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It was modified and revived in the 1990s, primarily by chiropractors, and also by osteopathic physicians; this was likely due to safer anesthesia used for conscious sedation, along with increased interest in spinal manipulation (SM). [26] In the MUA literature, spinal manipulation under anesthesia has been described as a controversial procedure.
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Manipulation under anesthesia (MUA)—This is performed by a chiropractor certified in this technique in a hospital-outpatient setting when the patient is unresponsive to traditional adjustments. Techniques
Most contraindications apply to the manipulation of the affected region. [63] While safety has been debated, [3] and serious injuries and deaths can occur and may be under-reported, [4] these are generally rare and spinal manipulation is relatively safe [46] when employed skillfully and appropriately. [5]
Spinal manipulation, which chiropractors call "spinal adjustment" or "chiropractic adjustment", is the most common treatment used in chiropractic care. [83] Spinal manipulation is a passive manual maneuver during which a three-joint complex is taken past the normal range of movement, but not so far as to dislocate or damage the joint. [84]
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For neck pain, manipulation and mobilization produce similar changes, and manual therapy and exercise are more effective than other strategies. [12] A 2015 Cochrane systematic review found that there is no high-quality evidence assessing the effectiveness of spinal manipulation for treating neck pain. [13]