If all conservative treatments fail, Manipulation Under Anesthesia (MUA) can be an option. This revolutionary treatment offered by Central Florida Pain & Rehab Clinic consists of adjustments and stretching movements under sedation.


WHAT IS MUA?
Manipulation Under Anesthesia, otherwise known as MUA, is a non-invasive procedure increasingly offered for acute and chronic conditions, including: neck pain, back pain, joint pain, muscle spasm, shortened muscles, fibrous adhesions and long term pain syndromes. Manipulation Under Anesthesia is exactly what it sounds like. After medical clearance, the patient is lightly anesthetized to achive total relaxation, then adjustments and stretching movements which would normally be too painful to even consider are easily, painlessly and quickly accomplished.

IS MUA NEW OR EXPERIMENTAL?
MUA is neither new nor experimental. It has actually been practiced since the late 1930s and used by osteopathic physicians and orthopedic surgeons for many years as a proven form of treatment.
During the past eight years, interest in MUA has greatly increased thanks to tremendous advances in anesthesiology.
Today, MUA is a multi-disciplinary outpatient procedure that takes place in a controlled setting, usually over the course of one to three days.
Using specialized osteo manipulative techniques supported by the expertise of MDs, DCs, DOs, RNs and anesthesiologists, MUA achieves maximum results for qualified patients.

WHAT DOES MUA WORK?
MUA achieves results where other treatments fail because it allows your caregivers to adjust the bones and muscles - the therapy of choice - without the usual resistance.
"Twilight" sedation allows you to be responsive and relaxed, not apprehensive.
Manipulations are completed gently, and without the patient's usual pain-trained psychological resistance.
Fibrotic adhesions, which limit range of motion and contribute to pain, are altered; muscles are stretched; collagen fibers are remodeled to eliminate or reduce restriction. Pain and discomfort are decreased.

WHO CAN BENEFIT FROM MUA?
MUA can be a valuable procedure for people with chronic neck, back, and joint problems - conditions caused by long-term disabilities, accidents, and injuries that have not been responsive to conventional treatment - but MUA is not for everybody.
Common, general indications that MUA could be effective include:

• Fibroadhesion buildup.
• Chronic disc problems.
• Herniated disc without fragmentation.
• Chronic myofascitis.
• Torticollis.
• Chronic re-injury.
• Failed back surgery.
• Fibromyalgia.
• Intractable pain from neuromusculoskeletal conditions.

Patients who have reached a plateau using traditional therapy also can significantly improve their quality of life using MUA.

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 and begins with specialized techniques that first methodically start in the cervical spine with gentle axial traction, forward and lateral flexion movements, followed by adjustive procedures.
The doctor then moves on to the thoracic spine, using mild stretching techniques and adjustment and finally into the lumbar spinal regions using flexion and traction techniques plus stretching, targeted massage and knee-to-chest rolls as well as lumbar adjustment.
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 and will be continually monitored in the recovery room.

HOW DO I BEGIN AN MUA TREATMENT PLAN?
Once proper patients are selected by the physician using standards of care as described by the National Institute for MUA, the typical MUAtreatment plan begins with a medical screening process to clear the patient for anesthesia. Medical tests may include:

• CBC blood studies.
• SMA 6.
• Chest X-ray and EKG (electrocardiogram) for patients age 50 and older.
• And a pregnancy test for female MUA patients.

Your physician may also order additional test, such as MRI (magnetic resonance imaging), CT (ct scans), and other diagnostic tests, if needed.
After receiving medical clearance, the patient is scheduled at the facility where the MUA will be performed.

WHAT ARE THE EFFECTS OF MUA PROCEDURE?
The proposed effects of Manipulation Under Anesthesia therapy include the following:

• Breaking up scar tissue (adhesions) both in and around the spinal joints, commonly caused by multiple injuries or failed back surgery.
• A decreasing chronic muscle spasm.
• Overcoming super-sensitivity of injured areas, making the patient unable to cooperate for effective treatment.
• Stretching persistent shortened muscles, ligaments and tendons.
• Relief from pain and radiating symptoms caused by damaged invertebral discs.

Most importantly however, Manipulation Under Anesthesia affords patients immediate relief and noticeable difference in their daily lives post-procedure. These positive results only continue to improve with time and post-MUA therapy.

DOES INSURANCE COVER THIS PROCEDURE?
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.

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