Indications and contraindications
In general, patients selected for manipulation under
anesthesia have received a minimum of six to eight weeks
of conservative care. Additionally, there are a number
of specific indications and contraindications that need
to considered prior to undertaking manipulation under
anesthesia, including:
Indications
- Neck, mid back and low back pain
- Chronic muscle pain and inflammation
- Acute and chronic muscle spasm
- Decreased spinal range of motion
- Chronic fibrositis
- Nerve entrapment
- Pseudo-sciatica
- Sciatica where disc bulges are contained less than
5 mm
- Failed back surgery
- Chronic occipital or tension headaches
- Conditions where narcotic pain relievers are of
little benefit
- Traumatic torticollis
- RSD
Contraindications
Contraindication to anesthesia as determined by current
medical literature and is the responsibility of the
licensed medical co-manager (anesthesiologist).
Contraindications to manual manipulation of high velocity,
low velocity or soft tissue techniques as established
by current literature relative to technique specific
for articular derangements, bone weakening and destruction
disorders, circulatory and cardiovascular disorders,
or neurological disorders.
Specific contraindications to manipulation of the spine
under anesthesia include:
- Malignancy with metastasis to bone
- Tuberculosis of the bone
- Fractures
- Acute arthritis
- Acute gout
- Uncontrolled diabetic neuropathy
- Syphilitic articular or periarticular lesions
- Gonorrheal spinal arthritis
- Excessive spinal osteoporosis
- Evidence of cord or caudal compression by tumor,
ankylosis and malacia bone disease.
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