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Spinal manipulation is an ancient healing art practiced by a wide variety of cultures. The earliest know recorded reference to spinal manipulation is found in a Chinese document dating to approximately 2700 BC.

Chronic pain sufferers across the nation have discovered tremendous health benefits that can be restored by a procedure known as Manipulation Under Anesthesia, or M.U.A.

M.U.A. is exactly what it sounds like.

After medical clearance, the patient is lightly anesthetized to achieve total relaxation, then adjustments and stretching movements which would normally be too painful to even consider are easily, painlessly and quickly accomplished.

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:

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

  • Chronic muscle spasm.

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

  • Persistent shortening of muscles, ligaments and 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. 

Spinal manipulation is needed when joints in the vertebral column become locked and immovable. It is the chiropractors' responsibility to restore the function to previously movable joints.

After completion of a thorough examination, including x-ray and other diagnostic procedures, a doctor may determine that spinal adjustments are necessary. If, after 6 to 8 weeks of treatment, your condition does not improve, your doctor may determine that M.U.A. would most likely resolve your condition.

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:

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

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

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

  • Fibro adhesion buildup

  • Chronic disc problems

  • Herniated disc without fragmentation

  • Chronic myofascitis

  • Intractable pain from neuromusculoskeletal conditions

  • Torticollis

  • Chronic re-injury

  • 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.

Who Should Not Have M.U.A.?

Since the main reason for having M.U.A. is the persistence of a stubbornly dysfunctional and disabling spine, the absence of joint dysfunction is a good reason not to undergo M.U.A. There are conditions that many people have that would also be 'contra-indications' for M.U.A. such as:

  • Osteoporosis

  • Heart disease and uncontrolled hypertension

  • Advanced age

  • Bone weakening diseases

  • Cancer

  • Particular circulatory diseases

  • Uncontrolled diabetes

  • Previous stroke

What to Expect With Spinal Manipulation Under Anesthesia ?

Once a patient is selected by the chiropractor using standards of care as described by the National Academy of MUA Physicians, the typical MUA treatment plan begins with a medical screening process to clear the patient for anesthesia. Medical tests usually will include:

  • CBC blood studies

  • SMA 6

  • Chest X-ray and EKG, or electrocardiogram, for patients age 50 and older

  • A pregnancy test for female M.U.A. patients

Your chiropractor may also order additional tests, such as MRI, or magnet resonance imaging, CT, or cat scans, and other diagnostic tests, if needed. After receiving medical clearance, the patient is scheduled at the facility where the M.U.A. will be performed.

What is the procedure like? On the day of the M.U.A., the patient must be accompanied by a friend or family member to drive the patient home afterwards. M.U.A. is not an invasive surgery. It is simply spinal manipulation and mobilization performed in an operating room environment. It is somewhat similar to what is done in the chiropractor's office, but with the added aid of anesthesia. The actual adjustments are very gentle. An intravenous catheter is inserted in the patient's arm and a small amount of anesthesia is administered by a qualified anesthesiologist. The procedure usually lasts less than 15 minutes. After the patient has fallen asleep, the muscles affecting spinal function are stretched and the dysfunctional areas of the spine are manipulated. The patient wakes up quickly thereafter and is monitored by qualified personnel until the patient is ready to be discharged. In some cases, the procedure is repeated over 2, 3, and occasionally 4 days. Most M.U.A.'s are performed over three consecutive days. A series of M.U.A.'s has proven to be much more thorough and effective in the majority of cases.

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.

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