Accessibility View Close toolbar

131 East Huntington Drive

Arcadia, CA 91006 US

(626) 445-0326

Manipulation Under Anesthesia, Certified

S.M.A.R.T. Spine Institute and Surgery Center specializes in Manipulation Under Anesthesia in Arcadia, CA. Manipulation Under Anesthesia (MUA) is a non-invasive procedure that treats acute and chronic pain that has not responded to conventional treatment methods. We provide treatments that involve non-invasive remedies for acute and chronic pain. We treat health issues such as:

- Neck Pain
- Back Pain
- Joint Pain
- Muscle Spasm
- Shortened Muscles
- Fibrous Adhesions
- Long Term Pain Syndrome

MUA is also utilized to break up excessive scar tissue by orthopedic surgeons whose patients have not had optimal recovery of their joint’s range of motion (ROM).

This multidisciplinary treatment is meant to improve articular and soft tissue movement using controlled release, myofascial manipulation and mobilization techniques. All of this is done while the patient is sedated using monitored anesthesia care (MAC). The patient may be asleep under general anesthesia, locally numbed through spinal injections, or mildly sedated during the procedure.

The actual MUA treatment consists of a series of stretches and artificial articulation of the patient's joints through their full ranges of motion. Low intensity, repetitive stretching helps to break the mold of internal scar tissue that restricts movement. In other cases, high impulse velocity thrusts may be performed to break barriers on movement and naturally release scar tissue, reduce joint restriction and stretch shortened muscle fibers.

What To Expect

The procedure is performed with the patient under anesthesia. It could be either in general anesthesia or moderate sedation. This depends on the degree of pain experienced by the patient or the severity of his or her health conditions. The anesthesia works to reduce pain, spasms, muscle reactions, reflex and other bodily reactions that could hinder the delivery of the therapy. Once the anesthesia takes effect, the therapist or the physician can now break up soft tissue adhesions and joint scar tissues without the patient resisting the procedure.

The patient normally goes through a great deal of testing before this procedure is performed to ensure that they are healthy and to fully observe the area to be treated. This allows for a smooth and safe anesthetizing of the patient and an assurance that they will receive the maximum benefit of the procedure. These exams may consist of:

    • Medical History
    • Physical Exam
    • Laboratory Exam
    • Radiological Exam
    • Electrodiagnostics
    • Ultrasound

The patient will find an immediate increase in mobility following the procedure, but will likely feel drained and sore as if they had just undergone a strenuous exercise session. Rehabilitation should begin as soon as possible, with as active a program as is admissible by the patient. Rehabilitation programs may include electrostimulus, ultrasound, heating and massage.

Read below for Frequently Asked Questions on Manipulation Under Anesthesia

FAQ: Manipulation Under Anesthesia

What is Manipulation Under Anesthesia?

Manipulation Under Anesthesia is a non-invasive, insurance-reimbursable procedure used to treat acute and chronic conditions, including neck pain, back pain, joint pain, muscle spasm, shortened muscles, fibrous adhesions and long term pain syndromes.By lightly sedating the patient, once painful adjustments and movements are accomplished quickly and pain-free helping to greatly improve or even restore range of motion.Manipulation Under Anesthesia is a viable alternative for those patients that are not responding to traditional conservative care or have even failed to improve after surgery.

History of MUA

Manipulation Under Anesthesia is an established and widely recognized procedure that has been utilized by both chiropractic and allopathic physicians for more than sixty years.The practice of MUA can be traced back to the late 1930’s and its popularity has continued to grow in recent years as research has shown that MUA is not only safe, but is considered a medically necessary treatment that is covered by all major insurances and even Medicare.

Who is a Candidate for Manipulation Under Anesthesia?

In general, patients selected for Manipulation Under Anesthesia are those with certain conditions like adhesive capsulitis of the shoulder or post-operative knee surgery that have attempted conservative therapy with no improvement. Manipulation Under Anesthesia can also be performed for failed-low-back after spine surgery, radiculopathies, spondylopathies, and so on.

Where is the Manipulation Under Anesthesia Procedure Performed?

The Manipulation Under Anesthesia procedure is performed at Bay City Surgery Center, a fully-accredited, chiropractor-friendly Ambulatory Surgery Center located in Torrance CA. Here, patients receive the best in comprehensive, personalized care as well as the convenience and privacy of a same-day surgical center.Bay City Surgery Center has been a local leader in Manipulation Under Anesthesia with over a decade of experience in facilitating this necessary treatment for chiropractors in the community. Our staff is well-trained in this specialized treatment which will ensure a smooth and safe process, for patients and chiropractors alike.

Who Performs the Manipulation Under Anesthesia Procedure?

In California, MUA must be recommended by a medical doctor and performed by 2 licensed chiropractors or a medical doctor. Evaluation by a Board Certified Pain Management Physician will be coordinated prior to treatment, if requested, and Assistant Chiropractors with certification in MUA can be provided for solo practitioners for patients who require this treatment.

What are the Potential Benefits of Manipulation Under Anesthesia Procedure?

The potential benefits of Manipulation Under Anesthesia therapy include:

- Releasing scar tissue (adhesions) in and around joints.
- Decreasing chronic muscle spasm
- Stretching persistently shortened muscles, ligaments and tendons
- Relief from pain and radiating symptoms caused by damaged intervertebral discs.

Most importantly however, Manipulation Under Anesthesia can provide patients immediate relief and a noticeable difference in their daily lives post-procedure. These positive results only continue to improve with intensive post-MUA therapy

What happens after MUA treatment?

Treatment may require three or more sessions to maximize gains. Intense rehabilitation during this time is necessary to promote improvement and letters of medical necessity by a medical doctor are often provided.

“As a pain management physician I have seen firsthand the significant improvements provided by appropriate, multidisciplinary treatment. Chiropractic manipulation under anesthesia can often make the difference in rehabilitation efforts when office-based treatments fail.”Dr. Eduardo Anguizola, MD, Board Certified in Pain Management and Anesthesiology Medical Director

“Manipulation Under Anesthesia has been a staple of my practice for many years. This simple yet effective procedure has helped hundreds of my patients. Becoming MUA certified is one of the best decisions I’ve made for my life and my patients. It allowed me to grow as a practitioner and gave me the opportunity to separate myself from my competition.” Richard Sayegh,CMUA, D.C.

“It’s now been 2 months since the procedure, and I feel great! I haven’t felt like this in over 20 years. I can walk with no pain and do stretches that I wasn’t able to attempt before the MUA. I would definitely recommend the MUA procedure to others who live in pain. If you are looking for long lasting and effective ways to cure your symptoms, MUA is the way to go. The sooner you do it, the better you will feel” –R Star, Patient


Office Hours


9:00 AM-6:00 pm


9:00 AM-6:00 pm


9:00 AM-6:00 pm


9:00 AM-6:00 pm


8:00 am-5:00 pm


9:00 am-12:00 pm