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Overview of Manipulation Under Anesthesia Certification


Manipulation Under Anesthesia (MUA) is by far one of the most exciting and effective osteopathic, chronic pain and physical medicine procedures being performed today for the treatment of chronic and recurrent back pain, fibroblastic proliferative changes, chronic muscle spasm, failed back syndromes, herniated discs and unresolved headaches of non-organic origin. The procedure is within nationally published practice guidelines and parameters of care.

MUA expands the primary role of the M.D., D.O., D.C., D.P.T. and other PM&R physicians in chronic pain treatment and physical medicine. It enables the physician to provide a higher level of care, as well as an alternative to surgery to their patients.
When proper treatment protocols are followed, MUA consistently generates life changing results for carefully selected patients.

Manipulation Under Anesthesia, or MUA, is a highly specialized, non-invasive stretching technique for chronic pain patients who have failed to respond to long term conservative care. Manipulation Under Anesthesia works by breaking up adhesions and scar tissues to restore range of motion while the patient is in a safe, temporary twilight sedation. 

Manipulation under anesthesia uses a combination of specific short lever manipulations, passive stretches and specific articular and postural kinesthetic maneuvers in order to break up fibrous adhesions and scar tissue around the spine and surrounding tissue.

The manipulation procedures can be offered in any of the following ways:

  • Under general anesthesia

  • During mild sedation

  • Following the injection of anesthetic solutions into specific tissues of the spine.

The treatment is performed in a hospital or ambulatory surgery center (ASC) by licensed physicians with specialized training and certification specifically for the procedure. A team approach is required to have safe and successful results. The procedure can also be performed in office if the required equipment is readily available  

The team includes the anesthesiologist, the prime physician/surgeon/chiropractor who performs the manipulation, and the first assistant, also an M.D., Osteopathic or Chiropractic physician certified in Manipulation Under Anesthesia.
The procedure is most commonly performed in an ambulatory surgery center or hospital.

The combination of manipulation and anesthesia is not new or experimental, this treatment has been part of the manual medical arena for more than 60 years. Manipulation Under Anesthesia is an established medical procedure with a CPT Code designate of 22505. This is noted in the American Medical Association’s Current Procedural Terminology Publication.