Manipulation Under Anesthesia


Is chronic pain interfering with your life?

Think you’ve tried everything? Think Again!

“The best thing about MUA/FRP is that it gives you your life back!”

When intense, chronic pain doesn’t respond to conservative or traditional treatments, surgery is not the only remaining option There is an alternative. In fact, debilitating problems may persist even after surgery, and surgeons themselves refer patients to Dr. Bidkaram for Fibrosis Release Procedures with Manipulation Under Anesthesia (FRP_MUA) to relieve adhesion’s and scarring that are common after-effects of spinal surgery.

MUA/FRP has been Proven to be Effective for Patients Who Experience:

  • Recurrent Pain and Aggravation Following Injuries
  • Persistent Pain After Back Surgery
  • Fibrotic Adhesions or Internal Scarring That Limit Motion and Cause Pain
  • Unfragmented Herniated Disc and Chronic Disc Problems
  • Chronic Muscle Spasm, Myofascitis
  • Neuromusculoskeletal Conditions with Intractable Pain

What Is Manipulation Under Anesthesia/Fibrosis Release Procedures?

Manipulation Under Anesthesia/Fibrosis Release Procedures (MUA/FRP) is the use of manual manipulation of the spine combined with the use of anesthesis. The addition of anesthesia allows for the benefits of manipulation to be shared with those patients who cannot tolerate manual techniques because of pain response, spasm, muscle contractures, and guarding. It is also a proven procedure for those patients whose chronic pain has not responded satisfactorily to in-office chiropractic care and other adjunctive procedures. MUA/FRP uses a combination of specific short-level arm manipulations, passive stretches, and specific articular and postural kinesthetic integrations to obtain a desired outcome. It is a multidisciplinary procedure where a medical doctor and chiropractors work together to offer you the most benefit from these procedures. The chiropractors provide the services that they are expert in and are within their scope of practice, such as the spinal adjustments, traction, stretching, and myofascial release techniques. The medical physician, board certified in anesthesiology, provides all of the medical treatment, including medical management and the dispensing of any necessary medicines at their discretion and based on their area of expertise. This assures you the safest and most effective combination of expertise to assure that you receive optimal benefit from these very safe and effective procedures.

Who Can Benefit From MUA/FRP And Why Does MUA/FRP Work?

The goals in treatment of mechanical spine pain is to correct the aberrant spinal motion of the involved segments, thereby improving function and decreasing pain. This is achieved via a variety of techniques, most of which can be simplified into two types of forces : (1) high-velocity, short-duration and (2) low velocity, long-duration.

These two applications of force will affect different aspects of the restricted components. The former affects the osseous disrelationship or misalignment. The latter addresses the “tough soft tissue” component. These applications are used in an isolated or combined fashion, depending on the nature of the lesion. Office based SMT (spinal manipulative therapy) is rendered via specific short-lever arm-adjustive forces typically combined with traditional physiotherapeutic modalities such as ultrasound, electrical stimulation, cryotherapy, traction, and passive/active rehabilitation.

A percentage of these patients ultimately will not respond to in-office spinal manipulative therapy on the basis of one or more of the following criteria:

Chronicity of the case because of joint or soft tissue fibrosis, which has inhibited restoration of appropriate joint mechanics.
Acute myofascial rigidity and painful inhibition, which disallows conscious SMT.
Severe joint dysfunction and subluxation such that correction of evident spinal biomechanical misalignment is not achievable through conscious SMT.
Contained disc herniation (bulge) that has become refractory to conscious SMT.
Multiple recurrences during the active-resistive phase of joint rehabilitation.

Is a one to three day outpatient procedure that utilizes a Doctor of Chiropractic’s expertise in a hospital or surgery center, in cooperation with anesthesiologists and other medical doctors.
The idea behind MUA isn’t exotic or experimental, the procedure has been practiced since the 1930’s by orthopedic surgeons and osteopathic physicians. Along with advances in anesthesia, experience has now accumulated as well as a substantial body of research demonstrating that the practice is safe and effective.

New interest has developed recently. MUA May Be Effective for Patients Who Experience:

- Recurrent pain & aggravation following injuries
- Persistent pain after back surgery
- Fibrotic Adhesions or internal scarring that limit motion and cause pain
- Unfragmented herniated disc & chronic disc problems
- Chronic muscle spasm, myofascitis
- Neuromusculoskeletal conditions with intractable pain