Manipulation Under Anesthesia (MUA)

Manipulation Under Anesthesia, otherwise known as MUA, is a non-invasive procedure increasingly offered for acute and chronic conditions, including: neck pain, back pain, joint pain, muscle spasm, shortened muscles, fibrous adhesions and long term pain syndromes.

The patient is lightly sedated, which is known as twilight sedation, the same sedation used during colonoscopies. They can then be mobilized, adjusted and stretched in a way not possible through traditional in-office care. Stretching and manipulation of the spine with the patient sedated is one of the gentlest and most effective methods of altering chronic pain. Manipulation Under Anesthesia is a viable alternative for those patients that are not responding to traditional conservative care or other invasive procedures such as pain management injections and surgery.

What is the History of Manipulation Under Anesthesia?

Manipulation Under Anesthesia is an established and widely recognized procedure that has been part of the manual medical arena for more than sixty years.  The practice of MUA can be traced back to the late 1930’s and its popularity has continued to grow in recent years as research has shown that MUA is not only safe, but also highly successful in treating acute and chronic musculoskeletal conditions.

Manipulation Under Anesthesia is a viable alternative for those patients that are not responding to traditional care or other invasive procedures such as surgery.  By anesthetizing the patient, once painful adjustments and movements are painlessly and quickly accomplished, helping to greatly improve or even restore range of motion.

In general, patients selected for Manipulation Under Anesthesia are those with certain neck, mid-back, low-back or other spinal conditions that have received conservative care for six to eight weeks with limited or no improvement in symptoms or findings. This may include chiropractic, physical therapy, and/or pain management/spinal injections.

MUA may also be appropriate for those patients that still experience pain after undergoing various invasive treatments such as surgery.

Common indications for Manipulation Under Anesthesia include neck, middle and lower back pain, chronic muscle pain and inflammation, acute and chronic muscle pain and inflammation, acute and chronic muscle spasm, chronic fibrous adhesions, nerve entrapment, disk pathology including herniated disks, torticollis and failed back surgery.

Not all patients qualify for MUA as certain contraindications prevent some from undergoing the procedure.

Manipulation Under Anesthesia also provides a more economical alternative to traditional surgery and usually qualifies for Medical Insurance Coverage, as MUA is an established medical procedure.

What is the Manipulation Under Anesthesia Procedure like?

The Manipulation Under Anesthesia procedure involves three consecutive days of treatment. During these three days a patient is treated with spinal manipulative therapy and MUA stretches. Since the patient is lightly sedated during the MUA procedure, the usual resistance and pain associated with stretching and manipulation is eliminated. Through the use of “conscious sedation,” a patient is conscious and responsive, but relaxed, allowing the physician to more effectively administer adjustments and stretches similar to those received during regular chiropractic visits. This form of sedation is also known as twilight sedation, which means the patient recovers quickly and is allowed to go home very shortly after the procedure.

After the series of treatment procedures, treatment continues as strengthening and stabilization programs are initiated over the next few weeks. Post-Procedure care is a vital part of the MUA procedure as fibrotic scar tissue can begin to form within 24 hours. Follow-up visits with a Chiropractic Physician is important as the stretches accomplished during the MUA procedure are built upon, helping the patient to regain strength and prevent future pain and discomfort.

What are the Effects of Manipulation Under Anesthesia Procedure?

The proposed effects of Manipulation Under Anesthesia therapy include the following:

• Breaking up scar tissue (adhesions) both in and around the spinal joints, commonly caused by multiple injuries or failed back surgery.
• A decreasing chronic muscle spasm
• Overcoming super-sensitivity of injured areas, making the patient unable to cooperate for effective treatment
• Stretching persistent shortened muscles, ligaments and tendons
• Relief from pain and radiating symptoms caused by damaged invertebral discs.

Most importantly however, Manipulation Under Anesthesia affords patients immediate relief and noticeable difference in their daily lives post-procedure. These positive results only continue to improve with time and post-MUA therapy.

Who Performs the Manipulation Under Anesthesia Procedure?

Those involved during the MUA procedure include the Board Certified Anesthesiologist, an MUA certified M.D./D.O. and/or D.C. who performs the manipulation with the assistance of  skilled nursing staff.  Locations where this procedure is performed include Regional Medical Centers, Local Hospitals and Surgery Centers, where the doctor has medical staff privileges. 

Only a physician that has been certified in MUA is able to perform the MUA procedure.