Is it okay to take over-the-counter medications that long in general for most people that don’t have issues with their stomach or she’s with their kidneys or some other reason that they can’t make take nonsteroidals and it usually is fairly well tolerated anybody taking blood thinners should definitely contact their physician first because there are interactions between the nonsteroidals and most blood thinners and so it’s it’s not that we don’t want patients to call us when they have this back pain but they don’t need to go through the ER very often can be handle over the phone and if there’s any question contact your primary care physician or or see an orthopedist gotcha so at any point during this four weeks I say the pains not two weeks have gone by and the patient hasn’t really it hasn’t gotten less the pain would you at that point prescribe a steroid or just wait out those four weeks maybe up the dose of the Ilia profe in a little bit at what point would you would you need a bigger evaluation of the patient I think in general we we expect to see a an improvement within the first week or so so if somebody’s not getting any better after that first or second week then we’re gonna change what we do whether it’s adding a steroid perhaps a muscle relaxant or something else or if the symptoms are giving any suggestion of progressing then we may initiate a further workup maybe get x-rays even if normally would want to wait four to six weeks before doing so gotcha so in general you normally want to get all these other tests on out of the way before you prescribe steroids or not necessarily well not necessarily because even in cases where you have something like a disc herniation most of the time those will get better without the need for surgery so somebody that has a couple of weeks of symptoms whether they’re just in the back or even in some cases mild symptoms affecting the legs we expect a favorable recovery we don’t necessarily have to get an MRI prior to treating somebody we would get an MRI if they’re not getting better over time or if the symptoms are progressive you