Comments on: Pain Management Manipulation under Anesthesia

By: Stephen R. Gunter, DC

Stephen R. Gunter, DC — Fri, 25 Jul 2008 09:32:49 +0000

Proper manipulation/adjustment of a patient requires their willing surrender of guarding reflexes, which is generally accomplished by establishing rapport and developing trust, or the application of massage or ultra sound. However, extensive fibrosis/scar tissue, or degenerative joints (arthritis), as well as other pain generators or anxiety may leave the patient in a state of hyper-vigilance that makes it difficult or impossible to achieve the desired effect. While I have never performed MUA, I have referred patients for pain management prior to treatment, and the combination of Vicodin and Valium renders the patient unguarded and highly cooperative, if still conscious. In any event, skillful performance improves outcomes.

By: D Smith

D Smith — Mon, 14 Jul 2008 14:20:54 +0000

I can see the DC who wrote this obviously doenst believe in MUA but thank god for the ones who do!!! I am a mother of 4, and after two surgery I could only get 50% of range of motion in my arm. I have 95% after my MUA. I dont think the doctors are taught in a few hours but building on what they are taught in school.
I am thankful to my doctor and surgery center for MUA’s and suggest any patient to get a doctor who believes in them for their opinion since I know first hand it can give you your life back
Sincerely
D Smith

By: Rick Sheldon, D.C.

Rick Sheldon, D.C. — Fri, 20 Jun 2008 19:27:17 +0000

I am near retirement after having practiced Chiropractic Medicine for over 30 years. I was an appointed member of the Florida Board of Chiropractic Medicine when we were asked to determine the protocols for MUA in Florida. We, the board, worked on this for months. We came up with a very thorough document defining safe protocols. At the beginning of the Board of Chiropractic meeting, (over six years ago) where we were to adopt the protocols, our board attorney made some very convincing recommendations: 1. There was no need for the Board of Chiropractic to adopt the protocols. 2. There were already standards of practice for MUA in place within the medical practice act. This may sound confusing but our board attorney explained: A chiropractor can take courses to familuarize himself and correctly administer the adjustment. The Anesthesiologist can administer the medications. The procedure must be conducted in the appropriate medical setting, which is controlled by the medical authority, not the chiropractic authority. ie surgery center, hospital or private medical office with all the required skilled backups. We as The Florida Board of Chiropractic Medicine
decided that no move was necessary. Adopting medical protocols was not within the scope of our Practice Act. The document we do diligently work on was made available to anyone who wanted to use it as a guideline.

By: Nicci D'Skyy

Nicci D'Skyy — Tue, 22 Apr 2008 18:40:50 +0000

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By: Snapshot E-Mail Spam Targeted at Chiropractors by Chiropractic Blogs

Thu, 10 Apr 2008 15:59:17 +0000

[...] spam e-mails to the inbox, this was just what appeared at the top of the fold. We have some MUA (manipulation under anesthesia) spam from some American Academy of something or other. There is also spam from a chiropractic [...]

By: Arleen

Arleen — Fri, 04 Apr 2008 14:54:08 +0000

I would like to find a Chiropractor who performs MUA and accepts Medicare and GHI as full payment in the N.Y.C. area

By: Mark

Mark — Wed, 20 Feb 2008 21:43:02 +0000

I was wondering if any of the D.C.’s who posted would be able to comment on the different trainings available for MUA. I have looked out there and there seems to be debate about whether all courses are accepted or recognized.

By: Mary

Mary — Thu, 31 Jan 2008 15:39:07 +0000

Carol…
If you have United Health Care they say it is experimental but, They will pay for the procedure. I do all the billing for the MUAs and as long as you have the information to back up why you want the procedure done then you as a client of United Health Care need to have the right to have it done. As David said its not experimental. Been around for over 60 years and Medicare recognizes it. Good Luck

By: Mary

Mary — Thu, 31 Jan 2008 15:35:35 +0000

I am really surprised at Michael Dorausch, DC I have worked with Chiropractors for many years and I have learned so much. I have never met or read any Chiropractor being so negative. Chiropractors are there to give hope and to help people in pain. I pushed the Doctor that I worked for to go through the MUA class not just for the learning experience but, I wanted him to have rights at our ER. After it was all done and said he is certified and is making alot of people happy and able to function again. I no longer work for him… I now work for the surgery center that performs the MUAs. That is how much i believe in it. So again Dr. Michael please do your homework before you try and step on toes of other Doctors and patients that have or are going to do the procedure or the class. ITS WONDERFUL AND IT IS EFFECTIVE.

By: David

David — Sat, 26 Jan 2008 12:32:49 +0000

MUA is not experimental or investigational. It has been around for 60 years and paid for by Medicare. Medicare has become the gold standard for medicine. If medicare recognizes it then it would generally not be considered experimenta or investigational. Unfortunately because health insurance is private they have the right to deny any procedure they want to. You as a client of that company can argue for it. Consult your MUA doctor to find out the procudure codes under medicare (use those terms to ask the doctor, he/she will know what you are talking about) and send a letter to United telling them this is a procedure recognized by medicare.

To Dr. Dorausch, I felt the same way you did when I first learned about MUA and I will agree with you that the marketing of the procedure does give the appearance of a snake oil sales man. However when you take the class you learn some really good techniques that you can use in your office. The reason the course is only a few hours is because we (chiropractors) have a fairly limited role in the procedure as a matter of fact after certification our mal prac rates do not increase at all. The procedure is a lot of deep stretching following the stretch you adjust. The adjustments are no more robust then what you would perform at your office. That fact that insurance pays for it great, why not make a lot of money for a service that really helps people.

You should really take the course before you comment on something you haven’t experienced. You may be surprised.