Manipulation Under Anesthesia (MUA) for the shoulder is a medical procedure to restore movement and reduce shoulder stiffness. A medical professional gently moves the shoulder through its range of motion while the patient is under general anesthesia. This releases tightened tissues, improving shoulder function. It is considered when less invasive treatments have not sufficiently improved shoulder mobility.
Understanding Manipulation Under Anesthesia
Manipulation Under Anesthesia (MUA) is a non-incisional procedure, without surgical cuts. It relies on passive movement of the shoulder joint by a trained medical professional. Patients receive general anesthesia, inducing complete muscle relaxation and preventing pain during manipulation. This relaxation allows the medical professional to overcome resistance from muscle spasms and protective guarding, which would otherwise hinder effective movement.
The primary goal of MUA is to break up adhesions or scar tissue around the shoulder joint. These adhesions restrict movement and cause significant stiffness. With muscles fully relaxed under anesthesia, the medical professional applies controlled forces to stretch and tear these restrictive tissues. This restores the joint’s natural gliding motion and improves flexibility.
Shoulder Conditions Addressed by MUA
MUA is considered for shoulder conditions with significant stiffness and limited range of motion. One common condition is adhesive capsulitis, or “frozen shoulder.” In frozen shoulder, the capsule surrounding the glenohumeral joint becomes inflamed, thickened, and contracted, leading to pain and a progressive loss of movement. MUA stretches or tears this tightened capsule and internal scar tissue.
The procedure also addresses stiffness from prolonged immobilization after injury or certain post-surgical conditions. For example, if a shoulder has been kept still due to a fracture or previous operation, scar tissue can accumulate, limiting mobility. MUA restores range of motion by physically breaking down fibrotic tissue that restricts movement. It is considered after conservative treatments, like physical therapy and injections, have not provided adequate relief.
The MUA Procedure Explained
The MUA procedure is performed in a hospital or outpatient surgical setting. Before manipulation, the patient receives general anesthesia, rendering them unconscious and relaxed. A nerve block may also be administered to numb the shoulder, aiding pain management immediately after the procedure.
Once under anesthesia, the surgeon or medical professional systematically moves the shoulder joint through its full range of motion. This involves controlled, firm manipulations in different directions, such as forward elevation, external rotation, and internal rotation. These movements stretch and release the contracted joint capsule, breaking apart fibrous adhesions that limit mobility. The process does not involve incisions, as the goal is to manually restore motion.
Recovery and Rehabilitation Following MUA
After MUA, immediate and consistent physical therapy is important to maintain the newly gained range of motion. Patients often begin rehabilitation exercises within days, sometimes on the same day as the procedure. Initial therapy focuses on passive and active-assisted range of motion exercises, such as pendulum swings and assisted stretches, to prevent re-stiffening.
A structured rehabilitation program follows, progressing from gentle movements to strengthening exercises over weeks or months. This program gradually builds strength and endurance in shoulder muscles. Patient adherence to prescribed exercises and therapy sessions is important for achieving and maintaining the best outcome, as the shoulder can otherwise return to its previous stiff state. Full recovery, including regaining functional range of motion, can extend for weeks beyond the procedure.