Manipulation Under Anesthesia

Manipulation Under Anesthesia

What is MUA?

MUA or manipulation under anesthesia is a noninvasive outpatient procedure offered for acute and chronic painful conditions of neck, back, sacroiliac joints, shoulder joints, and hips. MUA is a viable alternative for those patients that are not responding to traditional care or invasive procedure such as surgery. With the use of sedation, painful muscles and joints are comfortably stretched, massaged and adjusted. So how does the sedation work?

  • The medication sedates the pain producing nerves that have been chronically irritated due to restricted joints in the spine, shoulders, or sacroiliac areas.
  • Sedation allows complete muscle relaxation enabling the physician to stretch shorten muscle groups and to breakup adhesions caused by chronic pain in that area. In other words the sedation puts our muscles to sleep which allows the doctors to properly restore and actually improve movement of the affected joints.

A Safe Procedure: Manipulation Under Anesthesia has a very high safety profile. The side effects of the procedure are those of regular chiropractic manipulation. The MUA team consists of a board certified anesthesiologist, the MUA trained medical or osteopathic physician, and the MUA trained chiropractic physician. MUA is unique as it joins together multiple specialties for the therapeutic benefit of the patient. This procedure should only be performed by a physician that has been certified in the practice of MUA. MUA training is a postgraduate continuing education sponsored by many of the chiropractic colleges across the US. The course is typically 32 hours covering the history, scientific basis, and techniques of MUA.


In our opinion, MUA should be renamed as “stretching with sedation”. This procedure is 75% stretching and 25% manipulation of the joints. The results are remarkable.

Stretching the patient while sedated breaks up scar tissue adhesions in and around the joints. These adhesions are commonly caused by multiple injuries, car accidents, sports injuries, poor posture, or even failed back surgeries.


Who would benefit from this procedure? Patients that have the following respond extremely well to this procedure:

  • Fibro adhesion buildup ( chronic muscle pain/tightness)
  • Chronic disc problems
  • Herniated discs
  • Chronic muscle spasms
  • Intractable pain from neuromusculoskeletal conditions
  • Sacroiiliac problems
  • Frozen Shoulder
  • Failed back surgery
  • Pinched Nerves Sciatica

What do all these conditions have in common? They are painful conditions of the muscles, nerves, and joints that are chronic in nature (long term, unresponsive to traditional treatments) and that have scar tissue associated with it. This is the reason why MUA can successfully treat these conditions and the others fail.

How MUA Works?

The MUA procedure uses twighlight sedation to relax restricted muscles allowing the physician to gently stretch and adjust the spine. The MUA physician is trained to recognize where and how much stretching and adjustments are needed for each patient. Following the three-day procedure, post MUA exercises begin which will help to achieve the optimal benefit.

Typically a rehabilitation program lasts for 3-4 weeks post procedure. The proposed effects of the MUA include altering pain producing scar tissue formations, decompression of bulging/herniated discs, stretching of chronically tight muscles, and eliminating pain by improving range of motion of the affected joints. Patients often undergo various treatments, such as physical therapy, traditional chiropractic care, epidural injections, back surgery, and other treatments.

These do not address fibrous adhesions. Some patients feel temporarily better with these treatments, but their pain often returns. Studies have proposed that it is the adhesions and scar tissue that have built up around spinal joints and muscles that causes chronic pain. In order to offer long term pain relief, the fibrous adhesions in the joint capsules, discs, and surrounding supportive tissues must be treated.

Conditions MUA Treats

  • Neck, middle back and lower back pain
  • Sacroiliac Joint Problems
  • Herniated and Bulging Discs
  • Chronic muscle pain and inflammation
  • Acute and chronic muscle spasm
  • Decreased range of motion
  • Frozen Shoulder
  • Nerve entrapment
  • Sciatica
  • Failed back surgery syndrome
  • Chronic tension headaches
  • Chronic pain with narcotic dependence
  • Stable spondylolithesis
  • Fibromyalgia
  • and more!