Back pain can be caused by a variety of reasons the most common from what I’ve read is osteoporosis that’s one big reason doctor? Yes absolutely so the majority of fractures are due to osteoporosis and especially as we see the population aging we are seeing more patients presenting with osteoporotic compression fractures of the vertebral bodies but there can be other reasons as well. And Dr. Mena can you chime in on what those other reasons can be too cause maybe a spinal compression fracture. Other ones can be trauma no other ones can be cancer those are two other more common things that we can see nowadays related to compression fractures in the spine. And Dr. Pazzionis as baby boomers age are you seeing more patients with this condition? Absolutely Olga so we are seeing more patients with vertebral compression fractures as a larger percentage of the population increases over age 50 And can you explain why what do you think you’re seeing this? So peak bone density differes in men and women but men it’s generally 18 to 33 and women generally up to 40s where your peak bone density after that we do see a decline in bone density and that can be due to a number of factors so age-related vitamin D deficiency less weight-bearing activities in women unfortunately and patients do present with osteoporosis it’s under treated especially in our community and we do have patients presenting with back pain and they may have a series of osteoporotic compression fractures over a series of years and unfortunately this is something that is quite commonly seen.