Back and neck pain costs in the U.S. have increased from $26 billion in 1998 to $86 billion in 2005 with no improvement in outcomes. Of all chronic pain treatment approaches, multidisciplinary pain clinics are found to be more effective than almost any other alternative but the pain treatment community nevertheless has increasingly moved to interventional approaches. Unsuccessful back surgeries are so common that a unique medical diagnosis, ?Failed Back Syndrome? was created. How did we get into this situation? This workshop will explore the role of muscles in producing common pain problems. Muscles are essentially ignored as a source of pain even though they are approximately 50% of the body by weight. Even when muscles and soft tissue are acknowledged as a source of pain there is no agreed paradigm for evaluation, diagnosis, and treatment. The history of approaches to treat low back pain will be presented. A structured approach to assess and treat muscle pain utilizing a new model to identify pain muscles will be discussed. Preliminary data will be presented and an electrical detection device to identify a specific muscle-causing pain from tension, stiffness, spasm, or trigger points, will be demonstrated.