We understand that there are different types of back pain and I think that’s imperative to showcase what they are so let’s take it step by step I think we have a great analogy here in terms of a graphic that breaks it down for us here they are doctor three types of low back pain acute subacute and chronic can you walk us through what we’re seeing and explain each one? Great my pleasure to explain this so acute back pain is that back pain when it first develops we’re talking about the first four weeks you may have back pain immediately after doing something or you may have just had a really busy weekend or just move some heavy boxes and furniture and a few days later you’re developing this is a pain that usually resolves with just you know over-the-counter medicines some rest some anti-inflammatories concerning when it doesn’t respond to the usual remedies and that would typically put you to the subacute phase subacute is pain it’s lasting longer than usual so it’s been beyond four weeks your pain is not getting better despite your typical exercises or stretches this is actually when I see a lot of my patients they come in and say I’ve had this pain before but this episode is just it’s awful it’s not getting better I thought I was getting better but it’s not I’m nervous that there could be something else going on what do you recommend I do is everything okay is there something that I’m missing and then you have the chronic back pain. And that really now getting very painful. Absolutely these patients a lot of times they’re miserable they’ve been living like this for three months and their quality of life has just diminished they’ve been you know taking medicines longer than they would like they’re getting side effects they are just they’re not functioning and it’s harder to treat at this stage ideally the time to see your doctor would be in the acute or the subacute place.