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.
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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.
IS MUA NEW OR EXPERIMENTAL?
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.
WHO CAN BENEFIT FROM MUA AND WHY DOES MUA WORK ?
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.
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"
DOES INSURANCE COVER THIS PROCEDURE?
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.
WHAT IS THE MUA PROCEDURE LIKE?
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
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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 www.clear-institute.org