Definition & Overview
Stiffness of the joints in any part of the body could be quite painful and in some cases, debilitating. This condition can be brought about by muscle spasms, joint misalignment, inflammation, injury, or as a result of major surgery like total joint replacement.
Joint manipulation under anaesthesia is a procedure used to improve the movement of stiff joints in the body. Usually done under general anaesthesia, with the patient asleep and unable to feel any pain or discomfort, the joints are stretched and made to perform passive movements. However, there are also instances when local or regional anaesthesia is used to keep the patient awake though the joint being manipulated is kept numb. Anaesthesia is used to reduce spasm and reflex muscle guarding, as well as prevent patient’s anxiety and discomfort. The choice of anaesthesia to use usually depends on the type and severity of the condition.
Manipulation under anaesthetic is typically considered when patients no longer benefit from other rehabilitative efforts to relieve joint pain and stiffness. This procedure can help restore close-to-normal range of motion for affected joints and provide patients with longer lasting pain relief. It is also considered safe with low risk for infection since it is noninvasive.
Who Should Undergo and Expected Results
Joint manipulation under anaesthesia is recommended for:
- Patients suffering from chronic pain and stiffness of the neck, back, elbow, knees, shoulders, and pelvis
- Patients who underwent total joint replacement and unable to move the affected limb postoperatively without a great deal of pain
- Patients diagnosed with acute muscle spasms and fibromyalgia
- Patients suffering from persistent pain due to pinched or entrapped nerves
- Patients experiencing failed back surgery syndrome and chronic disc conditions
- Patients with carpal tunnel syndrome, curvature of the spine, joint capsulation, and gait abnormality
However, not all conditions leading to joint stiffness and pain can be addressed by manipulation under anaesthesia. Those with acute inflammatory arthritis and gout, severe osteoporosis, and older patients whose bones are too frail and brittle are discouraged from undergoing this procedure.
The procedure is known for producing generally positive outcomes with patients gaining back mobility of the affected joint and experiencing significant long-term pain reduction. Depending on the severity of the condition, patients may need to undergo several sessions to achieve optimal results. They are also advised to undergo physical therapy for several weeks following the procedure to prevent the regrowth of fibrous scar tissue that was broken down during manipulation. Stretching and flexibility exercises are also recommended to regain strength and maintain easy movements.
How is the Procedure Performed?
This procedure is performed in a hospital setting with the attendance of an anaesthesiologist whose tasks include monitoring the patient’s vital signs during the procedure to avoid possible complications. Once the anaesthesia is applied, the doctor will employ one or more manipulation techniques, varying from one patient to another. To decrease muscle spasms, procedures that involve the soft tissues, such as lateral and line stretching and separation of muscle origin and insertion are performed on the affected joint. The doctor could also use articulatory procedures such as putting the affected joint through full range of motion to gradually move the restrictive barrier and resume normal elasticity and feel. Specific joint mobilization techniques also aim to increase the range of motion as well as decrease muscle tension and stretch fibrous connective tissue that may have shortened due to an injury or disease.
The procedure usually takes about 15 to 20 minutes and the patient is typically discharged after a short monitoring period.
Possible Risks and Complications
Joint manipulation under anaesthetic is linked to the following risks and complications:
- Adverse reactions to the anaesthetic used
- Extensive pain immediately following the procedure, which is often addressed by the administration of painkillers
- Swelling and soreness of the affected joint, which may last for a few weeks
- Cortisone flare, if cortisone is administered to reduce inflammation
- Soft tissue damage
- Injury to the ligament or tendon
- Broken or fractured bone
- Injury to the muscle due to inappropriate or excessive application of force
Keating JC Jr (2003). “Several pathways in the evolution of chiropractic manipulation”. J Manipulative Physiol Ther26 (5): 300–21.
Eder M, Tilscher H. Chiropractic therapy: diagnosis and treatment (English translation). Rockville, Md: Aspen Publishers,
## What is Joint Manipulation Under Anaesthetic: Overview, Benefits, and Expected Results
**Overview of Joint Manipulation Under Anaesthetic:**
Joint Manipulation Under Anaesthesia (MUA) is a specialized medical procedure combining joint manipulation with general anesthesia. It is typically performed to address conditions involving joint dysfunction or mobility restrictions. During MUA, a medical professional, usually an orthopedic physician or surgeon, gently manipulates the affected joint while the patient is sedated. This controlled manipulation aims to improve joint function, relieve pain, and restore range of motion.
**Benefits of Joint Manipulation Under Anaesthesia:**
1. **Pain Relief:** MUA can effectively alleviate pain and discomfort caused by joint dysfunction, making it a valuable option for individuals experiencing chronic or severe pain.
2. **Improved Joint Mobility:** Through manipulation, MUA helps restore and improve joint mobility by addressing restrictions and freeing up the affected joint.
3. **Increased Range of Motion:** By correcting joint misalignment and restoring proper mechanics, MUA can significantly increase the range of motion in the affected joint.
4. **Non-Invasive Procedure:** MUA is a non-invasive procedure, meaning it involves no surgical incisions or tissue disruption. This makes it suitable for those seeking a minimally invasive form of treatment.
5. **Complementary to Other Therapies:** MUA can complement other treatments such as physical therapy, chiropractic care, and medications. It helps address underlying joint issues, enhancing the effectiveness of these other therapies.
**Expected Results from Joint Manipulation Under Anaesthesia:**
1. **Immediate Relief:** For many patients, MUA can provide immediate relief from pain and discomfort, allowing them to experience improved mobility soon after the procedure.
2. **Gradual Recovery:** While some experience immediate benefits, full recovery and restoration of joint function may take several weeks or months. It is essential to follow post-operative instructions and rehabilitation exercises to ensure optimal outcomes.
3. **Long-Term Functional Improvement:** With proper post-op care and rehabilitation, MUA can lead to long-term improvement in joint function and mobility. It can reduce pain, enhance range of motion, and allow for better participation in daily activities.
**Risk and Considerations:**
MUA is generally considered safe, but like any medical procedure, it carries potential risks, including temporary soreness, bruising, and discomfort. It is crucial to discuss any concerns or specific risks with your doctor before undergoing the procedure.
Joint Manipulation Under Anaesthesia (MUA) is a highly effective procedure for treating joint dysfunction and restoring mobility. By combining precise manipulation with general anesthesia, it alleviates pain, improves joint function, and expands range of motion. MUA is a valuable option for individuals seeking non-invasive treatment for chronic joint issues. It is essential to have a thorough consultation with your doctor to understand your specific condition and determine whether MUA is the most suitable treatment approach for you.