Manipulative Techniques

Manipulation under anesthesia procedures may vary from patient to patient as medical necessity indicates by the involved tissues and existing relative contraindications and/or possible complications that may exist.

Specific Manipulation under Anesthesia Procedures

Some manipulation under anesthesia techniques may include:

  • Soft tissue procedures (lateral stretching, linear stretching, deep pressure, traction and/or separation of muscle origin and insertion). Treating the periarticular tissue, such manipulation under anesthesia procedures aim to decrease muscle spasms and increase tissue mobility.
  • Articulatory procedures (spinal mobilization without impulse, low velocity techniques). These manipulative techniques involving putting the articulation through a full anatomic range of motion and applying a passive serial repetitive oscillatory rhythmic springing force in the direction of the restriction. Treating the periarticular and articular tissue, such manipulation under anesthesia procedures aim to increase both the quantity of motion (by gradually moving the restrictive barrier and restoring the range of motion) and the quality of motion (by reestablishing a smooth range of motion with normal elasticity and feel).
  • Specific joint mobilization procedure (mobilization with impulse, high velocity technique). This manipulative procedure involves an extrinsic operator applied thrust overcoming restrictive articular movement, and engagement of the restrictive barrier and thrust through the barrier to achieve normal joint movement. Treating the articular and intra articular tissue, this manipulation under anesthesia procedure aims to increase the joint's range of motion, reduce joint restrictions, decrease hypertonicity (increased tension of the muscles) and stretch the shortened, fibrosed connective tissues of the articulation.

Shortly after manipulation under anesthesia, patients may quickly notice an increased range of motion along with some muscle soreness.

Written by Richard J. Reid, MD and Rosie Desimone, DC and Ben Eubank, DC