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So a lot of times so you're going to have some muscle pain and also pain from the joint kind of down in the lower part of that neck there you typically that's inflammatory medicines, maybe a muscle relaxer sometimes you talk about a steroid injections we can do a trigger point injection just real quick in the office into that muscle that may help calm it down and then really work with physical therapy on that area sometimes if it's causing deeper issue especially was going down the arm, then we may talk about the epidural and if it truly is the lower part of the cervical spine and it's causing that pain or numbness and things like that, the arm eventually after you've kind of gone through that whole gamut then we may discuss a surgery if it's appropriate

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