Manipulation Under Anesthesia

What is Manipulation Under Anesthesia?

Chronic pain sufferers across the nation have discovered tremendous health benefits by Manipulation Under Anesthesia or M.U.A. The patient is lightly anesthetized to achieve total relaxation and then adjustments and stretching movements which are normally too painful are painlessly and quickly accomplished. Usually a series of three or four treatments are necessary to achieve the desired results.

Who Can Benefit From M.U.A.?

M.U.A. can be a valuable procedure for people with chronic neck, back and joint problems--conditions caused by long-term disabilities, accidents, and injuries that have not been responsive to conventional treatment--but M.U.A. is not for everybody.

Common, general indications that M.U.A.could be effective include:

1. Fibroadhesion buildup

2. Chronic disc problems

3. Herniated disc without fragmentation

4. Chronic myofascitis

5. Intractable pain from neuromusculoskeleton conditions

6. Torticollis

7. Chronic re-injury

8. Failed back surgery

Chiropractic patients who have reached a plateau using traditional therapy also can significantly improve their quality of life using M.U.A.

Occasionally, certain spinal conditions fail to respond sufficiently to conventional care of doctors, physical therapists or even chiropractic doctors. Some of the impediments to in-office adjustment of the spine that may require the aid of an anesthetic are:


1. Buildup of scar tissue (adhesions) both in and around the spinal joints commonly caused by multiple injuries or failed back surgery.

2. Chronic muscle spasm.

3. Super-sensitivity of injured areas making the patient unable to cooperate for effective treatment.

4. Persistent shortening of muscles, ligaments and tendons.  M.U.A. has also been shown to be effective in relieving pain in cases of damaged intervertebral discs. Some disc injuries are serious enough to require surgery, but they are relatively infrequent.

How does anesthesia help the manipulation?

When movement of the spine is extremely and intolerably painful, the benefit of being unconscious is obvious, but the anesthesia performs other important functions, such as:

1. Shuts off the muscle spasm cycle to allow spinal movement.

2. Sedates the pain perceiving nerves that have been irritated due to the dysfunctional spine.

3. Allows complete muscle relaxation to allow the doctor to stretch  shortened muscle groups and to break adhesions caused by scar tissue.

How do I begin an M.U.A. treatment plan?

Patients are selected by the chiropractor using standards of care as described by the National Academy of M.U.A. Physicians. Then a medical screening begins to clear the patient for anesthesia, including blood tests, chest x-ray and EKG, and a pregnancy test for female patients. Your doctor may order additional tests, if needed or he can refer you to your primary MD for a workup.

What is the M.U.A.procedure like?

The patient is given a sedative--usually Deprivan and/or Verced, and sometimes Fentanol to achieve the comfortable "twilight" sleep that makes treatment possible. The doctor uses the same stretching techniques and adjustments that the patient has received in his office, but the patient is more responsive because of the more relaxed state brought on by the sedative. The procedure usually takes about 15 minutes.

What happens after the procedure?

The patient is awakened and taken to recovery where he or she is carefully monitored by the OR nurse. Recovery time is fifteen to twenty minutes, after which the patient receives fluids and a light snack. therapy begins the same day with the patient visiting the chiropractor's office to undergo a combination of stretching exercises, cryo-therapy and electrical stimulation to eliminate or reduce soreness. The patient then returns home to rest. The procedure may be repeated three or four days. Rehabilitation for the next two or three weeks includes stretching, flexibility and strengthening exercises and periodic adjustments by the doctor.

Post-procedure care:

Post-procedure care is one of the most important parts of the M.U.A. procedure and makes it truly effective. The therapy begins immediately--the same day. At this time, the patient visits the chiropractor's office and undergoes a combination of stretching exercises, cryo-therapy and electrical stimulation to eliminate or reduce soreness. The patient then returns home to rest.  After the last M.U.A. procedure, the patient should follow an intensive therapy program for seven to ten days consisting of the same stretches accomplished during the procedure and adjustments made in the doctor's office. Rehabilitation for the next two or three weeks includes stretching, flexibility and strengthening exercises, plus periodic adjustment as required by the doctor. This regimented post-M.U.A. therapy will help the patient regain pre-injury strength and help prevent future pain and disability.

What are the usual results from M.U.A.?

The patient should experience an immediate increase in range of motion, even though there may be some temporary added muscle soreness similiar to the feeling of having completed an aggressive exercise session. If symptoms were severe, there should be significant change, either immediately or within a short period following the procedure.


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