Manipulation Under Anesthesia (MUA) is a technique for helping patients originally pioneered by osteopathic physicians late in the 1930’s. For the last 25 years Chiropractic Physicians have been teaming up with Medical Doctors while developing and utilizing this procedure for the overwhelming majority of these procedures conducted.
According to studies, the procedure boasts a very enthusiastic high success rate. For example, MUA has an 83% success rate of good to excellent results as compared to 51% of surgical patients (Robert Menser, MD, Orthopedic Surgeon). Follow up 3 years later demonstrates a 51% of patients still reporting good to excellent results (Donald Chrisman, MD, Orthopedic Surgeon). Larger trial studies demonstrated out of 723 patients, which 71% had good results, 25% fair results and only 4% still required surgery (D. Siehl, DO). Another large study of 517 patients with disc herniation treated with spinal manipulative therapy reported 78.6% of the cases responded well and avoided surgery. Similar statistical results were found in a study done by Krumhansl and Nowacek on 171 patients post MUA: 25% had no pain, 50% were much improved, 20% were better, 5% had no relief. Also, West et al. reported177 patients post-MUA: 68.6% able to return to work, 58.4% required no more medication, 60.1% had lumbar pain resolved.
INDICATIONS FOR THE PROCEDURE
Manipulation of the spine and extremity joints under anesthesia is recommended for patients suffering from acute but mostly chronic musculoskeletal problems. The patient’s typically have been unresponsive to previous conservative therapy. Patients with spinal disc disease, chronic sprain and strain problems, myofascial pain syndromes and muscular spasm resulting in restricted range of motion often benefit from this procedure. These types of patients generally received improvement with conservative manual therapy but the relief is often only temporary. This more advanced manipulation therapy frequently results in significant long-term improvement.
The following conditions are often treated with MUA:
- Bulging, protruded, extruded, or herniated discs without free fragment
- Frozen or fixated spinal or extremity joints
- Failed low back surgery patients
- Nerve compression syndromes related to adhesion formation
- Restricted range of motion with associated pain and dysfunction
- Unresponsive musculoskeletal pain which interferes with daily life and sleep patterns that is appropriate for treatment by manipulation
- Unresponsive muscle contraction
- Chronic post-traumatic or whiplash syndrome
- Chronic neuro-musculoskeletal pain requiring ongoing periodic treatment