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Manipulation Under Anesthesia | Manipulation Overview | MUA History
MUA Pathomechanics | MUA Success Stories | Pain Management
MUA FAQ’s | MUA Research


MUA Frequently Asked Questions

MUA is a Conservative Treatment Alternative
for Patients with Chronic Pain

  1. What is MUA?
  2. How and where is MUA performed and how long does it take?
  3. Is MUA new or experimental?
  4. Who can benefit from MUA?
  5. Why does MUA work?
  6. How do I begin an MUA treatment plan?
  7. What’s the MUA procedure like?
  8. What happens after the procedure?

What is MUA?

Manipulation Under Anesthesia (MUA) is an outpatient procedure that effectively treats chronic neck, back and extremity pain and dysfunction. Most candidates for MUA have already had an adequate trial of conservative care including medications, injections, in-office manipulations, rehabilitation, physical therapy, and some have even been considered for surgical intervention. These individuals have mechanical dysfunction of the joints and scar tissue build up in the supporting soft tissues of the spine resulting in joint and muscle dysfunction, chronic stiffness and pain. Many patients with herniated discs have avoided surgery by undergoing a series of MUA procedures. Numerous patients who have already undergone surgery develop scar tissue and are referred to Dr. Sofo by their surgeons and treating physicians for the MUA procedure.

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How and where is MUA performed and how long does it take?

MUA is performed in a hospital or ambulatory out patient surgical center in an out patient surgical setting with board certified anesthesiologists supervising and providing the anesthesia. Patients receive a sedative and then experience a twilight anesthesia much the same as when they are peacefully sleeping. This allows the doctor to gently manipulate the joints and soft tissues that have become chronically tight and inflexible resulting in pain and dysfunction. The procedure takes less than an hour and is usually performed first thing in the morning for three consecutive days for maximum results. The patient then may come in for follow up office visits for a brief period of continued physical medicine interventions to maintain the flexibility and increased range of motion accomplished with the MUAs.

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Is MUA new or experimental?

MUA is neither new nor experimental. It’s actually been practiced since the late 1930s and used by osteopathic physicians and orthopedic surgeons for many years as a proven form of treatment. During the past eight years, interest in MUAM has greatly increased thanks to tremendous advances in anesthesiology. Today, MUA is a multi-disciplinary outpatient procedure that takes place in a controlled hospital or ambulatory surgical setting, usually over the course of one to three days. Using specialized chiropractic techniques, supported by the expertise of MDs, RNs and anesthesiologists, MUA achieves maximum results for qualified patients. Countless recent case studies and medical research continue to show that MUA is widely regarded as safe and effective.

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Who can benefit from MUA?

MUA can be a valuable procedure for people with chronic neck, back and joint problems caused by long-term disabilities, accidents, and injuries that have not been responsive to conventional conservative treatment – but MUA is not for everybody.

Common, general indications that MUA could be effective include:

  • Fibro adhesion buildup
  • Chronic disc problems
  • Herniated disc without fragmentation
  • Chronic myofascitis
  • Chronic Headaches/Migraines
  • Intractable pain from neuromusculoskeletal conditions
  • Torticollis
  • Chronic re-injury
  • Failed back surgery
  • Chiropractic patients who have reached a plateau using traditional therapy also can significantly improve their quality of life using MUA.

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Why does MUA work?

MUA achieves results where other treatments fail because it allows your caregivers to adjust the bones and muscles – the therapy of choice – without the usual muscular resistance. “Twilight” sedation allows you to be responsive, but not apprehensive. Manipulations are completed gently and without the patient’s usual psychological resistance. Fibrotic adhesions, which limit range of motion and contribute to pain, are altered; muscles are stretched; collagen fibers are remodeled to eliminate or reduce restriction. Pain and discomfort are decreased. The adjustments received using MUA are similar to those the patient experiences during regular chiropractic visits, but require less force simply because of the relaxed state.

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How do I begin an MUA treatment plan?

Using standards of care as described by the National Academy of MUA Physicians, the doctor selects patients.

  • Your doctor may also order additional tests, such as an MRI, or magnetic resonance imaging, CT (cat scans), and other diagnostic tests, if needed.
  • After receiving clearance, the patient is scheduled at the facility where the MUA will be performed.

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What’s the MUA procedure like?

On the day of the MUA, the patient must be accompanied by a friend or family member to drive the patient home after the procedure. No patient will be allowed to drive following this procedure. The patient then confers with the anesthesiologist, is gowned and the sedative is administered to achieve the comfortable “twilight” sleep that makes treatment possible. If the full spinal procedure is performed, MUA begins with specialized techniques that first methodically start in the cervical spine (neck) with gentle stretching techniques, followed by adjustive procedures. The doctor then moves on to the thoracic spine (mid back), using mild stretching techniques and adjustment and finally into the lumbar (lower back) spinal regions using traction techniques, plus stretching, as well as lumbar adjustment.

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What happens after the procedure?

After the procedure is completed, the patient is taken to recovery, where he or she is carefully monitored by the nursing staff. Recovery time is generally 15-20 minutes. After recovery, the patient receives fluids and a light snack. The doctor and anesthesiologist also remain in attendance until the patient is discharged. To achieve results in most chronic cases, the MUA procedure is repeated for an additional 2 consecutive days. The doctor may adjust only the area of abnormality plus the adjacent area, the adjacent area only, or all three areas, depending on the doctor’s assessment of the condition.

Post-procedure care is one of the most important parts of the MUA procedure and makes it truly effective. The therapy begins immediately after the MUA procedure is completed. At this time, the patient visits the doctor’s office and undergoes a combination of stretching exercises, cryo-therapy and electrical stimulation to eliminate or reduce soreness. The patient then returns home to rest. Following the MUA procedure, the patient should follow an intensive therapy program for 4 to 8 weeks. This is to include modalities as needed initially and then rehabilitation to include stretching, flexibility and strengthening exercises, plus periodic adjustments as required by the doctor. A regimented program of post-MUA therapy will help the patient regain both pre-injury strength and help prevent future pain and disability.

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Call our Princeton chiropractic office today!



Princeton Chiropractic
and Sports Rehab

601 Ewing St., Ste C3,
Princeton, NJ 08540
(609) 921-1705
Princeton, Mercer and Somerset county families enjoy chiropractic and its amazing benefits.