INTRODUCTION TO MUA
For chronic pain sufferers a simple and painless procedure is offering a level of relief never dreamed possible. Instead of allowing chronic pain patients to slip into a cycle of drugs and surgery, our doctors are giving them the opportunity to live pain free lives through a procedure known as Manipulation under Anesthesia (MUA).
Established and widely recognized in the medical arena for more than sixty years, MUA is a viable alternative for patients that have failed to achieve long term relief from chiropractic treatments, physical therapy, narcotic pain medications or surgical procedures. MUA in conjunction with post treatment rehabilitation has proven to be an effective procedure for many patients suffering with chronic pain syndromes.
WHAT IS MANIPULATION UNDER ANESTHESIA?
Manipulation under anesthesia, otherwise known as MUA, is a non-invasive manual therapy procedure ( manipulation , stretching and soft tissue mobilization ) performed in an outpatient surgicalal al center under light sedation. Being under anesthesia allows the body to relax therefore eliminating conscious resistance and guarding from over active muscles allowing the doctors to achieve better mobility and help resolve patients pain.
WHAT IS THE HISTORY OF MUA?
Manipulation under anesthesia (MUA) is neither new nor experimental. It's been practiced by osteopathic and orthopedic physicians since the 1930s. Thanks to advances in anesthesiology and technique, MUA has become a multidisciplinary outpatient procedure. The MUA procedure continues to gain widespread support and recognition in the medical community and is helping to bring much-needed relief to more patients than ever before.
CLINICAL RESEARCH ON MUA?
Multiple prospective and retrospective clinical studies have been performed evaluating the effectiveness of MUA in chronic unresolved back pain, acute and chronic disc herniations, cervicogenic cephalgia, and many other neuromusculoskeletal conditions.
Robert Mensor, M.D. orthopedic surgeon compares the outcomes of MUA and Laminectomy (a lower back surgical procedure) in patients with lumbar Intervertebral disc lesions and found that 83% of MUA patients had good to excellent results while only 51% of surgical patients reported the same outcome.
Donald Chrisman, M.D. orthopedic surgeon, reported that 51% of patients with unequivocal disc lesions and unrelieved symptoms after conservative care reported good to excellent results post-MUA at three years follow up.
Bradford & Siehl reported on 723 MUA patients, the largest clinical trial conducted on MUA, 71% had good results, and that 25% had fair results than 4% ultimately required surgical intervention.
Krumhansl and Nowacek reported on 171 patients who experience constant intractable pain, of durations from several months to 18 years, and who underwent MUA. All patients had failed the previous conservative interventions. Results reported that post MUA, 25% had no pain at all and were “cured”, 50% unaffected, 20% were “better but” pain continued to interfere with activities and finally 5% had minimal or no relief.
West et al reported in a 1998 study of 177 patients that 68.6% of patients out of work returned to unrestricted work activities after a series of three consecutive MUA procedures. At six months post-MUA, 58.4% of the MUA patients receiving medications prior to the procedure required no prescription medication post procedure.
In 2002 Palmieri et al demonstrate clinical efficacy of MUA performed in a series of three consecutive procedures. The average Numeric Pain Scale scores in the MUA group decrease by 50%, and the average Roland-Morris disability questionnaire scores decreased by 51% compared to the control group.
The medical literature is replete with case studies and literature reviews on MUA, in addition to clinical trials, all of which report positive clinical outcomes.
It is important to note that to date there have been no clinical trials that demonstrate MUA to be ineffective in an appropriately selected patient population.
WHO CAN BENEFIT FROM MUA?
MUA can be valuable, effective procedure for those people who have conditions that have not responded to conventional treatment. These conditions include:
- Neck, mid-back and low back pain
- Chronic muscle pain and inflammation
- Acute and chronic muscle spasm
- Decrease joint range of motion
- Post shoulder surgery stiffness or pain
- Frozen Shoulder
- Disc bulges or protrusions,
- Disc herniations less than 3 mm in the cervical spine & less than 5 mm in the lumbar spine,
- Chronic occipital or tension headaches
- Traumatic or spastic torticollis
- Muscle contracture and fascitis
- Myofascial pain syndrome
- Restricted hip joint mobility
- Nerve entrapment
- Failed Back Surgery
WHO PERFORMS THE MUA PROCEDURE?
Your MUA treatment team includes a board-certified anesthesiologist, our MUA certified doctors at West Valley Wellness & Rehabilitation along with a certified nursing staff to assist in the procedure as well as pre-and post-procedure care.
Only a physician that has been certified in performing MUA can perform the MUA procedure. At West Valley Wellness & Rehabilitation we take pride in our doctors who are not only certified by accredited institutions in MUA, but highly experienced, having helped relieve the pain of hundreds of patients across the valley.
WHY CONSCIOUS SEDATION?
When problems exist such as chronic muscle spasms, restricted joint function and chronic pain, conscious manipulation and stretching is not feasible without significant pain. Intravenous conscious sedation shuts off the muscle spasm cycle, sedates the pain perceiving nerves, and allows complete muscle relaxation. The doctors are then able to gently manipulate the joints through their normal range of motion, reduce restrictive adhesions restore normal range of motion. The procedure usually last 20 to 25 minutes and the patient wakes up shortly thereafter.
WHAT CAN PATIENTS EXPECT FROM HAVING MUA?
Despit some soreness, the patient should experience an immediate increase in range of motion, flexibility and a reduction of pain. In cases involving fibrous adhesions and shortened contracted tissues, there should be significant change, either immediate or within a short period of time following the procedure. Post MUA rehabilitation is a very important part of our program and greatly affects the outcome and results. The rehab will be planned and conducted by our referring physicians. The regimented post-procedure rehabilitation will help the patient continue to maintain full function and range of motion established during the procedure and will help prevent future pain and disability.
MUA is not an invasive procedure. It is simply manipulation, joint mobilization and stretching performed in an operating room environment under light sedation anesthesia. It is very similar to a chiropractic treatment, but with the added aid of twilight anesthesia. The actual procedure is very gentle and patients are often back to every day life within a few days.