Drug Delivery Report

Patients experiencing chronic pain may want to look at manipulation under anesthesia as a procedure option to get away from pain medications and avoid surgery. The problems that tend to do well with this procedure are muscle spams, scar tissue, chronic neck pain, back pain, and joint pain.

Pain caused by the lumbar, thoracic, or cervical spine, frozen shoulder, and any discomfort in the pelvic region or sacroiliac may be treated by manipulation under anesthesia (MUA). The treatment is safe and can serve as a replacement for more intrusive and dangerous medical procedures. There are three primary ways that patients undergo this procedure.

1. During mild sedation

2. Under general anesthesia

3. After injection into the specific area being worked on with anesthetic

Specialists working in a team environment to assure the safety of the patient may perform this procedure in a medical surgery facility. Manipulation under anesthesia is always a team effort, which generally consists of the anesthesiologist, the chiropractor or doctor responsible for the manipulation, and an assistant.

Unlike typical chiropractor procedures, MUA is performed in an outpatient surgery center, not an office setting.

The primary aim of manipulation under anesthesia is to break up scar tissue or fibrous adhesions that center around the spine. The process uses specific kinesthetic maneuvers of postural and articular varieties, passive stretches, and short-lever manipulations of the spine specific to the problem areas.

Although the terminology might be new to many people, manipulation under anesthesia is far from a new procedure. It has been a part of medical treatment for more than sixty years and has its own CPT Code designation.

Who Receives Treatment

Most spinal manipulation procedures are done for back and neck injuries, but not all require an MUA, and some doctors might hesitate to perform manipulations based on several factors such as the medical condition. One of the primary reasons an MUA is done is for adhesive capsulitis, also termed frozen shoulder.

Other care and treatment is often attempted before spinal manipulation, but if those efforts prove ineffective, manipulation is the next step. Scar tissue builds up along with adhesions during prolonged aggravation of spinal joints. Over time, this produces chronic pain in the spine and surrounding muscles.

While epidural injections, PT, and chiropractic treatments often give temporary relief from pain, they don't treat the underlying issue with scarring. Spine surgery does not often address this and the situation may worsen. MUA gives lasting results for chronic neck and back pain.