Manipulation under Joint Anesthesia (MUJA)

Considerations for Manipulation Under Joint Anesthesia (MUJA):
MUJA, has advanced into the field in the past 4 or 5 years as an alternative to conscious sedation by using joint injection to decrease the inflammation in the joint, anesthetize the joint, and manipulate the joint to provide mobilization and flexibility while decreasing joint irritation.

MUJA is used for acute care MUA and is being put forward by the concept that relief from intractable pain (pain, neuromusculoskeletal in origin, with no relief) could be provided by injection into the affected joint, with mobilization and manipulation used secondarily to diffuse the injected medicine and help eliminate the inflammatory reaction in the affected joints (Dreyfuss, Michaelsen, & Home, 1995).

Early mobilization of the involved joints, despite otherwise intractable pain and/or muscle spasm, reduces compressive forces on the discs, facet capsules, and nerve roots (Which would cause additional scar tissue if left untreated), thereby allowing nutrients and fluids into the area of the lesion and helping the body heal itself more naturally and rapidly.

In Acute Care MUA, MUJA reduces:

• Excessive scar tissue build-up
• The chance for muscle contracture
• Duration and frequency of regular outpatient spinal manipulative therapy
• The percentage of resultant permanent impairment

MUJA has been used to affect joint involvement in chronic neuromusculoskeletal conditions. Injection into the involved joint to determine the pain location has been utilized for many years as both an objective diagnostic tool and a therapeutic tool. It is employed in conjunction with the injection to improve joint mobility. The same standards of care and protocols are followed when patients are chosen for the MUJA procedure as for the MUA procedure. The conditions treated with MUJA are somewhat the same as MUA, with the exception being more joint involvement as compared to myofascial and/or muscular involvement.