Manipulation under anesthesia procedures may vary depending on the doctor’s methods and what is needed for each individual case. The location of the pain source, as well as any medical conditions unique to the patient, can help determine which maneuvers and stretches may be beneficial and which should be avoided.

See Chiropractic Adjustment

Specific Manipulation under Anesthesia Procedures

Some common spinal MUA techniques performed during the procedure:

  • Soft tissue procedures include lateral stretching, linear stretching, deep pressure, traction and/or separation of muscle origin and insertion. While treating the soft tissues around the spinal joints, these procedures aim to decrease muscle spasms and increase tissue mobility.
  • Spinal manipulation, also known as high-velocity low-amplitude (HVLA) thrust, typically involves a trained medical professional holding the body and spine in certain positions while applying an external thrust (usually with the hands) to overcome restrictive joint movement. If the thrust can overcome the restrictive barrier, the joint’s normal range of motion may be restored or at least improved. Spinal manipulation treats the tissues both in and around the joint, aiming to increase the joint's range of motion, reduce joint restrictions, decrease elevated tension in the muscles, and stretch the shortened, scarred connective tissues around the joint.

    See Spinal Manipulation: High-Velocity Low-Amplitude (HVLA)

  • Spinal mobilization, also known as gentle chiropractic or low-velocity techniques, involve slowly moving the joint until a firm endpoint is reached. No extra thrust is given to go past the natural endpoint but rather, a slow stretch to a firm end-range of tissue tension. These gradual movements put the joint through its full range of motion and may be repeated rhythmically. Spinal mobilization aims 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).

    See Spinal Mobilization: Gentle Chiropractic Techniques

There are other techniques that may sometimes be used during spinal MUA, such as traction, as well as variations of each technique.


How Spinal MUA Techniques Feel

Due to the anesthesia and other medications that may be used, patients typically do not feel anything during spinal MUA, or at least not anything that is perceived as unpleasant. After the procedure is over and the anesthesia starts wearing off, patients may soon notice an increased range of motion in the back and/or neck. If the procedure was successful, the pain level prior to the procedure is reduced or eliminated. However, an unsuccessful procedure can result in no pain relief or even a worsening of symptoms.

Even if the procedure is successful, most spinal MUA patients describe a general muscle soreness similar to what is experienced after a hard workout. This soreness, which is a result of the muscles and joints being significantly stretched and twisted to achieve the procedure’s full benefits, tends to go away within a few days.


Number of Spinal MUA Applications

Years ago, spinal MUA was typically performed on 3 consecutive days. Now insurance generally only approves one application of spinal MUA at a time. After the first application, insurance may require 2 to 4 weeks of chiropractic care and physical therapy to see how the patient is progressing. If the patient is improved, but not fully improved, another session may be warranted.

Post-procedure care is provided after each spinal MUA session. The amount of post-procedure care depends on the success of the MUA which varies from case to case.

Dr. Angela Christopher is a chiropractor specializing in spine care and sports medicine. For more than 10 years she owned AZ Spine Disc and Sport, a multi-specialty sports medicine and pain management practice in Phoenix, AZ.