from bed rest for back pain unless there has been an injury that has necessitated that bed rest but we definitely encourage exercise and also movement weight loss and weight loss and healthy eating fortunately we do have a very good Spine Center that I often refer patients to so that they have a complete evaluation which also includes physical therapy which is guided exercise and conditioning which I think all of us could use a little help in knowing what we should be doing and how to better take care of ourselves