Scientific Evaluation

[edit]Scientific evaluation of MUA

Multiple prospective and retrospective clinical studies have been performed evaluating MUA in chronic unresolved back pain, acute and chronic disc herniations, cervicogenic cephalgia, and many other neuromusculoskeletal conditions with attendant articular dyskinesia.

Robert Mensor, M.D. orthopedic surgeon, compared the outcomes MUA and laminectomy in patients with lumbar intervertbral disc lesions and found that 83% of MUA patients had good to excellent results while only 51% of the surgical patients reported the same outcome.

Donald Chrisman, M.D. orthopedic surgeon, reported that 51% of patients with unequivocal disc lesions and unrelieved symptoms after conservative care had been rendered reported good to excellent results post MUA at three years follow up.^[1]

Bradford & Siehl reported on 723 MUA patients, the largest clinical trial conducted on MUA procedures, that 71% had good results, and that 25% had fair results and 4% ultimately required surgical intervention.^[2]

Krumhansl and Nowacek reported on 171 patients who experienced constant intractable pain, of durations from several months to 18 years, and who underwent MUA. All patients had failed at previous conservative interventions. Results reported that post MUA, 25% had no pain at all and were “cured”, 50% were “much improved” with pain markedly reduced and ADLs essentially unaffected, 20% were “better but” pain continued to interfere with activities and finally 5% had minimal or no relief.^[3]

West et al reported in a 1998 study of 177 patients that 68.6% of patients out of work returned to unrestricted work activities after a series of three consecutive MUA procedures at 6 months post MUA, that 58.4% of the MUA patients receiving medications prior to the procedure required no prescription medication post procedure and finally that 60.1% of patients with lumbar pain resolved post MUA series of procedures.^[4]

In 2002 Palmieri et al demonstrated clinical efficacy of MUA performed in a series of three consecutive procedures. The average Numeric Pain Scale scores in the MUA group decreased by 50%, and the average Roland-Morris Questionnaire scores decreased by 51% compared to controlled group.

In addition the extant literature, there are currently ongoing prospective clinical trials with appropriate outcome instruments assessing the clinical and fiscal efficacy of MUA in a selected patient population.

The medical literature is replete with case studies and literature reviews on MUA, in addition to clinical trials, all of which report positive clinical outcomes. Further research is ongoing.

It is important to note that to date there has been no clinical trial that demonstrates MUA to be ineffective in an appropriately selected patient population.

Since the introduction of Manipulation Under Anesthesia training and certification courses in Switzerland by Dr. Rob Francis in 2002, the European chiropractic community has enthusiastically embraced the practice of Manipulation Under Anesthesia. Dr. Francis continues to train chiropractors and medical doctors in Europe through his university sponsored MUA certification courses