Epidural injections, give me let’s say a couple minutes what does that mean to patients? So what is that per se talks about? >So patients have back pain there are referred to a pain specialist for a procedure there’s different types of procedure so patient says well I need a nerve block because I heard my friend had a nerve block or I need an epidural because I heard my friend had an epidural so an epidural it’s not a procedure the epidural it’s a space it’s called the epidural space so what we do is call an epidural steroid injection in which you inject steroids in the epidural space all right and when someone for example it’s gonna have a baby and they have an epidural what happens is a needle gets placed in the epidural space and then an anesthetic is injected in that space so the epidural is the space where the medication goes so epidural steroid injections are effective tools in managing certain types of back pain we also have other types of nerve blocks like facet joint injection selectively nerve root blocks they all enter into the name of a block but they’re different procedure. >So what we’re going to do is we’re gonna bring up a graphic and we’re gonna have doctor who’s cart and show us on the graphic specifically the areas where he can begin to intervene. >Okay so in this graphic we have model spine showing know it’s like a blinking disc you which you know it’s showing you the different structures you have your vertebrae is you have the discs you have nerves that could all be etiology for the pain so in this graphic you can see what the disc is which is a fibrous material outside with a soft gel light material inside in this craft you see the image of a herniated disc in which the disc is protruding backwards and it’s touching a nerve root and that will give you the typical so that sciatic— That’s a pinched nerve with you know this radiation with a pinched nerve here you can see what’s called the spinal canal posteriorly you’ll have ligamentum flavum and the epidural spaces on this area.