The Danger & Stupidity of Neck Manipulation Under Anaesthesia

What is Manipulation Under Anaesthesia (MUA)?

MUA is nothing new. Orthopaedic surgeons sometimes use it to restore range of movement in a joint where regular post-surgical rehab could not restore the range of movement that was expected, so they put the person under anaesthesia and manipulate the joint.

I’ve only known it used on knees and shoulders.

But apparently chiropractors in the US are now cracking people’s neck under anaesthesia!! 🤯😱

Stupid and dangerous.

Here’s why.

Vertebral Artery Dissection

Neck manipulation even when you are awake comes with very severe risks. The risk is that it can sever your vertebral arteries, big blood vessels that take blood to your brain on the sides of your neck, you mess with them and you can have a stroke.

It’s called Vertebral Artery Dissection.

If you’re lucky, you may keep most of your function after a lengthy rehab, or it could leave you with permanent, life-changing impairment, or you die. ☠️

This risk is about 1 in a million, which sounds small, but if you care to look, you will see the stats stating people die from this every year.

There is also always someone sharing their personal experiences in comment sections like these. 👇🏽

INformed Consent

The risks vs benefits ratio for neck manipulation just doesn’t support it, the risk is far too high for the little bit of temporary relief you get from it.

I’ve never, in 26 years of being a physio, needed to crack someone’s neck to help them, there are many other tools in my tool bag that does the job just as well, if not better.

If joint manipulation is the only tool a health professional has for every patient they encounter, they’re not a health professional, they’re a one trick pony.

And even if for some bizarre reason I feel compelled to manipulate someone’s neck, there is a safety protocol I MUST follow.

Here in Australia, when a physiotherapist proposes to perform a neck manipulation, we must:

Perform the Vertebral Artery Insufficiency (VBI) test. If this tests positive, the end. No neck manipulation, no end of range mobilisation technique to be used.

We must also clearly communicate with our patients:

• What the technique is
• How it is done
• Its proposed benefits
• The risks involved
• What alternative treatments are available
• Let them ask all the questions
• Give them all the time they need to decide if and when they choose to have it

And most importantly of all, they must sign off on it to give their informed consent. ✍🏽

safety protocol

Chiropractors don’t seem to follow such a safety protocol, which I never understood why. It makes no sense that the profession that is NOT known for cracking necks (physiotherapy) has such a safety protocol but the profession known for cracking necks (chiropractic) doesn’t seem to have anything more than “checking for neuro symptoms” in their process. 🤷🏻‍♀️

As I’ve told you earlier, this is about the integrity of the vertebral arteries, so checking neuro symptoms alone is simply NOT enough.

What also makes no sense to me is that this dangerous treatment was supposedly done because the patients had too much muscle guarding for them to manipulate their necks when they are awake!

COntraindications

In Physio School here in Australia, I was taught muscle spasm/ guarding is a contraindication for manipulation, because you don’t know what the muscle is guarding “underneath”, which could well be a fracture!

I’ve actually seen this in one of my patients, they had this really stubborn spasm in their trapezius muscle which we had to work so gently around, it turned out they had a hairline fracture on the tip of their spinous process and their nervous system did exactly what it should do protecting the area with muscle spasm.

How chiros seem to not work with the same list of contraindications has boggled my mind all my career!

General Anaesthesia is Not Sleeping

So far we have only talked about the risks when you are awake, when you are unconscious under anaesthesia, it is exponentially worse because your nervous system can no longer protect you. 🧠

It is too easy for them to stretch you too far and with too much force, which means more risks of severing your vertebral arteries.

And it gets worse! Apparently these people go in for a one-hour MUA session THREE DAYS IN A ROW!!! 😱😱😱

3 sessions of general anaesthetic (GA) 3 days in a row is insane.

Going under GA is not the same as going to sleep, it comes with its own bag of risks!!!

THis is NOT healthcare!

How they manage to coerce anaesthesiologists to put patients under for them so they can play with people’s life boggles my mind. 🤯

But it makes sense when you see that congratulatory fist bump at the end of the video, that “yeah bro, you cracked that neck so good, you’re the man” bump. That tells me this was never about helping patients, it is entirely for their own fucking ego.

It disgusts me. 🤮🤬

Unfortunately someone will die from this and then the outrage will come demanding why something so stupid and dangerous was allowed to happen. Sadly, that is how society learns.

I hope by speaking out bluntly about this I can help prevent you or someone you love from becoming a sacrificial lamb in their egregious and egotistical game.

It’s wild out there friends, stay savvy.