Let’s take a graphic real quick of these non-operative treatment options which it’s always nice to have options in life right doctor, the first one is periodic observation that.> So it’s a good idea I’m generally very conservative so if patients have no pain, I like to encourage them to get back to the gym, get back to enjoying their life.> Okay over-the-counter pain relievers like.> You know that’s a big subject because narcotics are absolutely contraindicated unless you know for sure that pain will stop taking narcotics will result in addiction, non-steroidal anti-inflammatories are good way to go but when it takes a year to feel better it’s not reasonable because with non-steroidal anti-inflammatories even though they’re very common there comes risks, abdominal issues, gastritis, with steroids which can be applied with a needle precisely where the problem is causing pain, I get most of my patients better and there is even a new version of steroids that can be taken by mouth just for six days that combines an analgesic as well as a medication that protects the belly of these patients, their patients take is for six days when they are in trouble and not when they’re not in pain.> Got it, I’m gonna combine these two exercises and braces is another option?.> So exercise is a great they’re important for everyone maintaining abdominal strength is crucial, hamstring stretching, is very important and just generally staying active because remember disks get their hydration by diffusion, meaning that if there is no piston in of bones above and below those discs may degenerate faster, there isn’t good evidence of this but this is sort of what makes sense, so activity is very very good for maintaining health of the discs.> And the last one is epidurals, you are very high on those epidural .> Now I know, I don’t do these I send patients to a couple of clinicians who do a great job, these have a potential for risks, so it’s important to do these sparingly, it’s important to go to somebody who is very experienced, and who does nothing but, braces are reasonable as well but only as a short-term pain relief, remember that with bracing you’re not using your muscles, muscles atrophy and then without a brace there’s no more pain, so a brace can be a crutch, it would be a good idea to use it only when a patient really is, what they call here in Miami dolor insoportable, I really want one when it’s pain that’s just out of control.