Manipulation Under Anesthesia

Manipulation Under Anesthesia (MUA) is a non-invasive procedure increasingly offered for chronic conditions, including: headaches, neck & back pain, leg pain, joint pain, muscle spasm, Fibromyalgia, and long term pain syndromes. It is considered safe and is utilized to treat pain arising from the cervical, thoracic and lumbar spine as well as the sacroiliac, pelvic regions, and joints.

Manipulation under anesthesia uses a combination of specific short lever manipulations, passive stretches and specific articular and postural kinesthetic maneuvers in order to break up fibrous adhesions and scar tissue around joints, the spine, and surrounding tissue.

The Procedure

Licensed physicians who have specialized training and certification specifically for this procedure perform the treatment in a surgical center. A team approach is required to have a safe and successful outcome. The team includes the Anesthesiologist and two physicians certified in MUA who perform the manipulation. Dr. Clark is certified to do MUA procedures through the National Academy of MUA Physicians. Dr. Clark does his procedures with Dr. Michael Nunez, a Medical Doctor who is also certified in MUA. The combination of manipulation and anesthesia is not new as this treatment has been part of the medical arena for more than 80 years.

Why Under Anesthesia?

When body movement is difficult the benefit of being sedated is obvious, but the anesthesia performs other important functions such as:

Interrupting the cycle of muscle spasm to allow for increased movement
Sedating the pain perceiving nerves that have been irritated due to the dysfunctional spine or joint
Allowing complete muscle relaxation so that the doctor can stretch shortened muscle groups and reduce adhesions caused by scar tissue
Conditions that Benefit from MUA
MUA can be a valuable procedure for those who suffer with pain caused by:

  • Sciatica
  • Fibromyalgia
  • Low back pain
  • Neck pain
  • Lumbar / thoracic disc displacement
  • Neuralgia/radiculitis
  • Headache / migraine headache
  • TMJ Syndrome
  • Curvature of spine / scoliosis
  • Cervical /lumbar disc conditions
  • Joint calcification
  • Capsulitis of hip
  • Torticollis
  • Carpal Tunnel Syndrome
  • Piriformis Syndrome

Frozen Shoulder (Adhesive Capsulitis) is the most common condition treated with MUA. Almost all insurance policies will include MUA coverage for frozen shoulder. MUA can be instrumental in avoiding surgery for frozen shoulder.

The Treatment

After a patient is approved by Dr. Clark a typical MUA treatment plan begins with a medical screening process, clearing the patient for anesthesia. Medical testing usually will include:

  • CBC blood studies
  • SMA 6
  • Chest x-ray and EKG for patients age 50 and older
  • Pregnancy test for female MUA patients

After receiving medical clearance, the patient is scheduled at the facility where the MUA will be performed. Dr. Clark performs MUA procedures at a fully accredited Arizona State licensed ambulatory surgery center. On the day of the MUA, the patient must be accompanied by someone who is able to drive them home after the procedure. MUA is not an invasive surgery and the actual procedure is very gentle. An intravenous catheter is inserted into the patient’s arm and a board certified Anesthesiologist administers a small amount of anesthesia. After the patient has fallen asleep, a process of stretching the muscles takes place for about 20 minutes. Afterward the patient wakes up and is monitored by qualified personnel until discharge. Most MUAs take place over a period of 3 consecutive days.

After the last MUA procedure, the patient should follow an individualized 4-6 week program designed specifically for the patient by Dr. Clark. Rehabilitation includes stretching, flexibility and strengthening exercises. This regimented post-MUA therapy will help the patient regain pre-injury strength and help prevent future pain and disability.

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Our General Schedule


8:00 am-5:00 pm




8:00 am-5:00 pm


8:00 am-5:00 pm







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1420 North Bridge St. | Elkin, NC 38621