Manipulation Under Anesthesia (MUA) is a beneficial, non-invasive procedure to relieve pain associated with acute and chronic neck pain, back pain, joint pain, and migraines. It is performed on only those patients who have little or no response to any other treatment and meet all the requirements to be considered a candidate for the procedure. It is especially effective for people with conditions caused by long-term disabilities due to accidents or injuries that are not relieved through conservative treatment.

MUA uses a combination of specific short lever manipulations, passive stretches, and specific muscle, joint, and tendon movements to break up fibrous adhesions and scar tissue around joints, the spine, and surrounding tissue. MUA can be an alternative for patients facing invasive surgery.

Who is a Candidate? 

Before patients can be considered candidates, they need to receive a consultation with one of our Board Certified Physicians.

Some spinal syndromes respond poorly to conservative, conventional care because they do not address the underlying cause.

Whether it is a disc injury, old injury to the spine, or headaches, the chronic pain is caused by adhesions and scar tissue that have built up around the spinal joints and within the surrounding muscles.

Patient Evaluation and Screening

Patient selection is one of the most important aspects to ensure the MUA procedure will be a success. Not everyone is a candidate for this procedure. Candidates are selected for MUA after taking a thorough and adequate history, thorough examination, and appropriate diagnostic imaging and laboratory procedures necessary for an accurate diagnosis of the underlying condition.

The Procedure

MUA is performed under conscious sedation with the consideration of the anesthesiologists. The patient is given anesthesia (conscious sedation) selected by the anesthesiologist that is most appropriate based on their personal medical history. Two properly trained and qualified physicians take the patient through specific and controlled passive stretching techniques. These stretches are intense and the range of motion is taken beyond the point of consciously tolerable pain.

Deep tissue pressure, traction and muscle stripping are performed. Similar in thought to spray and stretch but at a much more deep and intense level–beyond what would be possible without being sedated.

Specific joint manipulations are then performed. This helps to increase the range of motion of the restricted joints, eliminate the deposited fibrosis within the joints, and stretch the shortened connective tissue within the joint to help restore normal motion. The patient is injected with anti-inflammatory medication, is awakened from the anesthesia, and is taken to recovery and monitored. When the conservative treatment of chronic becomes intolerable, the benefit of sedation becomes obvious.

Rehabilitative Care

Shortly after the MUA procedure, the patient usually experiences a dramatic increase in range of motion and decrease in pain. However, it is essential to complete a post-MUA rehabilitation program to ensure a permanent resolution of chronic pain.

In an effort to minimize the re-formation of adhesions, a post-operative care program is prescribed for four to six weeks. Patients who have experienced chronic pain for years can become severely de-conditioned.

As a result, they may require an additional 4 to 6 weeks of re-conditioning, work conditioning, and strength training.

MUA Is Not a New Procedure.
It Has Been the Topic of Research Since 1948.

Since the 1930s, MUA has been changing the lives of chronic pain sufferers and improving their quality of life. Documentation regarding the success and value of MUA has been recorded in the osteopathic literature since 1948, when Clybourne reported in the Journal of American Osteopath Association a success rate of 80–90% which has been maintained to this day.


What is Manipulation Under Anesthesia?

Manipulation Under Anesthesia (MUA) is a non-invasive procedure used to restore range of motion and relieve acute and chronic shoulder, knee, neck, back, joint, and migraine pain that has not responded to other treatments. MUA can be especially beneficial to patients with conditions caused by long-term disabilities that have resulted from accidents and sports injuries. When a patient is mildly sedated, our center’s trained physicians are able to perform deep tissue pressure, traction and muscle stripping at a much deeper level than what normally would be tolerated without sedation. A combination of short lever manipulations, passive stretches, and muscle, joint, and tendon movements are used to break up fibrous adhesions and scar tissue around joints and muscles. Scar tissue and fibrous adhesions can greatly restrict range of motion and cause pain.

What does the actual procedure entail?

The first step is a complete examination and consultation with one of the center’s physicians, who will determine whether a patient is a viable candidate for MUA. The procedure is performed under a sedative, selected on an individualized basis by the anesthesiologist. During the procedure, two specially trained physicians mobilize the patient’s restrictive areas utilizing controlled passive stretching techniques. The patient is also injected with anti-inflammatory medication. He or she is awakened when the manipulations and mobilizations are completed and then monitored during a recovery period.

What kind of results can be expected after having Manipulation Under Anesthesia?

Most patients experience dramatic improvement in their range of motion and a reduction in pain shortly after MUA. Following the procedure, patients must undertake a rehabilitation program for a minimum of two to four weeks to prevent the re-formation of adhesions and ensure long-term relief. For more than 60 years MUA has provided life-changing pain relief for a number of patients. The procedure boasts a success rate of 80-90 percent, according to the Journal of the American Osteopathic Association.

If you have any questions, on interested in if MUA will work for you please click here for our provider directory in your area.

Informational Video For Patients