Tag Archives: whiplash

Manipulation Under Anesthesia – When it’s right for you

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

 

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Manipulation Under Anesthesia

Dr. Elkins recently updated his certification to perform Manipulation Under Anesthesia or MUA. He initially became certified in 2000. MUA is a surgical procedure that is non-invasive and conducted when other conservative procedures have failed to either reduce the patients pain or returned them to the appropriate or expected functional levels at home or work.
There is a very selective procedure in terms of what types of patients are accepted into the treatment program. It is an often misunderstood procedure. However, the success rate based on scientific studies is quite impressive. Over 70% of patients report good to excellent results. Longer studies have found that patients are still pain three years following the procedure.
MUA is performed under the direct supervision of an Anesthesiologist. It does involve anesthesia that allows the patient to completely relax and is very safe. The procedure involves stretching muscles and scar tissue along with light impulse adjustments to the treatment area when necessary. As the Lead MUA Surgeon, you have the opportunity to produce results in as little as 1- 5 visits that otherwise would have taken months to years or possibly not resolved at all. A whopping 5% of patients went on to have surgery in the study following MUA procedures. That is a huge success. The greatest part remains that those patients undergoing the procedure generally report both high satisfaction and a return to normal functions in life.

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