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Common MUA Questions

What Can I Expect with an MUA Procedure?

On the day of the MUA, the patient must be accompanied by a friend or family member to drive the patient home after the procedure. No patient will be allowed to drive following this procedure.

The patient then confers with the anesthesiologist, is gowned and the sedative - usually Diprivan and/or Versed, and sometimes Fentanyl - is administered to achieve the comfortable "twilight” sleep that makes treatment possible. If the full spinal procedure is performed, MUA begins with specialized techniques that first methodically start in the cervical spine with gentle axial traction, forward flexion 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 then awakened from the anesthesia, which usually occurs minutes after the diprivan is stopped. They are taken to recovery and monitored until full recovery has occurred. This varies but is usually accomplished within a very short period of time. The patient is then discharged to rest until post-MUA therapy is begun later the same day.

What's the First Step in an MUA Plan?

Once proper patients are selected by the chiropractor using standards of care as described by the National Academy of MUA Physicians, the typical MUA treatment plan begins with a medical screening process to clear the patient for anesthesia.

Medical tests usually will include:

• CBC blood studies

• SMA 6

• Chest X-ray and EKG, or electrocardiogram, for patients age 50 and older

• And a pregnancy test for female MUA patients.

Your chiropractor may also order additional tests, such as MRI, or magnetic resonance imaging, CT, or cat 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 Happens After MUA?

After the procedure is completed, the patient is repositioned and awakened. then taken to recovery where he or she is carefully monitored by the OR nurse. Recovery time is generally fifteen to twenty minutes. After recovery, the patient receives fluids and a light snack. The doctor and anesthesiologist also remain in attendance until the patient is discharged.

Post-MUA therapy is a vital part of the MUA procedure and is accomplished the same day as the procedure to help continue the alteration of adhesions in the joints, joint capsules, and surrounding holding elements. Post MUA therapy consists of warming up the involved areas with passive stretching as was accomplished in the MUA procedure, followed by interferential stimulation and cryotherapy. The patient is then sent home to rest.

At this time the patient visits the chiropractor"s office and undergoes a combination of stretching exercises, cryo-therapy and electrical stimulation to eliminate or reduce soreness. The patient then returns home to rest. Following the last MUA procedure, the patient should follow an intensive therapy program for seven to ten days. This post MUA therapy should be the same stretches accomplished during the MUA procedure and adjustments made in the doctor's office. This is followed by rehabilitation for the next two to three weeks including stretching, flexibility and strengthening exercises, plus periodic adjustments as required by the doctor.

This exact procedure is repeated serially in most cases by having the patient return to the facility the next day and the following day(s). The average number of days for the MUA procedure to accomplish the desired outcome has been shown to be between 2-4 days. Consecutive day procedures have been shown to alter adhesion formation and joint dysfunction in a manner that single procedures do not accomplish. The concept is that a little more movement each day in incremental movements accomplishes the desired increase in range of movement and decrease pain far better than trying to spend great amounts of time on one day to accomplish the same movement.

This also has a dramatic effect on decreasing the post-MUA therapy time. This protocol for post-MUA therapy is repeated 7-10 days straight after the final MUA followed by pre-rehabilitation and then formal rehabilitation for 3-6 weeks. Additional assistance with the reduction of soreness and mild edema with an increase in range of motion, has been noted when small, portable, multi-modality interferential/NMES/HVPC devices are applied in the OR directly after the MUA procedures are accomplished and the patients are sent home with these units prior to receiving post-MUA therapy.

The rehabilitation program continues for 3-6 weeks following the MUA procedure to give the patient time to recover to pre-injury status. It gives the patient confidence that they have achieved recovery, and in most cases, the patient's return to work and daily lifestyle with a renewed feeling of confidence in their ability to accomplish everyday tasks that they have previously been unable to accomplish due to pain and reduced movement. Marked improvement (80-97%) has been the general rule when the properly selected cases have received this procedure. Strict adherence to standards and protocols should be the rule of thumb when considering the MUA procedure and only certified MUA practitioners taught through accredited institutions should be allowed to practice this technique - reimbursement should also reflect that proper educational standards have been achieved.

A regimented program of post-MUA therapy will help the patient regain both pre-injury strength and help prevent future pain and disability

"I had been wearing a collar for a year previously . . . "

“I always had this dull burning feeling, then a car accident made it even worse where I couldn"t even lie down . . . “

“I constantly had a burning pain, it just never would go away, even with treatment, and after MUA it was gone . . .”

“I always had this constant ache in the small of my back, time progressed, and I wasn’t getting any better . . . “

As a chronic pain sufferer, isn’t it time you considered Manipulation Under Anesthesia?

“The first day I could feel some improvement, but the second day is when I could feel a major difference . . . and the third day I remember saying to my wife when I woke up,’I can’t believe I’m actually getting out of bed without an ache’ . . . and from there on out it’s just gotten better.”