MUA procedures at Grundy County Pain Care Center can be performed on site in GCPCC's own surgical suite. An anesthesiologist outs the patient in a twilight state using IV medication. Conscious patients have reflex mechanisms that would prevent the joint's movement during the procedure. Sedation allows for the flaccid paralysis of the muscles, depression of the pain areas of the central nervous system and decreased activity at the myoneural junctions. Muscle spasms and other normal reflexes are suppressed.

During an average 30-minute MUA procedure, the practitioner moves the joint through an entire passive range of motion, then moves into the paraphysiological space, where the joint adhesions and resulting scar tissue formation are dissolved. There manipulations are gentle and produce postive results in almost all patients for whom MUA is deemed to be an appropriate treatment modality. The clinical areas where MUA is typically performed include the entire spine, sacroiliac and pelvic regions, along with the joints of the shoulder, elbow, wrist and hand as well as the lower extremities including the hips, knees, ankles and feet.

According to MUA protocol, most patients requirel between one and three sessions spaced a couple days apart, in order to prevent scar tissue -- which can form in as little as 48 hours -- form re-forming.

Dr.Brad says it has never taken more than three MUA provedures for a patient to notice a marked decrease in pain.

"It is really a combination of myofascial release, manual triggerpoint therapy, joint mobilization and manipulation," explains Dr.Brad. "You can get a lot deeper into the effected areas than you could in an office procedure, so you can see more dramatic results more quickly."

Not only is the procedure effective for patients, but due to the ammesia effects of the sedation, the majority of patients do not even recall having the procedure performed.

Dr.Brad became certified in the MUA procedure in 1998. Dr. Varma became certified in 2006, and is one of a handful of medical doctors certified in MUA procedures and technique. Now, the two work together to offer relief to patients who have sought their care.

WHO IS A CANDIDATE?

Most MUA Patients are suffering from choronic pain, herniated discs with or without radiculopathy, sports injuries or failed back surgeries. People with post-traumatic injuries, chronic headaches, neck and back pain, chronic muscle spasms, joint inflammation and fibromyalgia often benefit from MUA, where other techniques have proved unsuccessful. The typical patient seen for the MUA procedure usually suffers from chronic pain that has not been effectively managed by other methods, and is not a surgical candidate or failed at previous surgical intervention.

"Most insurence companies including Medicare will pay for this procedure; however, some will only authorize it after the patient has failed to have their condition resolved by other treatment modalities," says Dr.Brad. "We see a lot of patients suffering from frozen shoulders (adhesive capsulitis), hip and knee problems and chronic headaches. These conditions oftentimes respond well to this procedure."

Patients who are pregnant, have cancer or severe cardiac problems, are brittle diabetics, those with extensive hardware in their spines or patients who cannot tolerate the asnesthesia may not be candidates for the procedure.

Often, MUA patients have tried and failed in-office chiropractic manipulation, physical therapy, epidural injections, acupuncture and sometimes surgery. For these patients, MUA is often the last and best hope for managing their chronic pain.

"Fibromyalgia patients comprise a segment of the population that has traditionally had a hard time finding relief of their symptoms. We are having great success using MUA with fibromyalgia patients," says Dr.Brad. "When we combine the MUA with treatment to balance their hormones and enzyme systems, most of these patients see a dramatic improvement in their symptoms. For this reason, we are seeing more and more fibromyalgia patients being referred to us by physicians who are frustrated from the patient's failure to respond to conventional medical treatment."

POST-MUA REHABILITATION

After MUA, it is vital that patients immediately being a specially designed post-MUA rehabilitation program. Without follow-up care, adhesions broken up during the MUA treatment can being to re-form within days. The goal of post MUA therapy is to help the body heal in a way that will maximize improvement in range of motion and reduction of pain and prevent scar tissue re-formation in the future.

Post-MUA patients will be encouraged to follow up with a customized physical therapy plan that may include additional joint manipulation, passive stretching to improve range of motion, along with an active therapeutic exercise program to strengthen the surrounding supportive muscles and ligaments to minimize the potential of re-injury. The fact that GCPCC patients are allowed access to a wide range of clinicians and therapists in a multidisciplinary environment, provides them with an optimal setting to maximize the potential of achieving positive results and ideally, a long-term solution to their problems.

"I am excited about MUA," says Dr. Varma. "Even though nothing is 100%, so far, we have not had a single patient fail this therapy. Many patients come back and say, 'Doc, I'm feeling great!' They have been suffering so long that they can't believe the differance in such a short period of time."

OTHER PAIN CARE OPTIONS AT GCPCC

MUA is just one of many options for pain relief available to patients at the Grundy County Pain Center. Other innovative and promising therapies that are currently available include :

Spinal decompression therapy:
A nonsurgical method for reducing or correcting back pain. DTS therapy involves focused traction to the site of a damaged disc,rehabilitation for the supporting structures and overall strengthening of global musculature. Heat, muscle stimulation, ultrasound and cold laser therapy can offer additional benefit for inflammation and spasms in the supporting spinal muscles. Combined with home exercise and periodic office visits, most patients experience long-term back-pain relief.

Erchonia (low-level) laser :
Erchonia lasers are used to speed the healing process on a cellular level. The Erchonia laser is the first lowlevel laser in the world to gain FAD market clearance for the treatment of chronic neck and shoulder pain. With an Erchonia laser, bundles of light energy pass through the dermal layers, causing physiological changes within injured musculoskeletal tissue. Low-level laser light initiates increased microcirculation, enhancing tissue regeneration and decreasing pain and inflammation. See http://www.erchonia.com

Sympathetic therapy (STS):
This is a method of pain care that stimulates acupuncture points located in the hands and feel utilizing a unique form of FDA-approved electrical stimulation to treat chronic,intractable pain. Patients undergo a course of daily clinical treatments for two to three weeks. Those who respond well may be prescribed a home unit for ongoing therapy, and pain control sympathetic therapy is one of serveral electrical modalities used at GCPCC.

Prolotherapy:
A nonsurgical method for regeneration of ligaments and joint tissues that have been damaged by use, trauma or arthritis. Prolotherapy involves the introduction of a "sclerosing" agent such as sugar water at the ends of the ligaments, which causes a tightening or stabilizing effect to occur in the involved joint, oftentimes resulting in the reduction or elimination of pain and inflammation.

GCPCC also offers traditional chiropractic manipulation, physical therapy, massage therapy, acupuncture, homeopathic care, hormone balancing services, medication management, hypnosis and other options for successfully treating acute and chronic pain.

"We have a lot of plates spinning right now and we are very excited about the future," says Dr. Varma. "With the combination of MUA and the other techniques we offer here, very few patients don't come away without significant relief from pain. That is our ultimate goal." With all of the treatment options available to patients, it appears that they have nothing to lose but their pain.