How are Muscles being treated with Low Dose Naltrexone (LDN)?

Dr Norman Marcus, Pain Specialist
Pain Specialist Dr. Norman Marcus

How are Muscles being treated with Low Dose Naltrexone (LDN)?

The question is, how am I treating the muscles?  The nociceptors are most densely populated in the attachment sites in the entheses.  If one is doing an injection into a muscle, into the muscle belly itself to that tissue, you're missing where most of the pain is generated in the muscle.   You must go to the attachment.  The muscular tenderness attachment and the bony tenderness attachment.  If you don't know the specific muscle, you can't know the attachment site, so it's very important that you have some hypothesis as to what that specific muscle is.  When you're pressing on an area of the body you're pressing on layers of muscle and you don't know which layer you're in terms of producing tenderness when you're using pressure. So we use the electrical stimulus device and it allows us to go along the entire course of the muscle from origin to insertion. If we get tenderness or a sense of pressure along the entire muscle from the beginning to end, then that is a muscle that is sensitized. 

If you only get part of the muscle, it's not the right muscle.  You're in the wrong fugitive muscle. In the muscle that you think is the source.  You need to find the muscles that will give you sensitivity along the entirety of the muscle from beginning to end, and then your treatment, in terms of,  if there's going to be an injection technique, it should be to include the attachment sites as well as the entirety of the belly of the muscle. When we do it in that fashion, we very often do not have to re-inject the muscle, but that muscle will be deactivated and will not require additional treatment. 

Following such an injection we have a post-injection physical therapy protocol where we do neuromuscular electrical stimulation to contract just the muscle that was injected for three days and we use a limbering exercise program that was developed by my mentor Hans Krauss, who was President Kennedy's position, who got him better using these techniques.  You've been using pressure to identify a muscle using these types of injections and then using the same post-injection protocol along with exercises that Professor Krause developed at Columbia University School of Medicine where he gave these exercises to 300,000 people at the YMCA with an 80 percent success rate in reducing or eliminating back pain.

If a patient has muscle pain that's a more recent onset, we use conservative treatments and typical physical therapy treatments; we also use a laser in 860 and 980 nanometer laser or 25 watts.  It's a class 4 laser that requires goggles by the FDA and if we can catch it early enough, we may be able to eliminate the pain with these conservative methods.