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Manipulation under anesthesia combined with epidural steroid injection

B Ben-David1, M Raboy

  • 1Herzliya-Haifa (Horev) Medical Center, Israel.

Journal of Manipulative and Physiological Therapeutics
|November 1, 1994
PubMed
Summary

Combining medical and chiropractic care, specifically manipulation under anesthesia/epidural steroid injection (MUA/ESI), offers a breakthrough for persistent back pain. This integrated approach resolves cases resistant to conventional chiropractic or epidural treatments.

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Area of Science:

  • Integrative medicine
  • Pain management
  • Spinal manipulation

Background:

  • Persistent low back pain can be challenging to treat.
  • Conventional treatments like chiropractic care and epidural injections may not always be effective.

Observation:

  • Three cases of severe low back pain with disk protrusions, osteophytes, or herniations were studied.
  • Two patients did not respond to chiropractic care, and one did not improve with epidural steroid injection.

Findings:

  • A single treatment of manipulation under anesthesia/epidural steroid injection (MUA/ESI) provided significant relief in all three cases.
  • Patients who initially failed chiropractic care experienced dramatic improvement after MUA/ESI and maintained gains with subsequent chiropractic care.
  • In one case, MUA/ESI enabled chiropractic treatment for a patient with pain too severe to tolerate initial manipulation.

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Implications:

  • Cooperation between medical specialists (anesthesiologists) and chiropractors is beneficial for complex back pain.
  • The combined MUA/ESI followed by chiropractic care can overcome therapeutic dead ends.
  • This integrated approach offers a solution for patients with severe pain precluding initial conservative treatment.