Medication and muscle management Medication management Pain that cannot be eliminated can destroy one's quality of life. If nothing can be done to eliminate the cause of the pain, the provision of strong pain relieving medication that improves your ability to function is considered good and reasonable treatment. Other medications not originally intended for pain may provide additional relief. However sometimes there are contributing causes of the pain that have not been addressed. Muscle pain Patients are evaluated to determine if muscle treatment can diminish or eliminate the pain and accompanying symptoms. The Marcus Method relies heavily on the manual examination and specific patented testing procedures to assess the contribution of muscle and connective tissue in the overall pain problem. When Trigger Points are found or suspected they can be confirmed electrically allowing identification of the most tender muscles causing the pain. The majority of patients will respond favorably to this approach which provides an inexpensive but effective solution to common pain complaints. The muscle pain treatment consists of four basic elements: Exercise, Massage, Modalities and Injections Exercise: There are 22 exercises in the program. THe back pain exercises were developed at Columbia College of Medicine in 1958 and have helped over 80% of patients with complaints of back pain even with abnormal findings on a MRI or CT scan. These exercises were developed before the use of CT scans and MRIs. Therefore, the most important determination for requiring an operation was the clinical diagnosis not the imaging study. Massage: This therapy can diminish or eliminate skin and muscle pain. Tense muscles can be relaxed with appropriate massage therapy. There are specific types of massage that can eliminate skin pain. Modalities: Electrical stimulation techniques are important in the treatment of spasm and following trigger point injections. Trigger Point Injections: Muscles that have been painful for months or years may have developed hardened areas that are silent at rest but if the muscle is stressed will cause pain. These painful spots are generally called trigger points. Various approaches have been suggested to treat these painful muscle knots. Our approach is unique. It is an elaboration of the original contributions of Hans Kraus MD, who successfully treated former President JFK after other injection techniques had failed. Injections are made as painless as possible. They are followed up with a specific Physical Therapy protocol. After a muscle is injected with our technique, and the patient performs the prescribed exercises, it rarely if ever requires reinjecting.