Manipulation Under Anesthesia (MUA)

MUA Therapy

What is MUA?

MUA or manipulation under anesthesia is a noninvasive outpatient procedure offered for acute and chronic painful conditions of the neck, back, sacroiliac joints, shoulders, and hips. MUA is a viable alternative for those patients that are not responding to traditional chiropractic, physical therapy, invasive procedures such as injection therapy, or even surgery. With the use of sedation, painful muscles and joints are completely relaxed allowing Dr. Fischer to comfortably stretch, massage and adjust the involved areas more effectively than in an office setting. The results are usually life changing.


The MUA team consists of Dr. Bruce Fischer, one of the nation’s leaders in MUA, a board certified anesthesiologist, and an MUA trained medical physician. MUA is truly unique as it joins together the multiple specialties chiropractic, anesthesia, and medicine, for the therapeutic benefit of the patient. This procedure should only be performed by a physician that has been trained in the practice of MUA. Dr. Fischer has trained hundreds of chiropractors, medical doctors, and ambulatory surgery centers across the country and has published several journal articles on Manipulation Under Anesthesia.

Stretching With Sedation?

In our opinion, MUA should be renamed "stretching with sedation". This procedure is 75% stretching and 25% manipulation of involved areas of the body. The results are truly remarkable.

Stretching the patient while sedated breaks up scar tissue or adhesions in and around the muscles, discs, and connective tissues. These adhesions are commonly caused by multiple injuries, car accidents, sports injuries, poor posture, or even failed back surgeries. These adhesions are usually the reason why patients are not improving with their chiropractic treatment or pain doctors in an office setting, thus preventing full recovery from pain.


Manipulation Under Anesthesia has a very high safety profile. The side effects of the procedure are those of regular chiropractic adjustments. All patients are fully monitored by the anesthesia team at South Palm Ambulatory Surgery Center, Boca Raton. “Conscious sedation” is utilized for our MUA procedures. IV conscious sedation is extremely safe in an outpatient setting, as the patient is not under “general anesthesia”. Our patients are breathing on their own and are aware of the stretching procedures by the MUA physician. The total procedure lasts about ten minutes, and the patient can be in and out of the center and completely discharged within sixty minutes, not much longer than a typical office visit.


You would benefit from our procedure if you have: 1. Treated with multiple physicians and therapists with limited results, 2. You have ongoing prolonged treatment with chiropractors, physical therapists, or pain doctors, with limited/temporary results, and if you are not a candidate for surgery or ongoing pain medication. If you answered yes to any of these questions, then you are a candidate


  • Eliminate the need for ongoing and expensive in-office treatment
  • Avoid possible surgery
  • Avoid invasive painful non-surgical procedures such as injections (trigger point, epidural etc.)
  • Improve your quality of life by eliminating your pain and improving your ACTIVITIES OF DAILY LIVING

What do all these conditions have in common? They are painful conditions of the muscles, nerves, and joints that are chronic in nature (long term, unresponsive to traditional treatments) and that have scar tissue associated with it. This is the reason why MUA can successfully treat these conditions and the others fail.

How MUA Works

The MUA procedure uses twighlight sedation to relax restricted muscles allowing the physician to gently stretch and adjust the spine. The MUA physician is trained to recognize where and how much stretching and adjustments are needed for each patient. Following the three-day procedure, post MUA exercises begin which will help to achieve the optimal benefit.

Typically a rehabilitation program lasts for 3-4 weeks post procedure. The proposed effects of the MUA include altering pain producing scar tissue formations, decompression of bulging/herniated discs, stretching of chronically tight muscles, and eliminating pain by improving range of motion of the affected joints. Patients often undergo various treatments, such as physical therapy, traditional chiropractic care, epidural injections, back surgery, and other treatments.

These do not address fibrous adhesions. Some patients feel temporarily better with these treatments, but their pain often returns. Studies have proposed that it is the adhesions and scar tissue that have built up around spinal joints and muscles that causes chronic pain. In order to offer long term pain relief, the fibrous adhesions in the joint capsules, discs, and surrounding supportive tissues must be treated.


  • Neck, middle back and lower back pain
  • Sacroiliac Joint Problems
  • Pelvis and Hip pain
  • Herniated and Bulging Discs
  • Chronic muscle pain and inflammation
  • Acute and chronic muscle spasms
  • Decreased range of motion
  • Frozen Shoulder
  • Nerve entrapment
  • Sciatica
  • Failed back surgery syndrome
  • Chronic tension headaches
  • Chronic pain with narcotic dependence
  • Stable spondylolithesis
  • Fibromyalgia
  • and more!

What do all these conditions have in common?

They are painful conditions of the muscles, nerves, and joints that are chronic in nature (long term, unresponsive to traditional treatments) and that have scar tissue associated with it. This is the reason why MUA can successfully treat these conditions and the others fail. CALL DR. FISCHER AT 561-392-1333 TO SEE IF YOU ARE A CANDIDATE FOR THE MUA PROCEDURE.

Patient Testimonial

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“When I was pregnant with my first son, I was rear-ended and the railroad tracks came down on my car. I’ve had neck pain ever since then, really. They said I had soft tissue damage. I would always be in pain; Dr. Fisher would adjust my neck, the pain would go away and I would feel better, but it always came back. Then it started to get to where it would only last a couple of days, so that’s why we made the decision to do the MUA.

My apprehension was about the anesthesia more than anything else, especially as it was there days in a row, but it was a breeze. I had no problems at all and I feel very comfortable now saying that it’s a safe procedure.

Before I knew it, I was back up… I felt relief right away. It felt better.”
- Stacey V.

"My back pains started years ago. And I had been seeing chiropractors for years; I’ve done a number of things. But it really came to a head last year and it was really becoming a chronic, constant pain. I really felt like I need an alternative. [Manipulation under anesthesia] was the one for me.

The anesthesia is nothing. Since you’re not having surgery, there’s nothing to recover from. You’re not having as much as you would with a surgery, so you just come right out of it.

I tell everyone about this procedure. I feel so great. I mean when you’re in pain, there’s not a whole lot you can do, you’re life stops in a lot of ways… So I’m much more active now – and happy and comfortable!"
– Lisa G.

"I’ve been suffering from] lower back pain. I played football for 12 years and I got some lower back pain from tackling too many people. I’ve been to different chiropractors, acupuncturists, hypnotists; I went to discuss spinal decompression, but the problem with spinal decompression is that you’re not really relaxed enough to get into the muscles in the spinal cord. So we discussed doing MUA, which would allow you under anesthesia to relax enough to get into the muscle and skeletal fibers.

After the procedure I felt great. It was great relief, it stretched out my back… I had some very stiff calf and hamstring muscles because of the lower compression in my back, so it stretched that out, as well and really got into making me feel more relaxed, less tension in those places.

I would recommend [MUA] highly. It’s a very good procedure."
– Phillip A.