• Collins S
• Cremata E
• Solinger AB
• Clauson W
• Roberts ES

• Cervical Vertebrae / physiopathology
• Headache Disorders / therapy
• Low Back Pain / therapy
• Lumbar Vertebrae / physiopathology
• Manipulation Under Anesthesia
• Neck Pain / therapy
• Sacroiliac Joint / physiopathology
• Thoracic Vertebrae / physiopathology

METHODS: The treatment group was arbitrarily selected from the chiropractor's patient base who received the MUA protocol along with a follow-up in-office articular and myofascial release program that mimics the MUA procedures. The chiropractic adjustments and articular and myofascial release procedures were performed in a chiropractic office. The MUA procedures were performed in an outpatient ambulatory surgical center. Patients with chronic pain who had not adequately responded to conservative medical and/or a reasonable trial (4 months minimum) of chiropractic adjustments, and had no contraindications to anesthesia or adjustments, were selected. The 4 patients went through 3 consecutive days of MUA followed by an 8-week protocol of the same procedures plus physiotherapy in-office without anesthesia. Data included pre- and post-MUA passive ranges of motion, changes in the visual analog scale, and neurologic and orthopedic examination findings. The patients had follow-up varying from 9 to 18 months.

RESULTS: Increases in passive ranges of motion, decreases in the visual analog scale rating, and diminishment of subsequent visit frequency were seen in each of the patients.

CONCLUSION: Manipulation under anesthesia was an effective approach to restoring articular and myofascial movements for these 4 patients who did not adequately respond to either medical and/or in-office conservative chiropractic adjustments and adjunctive techniques.

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