Manipulation Under Anesthesia (M.U.A.) The fibrosis release technique The art, science and practice of the non-operative restoration of the function of bones, joints, muscles, tendons, and ligaments while the patient is under a gentle "twilight" anesthesia.  This fibrosis release technique is applied to the spine, hips, shoulders and knees.

If you are not familiar with our services and your first contact with us is online: We would be pleased to hear from you! Please let us know what your needs and questions are, we will be more than happy to help. 

To watch a video showcasing MUA which originally aired on WNBC                    copy and paste this link into your browser

SPECIAL OFFER:  Call Today for A No Charge consultation with Dr. Strauss.  Simply mention that you read this special offer on our website.  You will get to sit down with Dr. Strauss and discuss whether or not Manipulation under Anesthesia is an appropriate treatment for your condition.  Dr. Strauss will review your medical history and will answer any questions you may have.

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Our office is located in the heart of Rockland County, New York inside the Nanuet Mall.  We are conveniently located near to Nyack, New City, Pearl River, Monsey, Spring Valley and Montvale, New Jersey.

For more information or to make an appointment to discuss the suitability of MANIPULATION UNDER ANESTHESIA in your case, please contact the office directly or leave a message in the form below.

Manipulation under anesthesia (MUA) is  the use of manual manipulation of the spine, hips, shoulders and knees combined with the use of very light "twilight" anesthetic. The addition of anesthetic allows for the benefits of manipulation to be shared with those patients who cannot tolerate manual techniques because of pain response, spasm, muscle contractures, and guarding. MUA uses a combination of specific manipulations and  passive stretches.


Spinal manipulation under anesthesia (MUA) has been used to treat a wide variety of musculoskeletal disorders dating as far back as the 1930s and 1940s. Most of the forms of MUA discussed in the literature have been performed and documented by the medical and osteopathic professions. It would also appear that most of this research has dealt primarily with MUA as an approach to treating certain types of mechanical lumbar and cervical spine dysfunction. The generally accepted rationale for how MUA works is based on solid scientific data relating to muscle and joint physiology. Authors and researchers such as Guyton, Fung, Crowe, and Hill have all helped to establish the unique physiologic properties that synovial joints and muscles have and how those properties act when subjected to traction and stretching forces. MUA in the clinical setting is based on the hypothesis that fibrous adhesions in the joint capsules and surrounding supportive tissues can be altered by the use of specific manipulative and stretching techniques. The result of altering adhesions is increased mobility of the motor unit caused by an increase in flexibility of the supportive tissue. Siehl and Claybourne have documented the validity of MUA as a procedure useful in treating musculoskeletal disorders when restrictition of the joint, joint capsule, and surrounding musculature has taken place as a result of the formation of fibrous adhesions.


The goals in treatment of mechanical spine pain is to correct the aberrant  motion of the involved spinal areas or involved joints, thereby improving function and decreasing pain. 

Indications for MUA include:

1. Nerve entrapment (pinched nerves)

2. Chronic muscle pain and inflammation

3. Chronic muscle fibrosis (shortened restricted painful muscles)

4. Arthritis

5. Chronic disc degeneration with pain

6. Restricted motion of the joints with pain following a trauma

7. Old compression fractures of the spinal bones with pain and muscle spasm

8. Traumatic torticollis "wry neck"


MUA is covered by most insurances including workers compensation and no fault policies.  The coverage is dependent on the patient's medical necessity for the procedure.  You will be carefully evaluated for medical necessity before a decision as to whether you are a candidate for MUA.  The evaluation will consist of a complete history and physical examination, an x-ray examination which may include CT scan and or MRI, you may further need a laboratory examination of the blood and electro diagnostic tests.


Before the day of the procedure, the patient is instructed regarding food restrictions and use of medications. The patient will often be picked up by car service and then driven home after the procedure or a friend or family member will accompany them and do the driving. No patient will be allowed to drive themselves home after this procedure. The patient then signs an informed consent affidavit and right after is placed on the procedure table and vital sign monitoring is instituted, including electrocardiography, blood pressure, and pulse oximetry. Supplemental oxygen is given.

The MUA procedure generally takes between 15 and 20 minutes. The patient is continually monitored by an anesthesiologist. Blood pressures are obtained at least every 5 minutes, and a complete anesthesia record is maintained. The patient spends 30 minutes in the recovery room at the termination of the procedure. He or she will  be continually monitored in the recovery room.


Journal of Manipulative and Physiological Therapeutics Vol 22, Number 5, June 1999

Effective Management of Spinal Pain in One Hundred Seventy-seven Patients Evaluated for Manipulation Under Anesthesia

Daniel T. West, DC, Robert S Mathews, MD, Mathew R. Miller, and
George M. Kent, MD

Journal of Manipulative and Physiological Therapeutics Vol 22, Number 3, March/April 1999

Use of Cervical Spine Manipulation Under Anesthesia for Management of Cervical Disk Herniation, Cervical Radiculapothy, and Associated Cervicogenic Headache Syndrome

James Herzog, DC


Medicine is an ever-changing science. As new research and clinical experience broadens our knowledge, changes in treatment and drug therapy are required. The authors have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor any other party who has been involved in the preparation or publication of this web site or the information it contains or refers to warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or for the results obtained from the use of such information. Readers are encouraged to confirm the information contained herein with other sources.

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This is an excellent resource for non bracing, non surgical scoliosis care.  Dr Strauss is advanced certified with CLEAR Institute. The office is full equipped to deliver all CLEAR protocols.  For more info contact

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