Severe Back Pain

Chiropractic Manipulation Under Anesthesia


Chiropractic manipulation under anesthesia, also known as M.U.A is a non-invasive stretching and musculoskeletal manipulation technique. This type of chiropractic treatment can offer relief from chronic and constant back pain and other types of pain that have not responded well or at all to conservative non-surgical care. Chiropractic manipulation under anesthesia breaks up adhesions/internal scar tissue that could result from an injury or previous surgery, helping restore the normal range of motion and reduce pain. This technique is utilized to treat:

Adhesions can grow around:

  • Spinal joints
  • Nerve roots
  • Inside the surrounding muscles

This can result in restricted:

  • Movement
  • Limited flexibility
  • Pain

Undergoing chiropractic manipulation under anesthesia while sedated means the body is highly relaxed. This sedation allows the chiropractor to align the bones and joints and stretch the muscles without the individual’s voluntary/reflexive resistance. And the sedation allows the chiropractor to use less force, making the procedure painless.

Manipulation Under Anesthesia Specialists

This type of manipulation is a specialty procedure. Trained and certified physicians only perform it in the fields of:

  • Chiropractic medicine
  • Orthopedics
  • Physical therapy and rehabilitation
  • Osteopathy

Advantages of MUA treatment

Some individuals with pain respond well to regular chiropractic manipulation, physical therapy, or exercise. However, relief might only last for a few days or weeks, depending on their condition. This is where manipulation under anesthesia could improve the range of motion and relieve pain. Manipulation under anesthesia has been performed for more than sixty years. It can be cost-effective and safer than invasive treatment like spine surgery. It is recognized and covered by most insurance and workers’ compensation plans.

Determining if MUA is right for the individual and their condition

Manipulation under anesthesia is not for all individuals with back pain. MUA is only recommended for patients that meet the procedure’s criteria. Like any other type of recommended treatment, a doctor will carefully consider the individual’s medical history, symptoms, previous treatments, and effectiveness. A doctor will also perform a physical and neurological examination of an individual’s complete medical history. Test results will confirm the patient’s diagnosis and determine if anesthetic manipulation can help relieve pain and other symptoms. Tests can include:

  • X-ray
  • MRI
  • CT scan
  • Musculoskeletal sonograms use sound waves to produce images of muscles, tendons, ligaments, and joints.
  • EKG – electrocardiogram is a test that checks for problems with the heart’s electrical activity
  • The nerve conduction velocity test sees how fast electrical signals move through the nerve/s
  • Pregnancy test

Consideration for individuals with:

  • Pinched or entrapped nerve
  • Chronic/Persistent neck or back pain
  • Painful, restricted range of motion
  • Failed back surgery syndrome
  • Chronic sprains and strains
  • Acute muscle spasms
  • Fibromyalgia
  • Chronic spinal disc conditions
  • Fibrous adhesion/s

Not an appropriate treatment for individuals with:

  • Uncontrolled diabetic neuropathy
  • Spinal cord compression
  • Morbid obesity
  • Any cancer
  • Acute or healing bone fracture/s
  • Osteomyelitis vertebral bone infection
  • Acute inflammatory arthritis
  • Metastatic bone disease
  • Severe osteoporosis
  • Acute inflammatory gout
  • Tuberculosis of the bone
  • Co-existing medical problems could mean an individual may not be able to undergo any procedure that requires sedation.
  • Another reason why a patient’s complete medical history is vital


This procedure is usually performed in an ambulatory surgery center, which is a modern healthcare facility focused on providing same-day surgical care for diagnostic and preventive procedures, or at a hospital. An anesthesiologist administers the medicine/s. The patient could be sedated, not unconscious, or general anesthesia meaning complete unconsciousness. The choice of sedation depends on various factors, like the patient’s diagnosis and how severe the condition is. The anesthesiologist can recommend a specific type of medicine or a cocktail of medications for the patient’s comfort during and after.

Once sedated, the chiropractor utilizes specialized techniques to stretch, adjust and mobilize the affected areas of the spine and body. The manipulations free up fibrous adhesions or scar tissue in one or more areas of the spine and surrounding tissues. The procedure usually takes 15 to 30 minutes. The individual will be awakened and then carefully monitored in a recovery area. Many reports an immediate reduction in pain and a broader range of motion after the procedure. There is usually temporary muscle soreness, similar to the soreness after an intense workout.

Before being discharged, the patient is provided instructions about aftercare therapy. Instructions may include:

  • At-home warm-up movements
  • Physical therapy rehabilitation
  • Passive stretching
  • Electrical stimulation
  • Cryotherapy or cold therapy to reduce inflammation and pain

Sessions necessary

Depending on the diagnosis and response to the initial session, manipulation under anesthesia could be performed sequentially on consecutive days or two to four days. With each session, the chiropractor adjusts a little more, incrementally helping achieve the desired increase in movement and pain reduction/alleviation.

Physical therapy, exercise, and stretching

Individuals continue with physical therapy three to six weeks after the procedure to help prevent back pain from returning and any fibrous adhesions/scar tissue broken up from reforming. Exercise and stretching will help strengthen and stabilize the abdominal and spinal muscles and prevent pain from returning.



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That is because protein requirements for the elderly are usually higher than for younger individuals. This comes from age-related metabolism changes that include a decreased response to protein intake. This means that an older individual needs to consume more protein to achieve the same anabolic effect. Micronutrient deficiency is a lack of nutrients like minerals and vitamins. These support important bodily processes like cell regeneration, immune system function, and vision. A common example is iron and calcium deficiencies. This type of deficiency has the greatest impact on normal physiological functions in conjunction with protein-energy deficiency, as most micronutrients are acquired from food.


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Professional Scope of Practice *

The information herein on "Chiropractic Manipulation Under Anesthesia" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.

Blog Information & Scope Discussions

Our information scope is limited to Chiropractic, musculoskeletal, acupuncture, physical medicines, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions.

We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system.

Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.*

Our office has reasonably attempted to provide supportive citations and has identified the relevant research studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez, DC, or contact us at 915-850-0900.

We are here to help you and your family.


Dr. Alex Jimenez DC, MSACP, RN*, CCST, IFMCP*, CIFM*, ATN*


Licensed as a Doctor of Chiropractic (DC) in Texas & New Mexico*
Texas DC License # TX5807, New Mexico DC License # NM-DC2182

Licensed as a Registered Nurse (RN*) in Florida
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Dr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
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