Manipulation Under Anesthesia for Chronic Pain

Manipulation under anesthesia (MUA) is a noninvasive stretching and manipulative technique. MUA may be performed to offer relief from chronic and recurrent back pain and other types of pain that have not responded to long-term conservative (ie, nonsurgical) care. MUA breaks up adhesions (internal scar tissue that can result from injury or surgery) and may help restore more normal range of motion and reduce pain. It is used to treat back, neck and joint pain, as well as muscle spasms and long-lasting pain syndromes.

  • Adhesions can grow around spinal joints and nerve roots, and inside surrounding muscles, resulting in restricted movement, limited flexibility, and pain.

A patient undergoing manipulation under anesthesia is sedated. While sedated, the patient is in a relaxed “twilight” state, similar to the sedation for a colonoscopy. Twilight sedation allows the doctor to adjust bone/joint alignment and stretch muscles without the patient’s voluntary or reflexive resistance to the treatment. Sedation allows the doctor to apply less force, and makes the procedure painless.

Manipulation under anesthesia for back pain

Certified MUA Specialists
Manipulation under anesthesia is a subspecialty procedure. MUA is only performed by trained and certified physicians in the fields of chiropractic medicine, orthopaedics, physical medicine and rehabilitation, and osteopathy.

Are there advantages to MUA treatment?
Some patients with back pain respond well to chiropractic manipulation, physical therapy or exercise—but their relief may only last days or weeks. Sometimes, MUA is more successful in improving range of motion and relieving pain. Manipulation under anesthesia, which has been performed for more than 60 years, can be more cost-effective and safer than invasive treatments, such as spine surgery.

  • MUA is recognized and covered by most insurance and workers’ compensation.

How does the doctor determine if MUA is appropriate care?
Similar to any other type of treatment recommended, the doctor thoughtfully considers the patient’s medical history, symptoms, and previous treatments and level of effectiveness. Manipulation under anesthesia is not for all people with back pain. Rather, the doctor only recommends MUA to patients who meet the procedure’s selection criteria.

In additional to talking with the patient about their complete medical history, the doctor performs a physical and neurological examination. Test results help the doctor confirm the patient’s diagnosis and determine if MUA can help relieve pain and other symptoms.

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Last updated 07/10/2018

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