Manipulation Under Anesthesia(MUA)
Frequently Ask Questions:
Q. What is MUA?
A: Manipulation Under Anesthesia (MUA)
Manipulation Under Anesthesia (MUA) is a non-invasive, medically approved procedure supported by research that has been published in well-respected journals.
MUA is a procedure for patients who suffer from long-term musculoskeletal pain and loss of proper function to the injured area. MUA works for patients who experience neck, back, pelvic, upper, and lower extremity pain and loss of proper function. These patients have tried and had no success with pain management, physical therapy, massage therapy, epidural injections, back surgery, drugs, and even chiropractic care. MUA procedures use refined and specialized manipulation, stretching, and joint mobilization to target chronic joint and muscle pain. These methods without anesthesia may not be effective because of the pain resistance, restrictive motion, and spasms that have developed over a long period of time. When sedated, it eliminates that pain resistance and restrictive muscle spasm, allowing the doctors to restore joint motion, stretch shortened spastic muscles, and break down the adhesions caused by scar tissues. In other words, when stretching the injured area for proper healing, the adhesions (scar tissue build-up) trigger a pain response preventing the doctor from going beyond the injury. The patient’s body will resist, preventing the doctor from breaking the adhesions. When in pain, the patient cannot voluntarily control this pain response as it is the body’s natural self-defense. When sedated, this self-defense mechanism is turned off, allowing the doctor to stretch beyond the adhesions.
MUA is performed by a licensed physician with extra training and certification specifically for this procedure. A team approach is required to have a safe and successful outcome. The team includes at least two certified MUA doctors, an anesthesiologist, and a pain management doctor. The procedure is generally done in a surgical or ambulatory setting. The combination of anesthesia and manipulation has been a part of the medical arena for more than sixty years. This procedure is in no way experimental or investigational.
Q. How do I know if MUA is for me?
A: MUA Patients are patients who have tried everything from allopathic medicine to Chiropractic treatments and received limited success. In general, patients selected for MUA are those who have received conservative care for at least 6 to 8 weeks before seeing an MUA doctor. Dr. Abdallah will perform a full spinal examination and determine if you are a good candidate for MUA. If he feels that MUA will benefit you, he will try traditional chiropractic care for 3- 4 weeks. If you have very little success then he will refer you to another MUA-certified doctor for a second opinion. If he/she believes you are a candidate then he/she will refer you to a physician who will make sure there are no contraindications for an MUA procedure. The physician may order x-rays, MRI, CT scans, and/or laboratory tests. If the physician finds that there are no contraindications, then you are a perfect candidate for MUA. Some of the contraindications for MUA are as follows: acute arthritis, fractures, tuberculosis of the bone, malignancy with metastasis to the bone, acute gout, uncontrolled diabetic neuropathy, evidence of cord or caudal compression by tumor, and excessive spinal osteoporosis.
Q: What else can MUA help with?
A: MUA can also help with:
Patients who have failed to respond to conservative treatments
Chronic or recurrent pain
Nerve entrapment- Facet Syndrome
Failed surgery
Frozen Shoulders
Disc herniation/ Bulging Disc
Traumatic Torticollis
Fibromyalgia
Chronic Sprain/ Strain
Lumbarization/ Sacralization
Q: How Do I Know If I Am Not A Candidate For MUA?
A: You are not a candidate for MUA if you have one or more of the following:
Infectious Disease
Acute fracture
Acute Inflammatory Arthritis (gout or rheumatoid)
Tuberculosis
Gonorrheal Spinal Arthritis
Advanced osteoporosis
Uncontrolled diabetic neuropathy
Widespread staphylococcal or streptococcal infection
Respiratory infection
Malignancy, metastasis, or metastatic bone disease
Prior history of stroke
Discitis
Osteogenesis imperfecta
Vertebral artery syndrome
Clotting disorders
Pregnancy
Q: What does the MUA Procedure consist of?
A: Once you are approved for an MUA procedure, you are scheduled to come in on a Friday, Saturday, and Sunday. The actual procedure lasts approximately 20 minutes each day. The treatment is done for three consecutive days. The reason for this is because, through a series of MUA’s, three consecutive treatments have been clinically proven to be much more effective than one treatment alone. Also, we do not continue treatment for a fourth day because research shows that after the third treatment there is little to no additional improvement.
During sedation, the MUA doctors work in teams. Together they perform lateral and linear stretching, deep pressure, traction or separation of the muscle origin and insertions, mobilization without impulse, low-velocity adjustments, moving the joints to their full range of motion, and friction tissue work.
Q: Why is Anesthesia important when doing an MUA?
A: Anesthesia is important for a few reasons. It is usually difficult for a patient to relax when they are in pain and the anesthesia allows the patient to relax through the intensive treatment. In addition, the anesthesia shuts off the muscle spasm cycle to allow spinal and joint movement, it sedates the pain perceiving nerves that have been irritated due to a dysfunctional spine and/or joint, and it allows complete muscle relaxation to allow the doctor to stretch beyond the adhesions (scar tissue build-up).
Q: When does MUA do to your body?
A: When going through an MUA, we are breaking up scar tissue, decreasing muscle spasm, overcoming sensitivity of the injured area, stretching the shortened muscles, tendons, and ligaments, and relieving pain and radiating symptoms.
Q: Once the MUA Procedure is done, what happens next?
A: Post-procedure therapy and rehab are crucial and must be done. If the post-procedure is ignored, the patient will not get the full benefit of the MUA procedure. The patient may actually return to their pre-procedure status. Post-procedure therapy and rehab require you to see your MUA doctor three times a week for eight weeks. The treatment protocol will change every two weeks. It will consist of MUA stretching protocol, passive and active range of motion, massages, isometric strengthening, and strengthening.
Q: Are there any studies or research on MUA?
A: Absolutely. Here is some research:
http://www.thespinejournalonline.com/article/S1529-9430(02)00196-1/abstract
http://www.jmptonline.org/article/S0161-4754(05)00189-2/abstract