Research & standards
The Published Standard We Follow
The library
Two reference works
Vol. 22 · Article 7 · 2014
IPeer-reviewed practice guideline
Guidelines for the practice and performance of manipulation under anesthesia
Gordon R, Cremata E, Hawk C. Guidelines for the practice and performance of manipulation under anesthesia. Chiropractic & Manual Therapies. 2014;22:7.
DOI: 10.1186/2045-709X-22-7CRC Press · 2005
IITextbook
Manipulation Under Anesthesia: Concepts in Theory and Application
Edited by Robert C. Gordon. CRC Press, 2005.
§1 How the guideline was developed
The 2014 guideline was developed through a 2013 expert consensus process using a Delphi method, in which a panel reviewed and rated draft recommendations over multiple rounds. It addresses patient selection, establishing medical necessity, how the procedure is performed, and follow-up care.
§2 An honest look at the evidence
For spinal MUA, published research consists mostly of observational studies and case series; large randomized controlled trials are limited. Some insurers regard spinal MUA as investigational. A practice guideline describes how a procedure should be done — it is not proof of broad effectiveness.
Evidence for shoulder MUA in frozen shoulder (adhesive capsulitis) comes from a separate clinical context and should not be extrapolated to spinal MUA.
MUA is not described here as FDA-approved or conclusively proven, and individual results vary.
Begin here
Your Next Step Starts With an Evaluation.
Candidacy for MUA is determined only through clinical assessment — a review of your history, prior care, and measured motion before any recommendation is made.