Talk to us a little bit about upper spine pain neck, pain also very common in your practice, correct? >Very common. >So are the modalities different or the treatment approaches a little different do we have to be more careful with with what the approach should be from a primary care standpoint and from a patient standpoint, does that change at all? >It might very little bit and spine related pain in the majority of the cases it’s a muscle / ligament type of problem initially if the patient does not have a neurologic symptom or deficit like we discussed in the prior segment the ideology most likely it’s going to be actually outside of the spine and the supporting structures of— >Ideology means the cause that’s a doctor term— >Mainly outside of the spine structures and more involving the supporting structures which are the muscles and the ligaments in that area. >We have another graphic that we wanted to show which again focuses around neck pain and some of the tips that we can use to avoid neck pain how can we go through those? >Yes of course a good posture spine related pain is a lifestyle disease right meaning if you all have a sedentary life you sit in a desk job for 8 hours a day or 10 hours a day you overeat you become overweight and you’re sedentary you will have problems so modifying all these factors will improve your chances of recovering from this terrible problem stretching is a it’s a good option on people that suffer from neck or low back pain before they do activities there are studies that were recently published the document that people that have back pain or neck pain regardless of the reason or the cause of the pain they enroll in two three specific types of activities mainly yoga, Pilates or Tai Chi the quality of life improves in most patient after six months of regular practice will not have pain.