This is a procedure that has been done since the 1930s in the osteopathic
profession . The procedure has been used extensively and very successfully.
In the day and age of cost conservation for hospitals the procedure has been
not as well utilized. However, we still have a need for the procedure on
selected patients.  We offer this procedure as an out patient, in office
procedure. This saves considerable money for medical bills.

The procedure has been extensively evaluated in the osteopathic profession.
With the advent of conscious sedation the use of general anesthetic is
usually unnecessary. That is why we can offer the procedure in our medical
office. The side effects of general anesthesia as well as the expense can be
avoided. The use of conscious sedation allows the patient to relax and
achieve the manipulation required without the muscle contraction associated
with any discomfort that the patient would normally experience with the
musculoskeletal problem normally.

Usually these patients have been in pain and muscle spasm for many weeks or
months. We realize that some patients are in so much pain or have a need for
a more extensive treatment than the patient can generally tolerate.
Generally, an osteopathic manipulative treatment can be quite well
tolerated.  However, sometimes patients have considerable muscle spasm
and/or fibrous tissue or anxiety making effective treatment impossible or
very difficult and time consuming.

In these cases we offer the option of having anesthesia in the form of
nitrous oxide(laughing gas) or intravenous sedation(conscious sedation) for
a short period of time in order to get the treatment or procedure done. This
is an outpatient situation and does not involve any hospitalization. It also
does not involve any need for another licensed physician to administer or
co-manage your case which would considerably increases the costs involved.
Another issue to consider is that insurance coverage will generally pay for
your anesthesia since you are dealing with a licensed physician and surgeon.


The patient is not required to undergo any specific number of  treatments
under anesthesia. Frequently, one treatment under anesthesia is sufficient.
More treatments involving manipulation without anesthesia may be necessary,
however.

Some proposed effects of manipulation under anesthesia therapy include the
following:

        ·breaking up fibrous tissues (adhesions) both in and around the
spinal joint commonly caused by multiple injuries or failed back surgery

        ·decreasing chronic muscle spasm

        ·overcoming super sensitivity of injured areas, making the patient
unable to cooperate for effective treatment.

        ·stretching persistent shortened muscles, ligaments and tendons

        ·relieving pain and radiating symptoms from damaged intervertebral
disc. Some disc injuries are serious enough to surgery, but these types of injuries are relatively infrequent.

 References:

        Chrisman et al.: "A study of the results following manipulation in
lumbar disc syndrome," Journal of Bone and Joint
             Surgery  46A, 1964.
        Saal et al: "The natural history of lumbar disc extrusions treated
non-operatively.: Spine, Volume 15, 1990.
        Kohlbeck FJ, Haldeman S, "Medication-assisted spinal manipulation"
The Spine Journal, Volume 2(4) 2002.

You will hear more about this procedure in the chiropractic profession
as some chiropractors have recently been granted hospital privileges. As
chiropractors are not fully licensed physicians and surgeons they are
considered as ancillary hospital staff  This is a limited category of staff
privileges in a hospital that requires the coverage of a fully licensed
physician and surgeon. Chiropractors may be called physicians in some states
but they do not have a full license to practice medicine in all its aspects.
Therefore, the chiropractor needs a fully licensed physician and surgeon in
a hospital to take the full responsibility for any medical or non medical
care rendered in the hospital facility . You are likely to run up a
considerable higher medical bill for the services rendered.

If you would like more information on this procedure, please contact
this office for an appointment.