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Chiropractic Research Review

MUA and Spinal Pain

Manipulation under anesthesia (MUA) utilizes specific short-lever arm manipulations, passive stretches and specific articular and postural kinesthetic integrations to treat musculoskeletal pain.

The addition of an anesthetic extends the benefits of manipulation to even those patients who cannot tolerate manual techniques because of pain response, spasm, muscle contractions or guarding.

This paper describes MUA and the selection criteria used by the authors in practice. The authors then detail the results of a study involving 177 patients (17-65 years of age). Patients underwent three sequential manipulations under intravenous sedation, followed by 4-6 weeks of various therapeutic modalities, including cryotherapy, interferential, active resistance and range-of-motion exercises, and osseous SMT. Patient outcomes included visual analog scale (VAS) scores, range of motion, and the use of pain medication.

Almost all (168) of the patients completed the entire program; their results are presented as follows:

* VAS ratings improved by 62.2% in patients with original cervical pain, and by 60.1% in patients with lumbar complaints.

* There was a 54% reduction in the number of patients using prescription pain medication from the pre-MUA period to six months after MUA.

* Whereas only 31.4% of the patients were able to work prior to the study, 64.1% returned to unrestricted activities six months after MUA.

West DT, Mathews RS, Miller MR, et al. Effective management of spinal pain in one hundred seventy-seven patients evaluated for manipulation under anesthesia. Journal of Manipulative and Physiological Therapeutics, June 1999:22(5), pp299-308.
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Chiropractic Research Review

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