Medical Management of Pain – by using different classes of medications in combination, pain can be better controlled than by using any single class of medications alone, this is known as multi modal therapy. In addition, we are beginning to use genetic analysis of patients in order to determine which opiates will be best utilized and metabolized in the body. The timing of when medications are taken relative to sleep and awake cycles is also crucial for proper treatment. We monitor proper medication compliance with random urine testing.