Manipulation Under Anesthesia (MUA) is a medical procedure designed to restore mobility and alleviate discomfort in musculoskeletal issues. It is a non-surgical option for individuals experiencing persistent stiffness or reduced range of motion in various joints.
Meaning of MUA
Manipulation Under Anesthesia (MUA) involves a medical professional moving a joint or body part in a controlled manner to improve its function. The “Manipulation” refers to the passive movement of a joint, aiming to restore its natural range of motion or proper alignment. This is achieved by stretching surrounding tissues, breaking down internal scar tissue, or releasing muscle spasms that restrict movement. The “Under Anesthesia” component signifies that the entire procedure is performed while the patient is under general anesthesia or deep sedation. This allows for complete muscle relaxation, preventing pain and involuntary muscle guarding during the manipulation, which enables the specialist to achieve movements that would otherwise be too painful or difficult.
Conditions Treated with MUA
MUA is commonly used for conditions characterized by significant joint stiffness, reduced range of motion, and chronic pain that have not responded to conventional treatments like physical therapy. A frequent application is adhesive capsulitis, or “frozen shoulder,” where the shoulder joint capsule becomes inflamed and contracted, leading to pain and severely restricted movement. MUA helps by forcefully moving the shoulder through its full range, breaking down the scar tissue and adhesions that cause the stiffness.
The procedure is also beneficial for persistent joint stiffness following injuries or orthopedic surgeries, particularly in the knee, hip, and elbow. After surgery, scar tissue, also called adhesions, can form and impede the movement of soft tissues and joints, limiting recovery. MUA can effectively break these fibrous adhesions, restoring mobility and improving functional outcomes. Additionally, it may be considered for chronic muscle spasms, certain types of nerve entrapment, and specific fracture reductions where muscle relaxation is essential for proper alignment.
The MUA Procedure
Before an MUA procedure, a thorough pre-procedure assessment is conducted, which typically includes imaging tests like X-rays, MRI, or CT scans, alongside a physical examination. This evaluation helps to identify the specific area requiring treatment and confirm the patient’s suitability for the procedure. The patient is then administered anesthesia, most commonly general anesthesia, ensuring they are unconscious and pain-free throughout the manipulation.
Once the patient is adequately anesthetized and their muscles are relaxed, a trained medical professional, such as an orthopedic surgeon, chiropractor, or osteopath, performs the manipulation. They apply controlled and precise movements to the affected joint to stretch tissues and break down scar tissue or adhesions, moving the joint through its full range of motion. The procedure itself is relatively short, often lasting around 20 to 30 minutes, and patients are typically discharged home the same day.
Recovery After MUA
Following an MUA procedure, patients may experience immediate soreness, discomfort, and some swelling in the treated joint. Pain management strategies, including rest, icing, elevation, and prescribed medications, are recommended to alleviate these initial symptoms.
Immediate and consistent physical therapy or rehabilitation is essential for recovery. This intensive therapy, often starting within a week to 10 days post-procedure, helps maintain the newly gained range of motion and prevents scar tissue reformation. The rehabilitation program is tailored to the individual and may include exercises, stretching, and other modalities. Most patients can expect to regain significant functional range of motion within approximately six weeks after MUA, though individual recovery timelines vary. Follow-up appointments with the medical team are important to monitor progress and adjust the rehabilitation plan as needed.