Treatment Options

Chiropractors diagnose conditions using the same approach as other health care providers. On your first visit, Dr. Poller obtains both your past medical history and the history of your current condition.

Dr. Poller performs a physical examination which includes, as appropriate, observation, range of motion of the appropriate areas, neurological and muscle function tests, orthopaedic tests to help identify your specific problem and palpation (examination by touch), paying special attention to the mobility of your joints.

Dr. Poller will perform or order, if required, additional diagnostic studies to help rule out or rule in certain conditions which may influence the diagnosis or proposed treatment program. Xrays are the most commonly used additional test.

If required, we will refer to another healthcare provider for specialized tests or treatment, should your condition be better suited to another discipline.

Treating your problem - After diagnosing your problem, Dr. Poller uses a combination of the following natural tools to return you to optimum function as soon as possible. (see also "phases of care")

- Manipulation Under Anesthesia
- Joint Manipulation Therapies
- Soft Tissue Manipulation
- Electrical Muscle Stimulation
- Ultrasound Therapy
- Cold Laser Therapy
- Super Luminous Diode Therapy
- Traction
- Ice Therapy
- Heat Therapy
- Myofascial Release
- Orthotics


Diplomate ACPM
Certified National Academy of
MUA Physicians

What Patients are saying about the MUA combined with post-MUA rehabilitation:

Jane – MUA Date: April 2003
My symptoms were extreme tightness of neck and shoulders from years of scar tissue build up. I was in constant pain and could not freely move my neck. I received a Manipulation Under Anesthesia and it's been nearly two years and I have very minimal if any pain. Being pain free has made the quality of my life much more enjoyable.

Point 1:
There are 23 shock absorbing disks that are interwoven into the vertebrae (spinal bones) above and below. The disks are amazing structures and can handle hundreds of pounds of pressure without collapsing. The central core of the disk is made of pulpy gelatinous material (Nucleus Pulposus). It is surrounded by hundreds of tough fibrous layers (Annulus Fibrosus) that keep the soft Nucleus material in the center. The Nucleus acts as a spring and separates the vertebrae and also functions as a ball bearing. Because of its central location, the Nucleus allows the vertebrae above and below it to rotate, tilt and flex in any direction.


Point 2:
The disks are integral components of the spinal curves. These curves are seen from the side of the body. The lumbar spine (red curve line) arches forward and the thickness of the disks are greater in the front. The joints in the spine are in the rear of the vertebral units and are called articular facets, as seen in the illustration above. When you bend forward, the disks are compressed by the vertebrae above and below (like scissor action). The disks are extremely flexible and elastic and can handle the bodies own weight, and then some. The fibers in the Annulus layers can be compressed, stretched and twisted millions of times over, in one lifetime.

Point 3:
As we age, the circulation to the disks becomes less and the fibrous and nucleus material begin to dry out (desiccation). The Annulus fibers become more brittle as a result and become less elastic. Time, usage and desiccation (compression, stretching, twisting and drying) tear the micro-Annulus fibers. The tearing of the fibers allow the soft gelatinous nucleus material to break through the many Annulus layers and the results are devastating to the function of the spine. Because the Nucleus is no longer gathered in the center, the height of the disk flattens and the function of the joint becomes abnormal and inflexible.


Usually, when the disk is compressed, the Nucleus is forced back and to one side, usually invading the space occupied by the spinal cord and spinal nerves. This is called a 'bulging disk'. If the Nucleus material reaches the outside layers of the disk and leaks outside the spinal column, it is called a 'disk herniation' and is like a flat tire. As a result, the nerves and spinal cord are trapped (pinched). This trapping causes partial or total malfunction of nerve impulses going in and out of the spinal cord. Muscles, organs and the brain receive altered messages. Sometimes, this can cause disabling pain, numbness and weakness in various parts of the body.


Point 4:
Manipulation Under Anesthesia, combined with post MUA rehabilitation, is a protocol that leverages the vertebrae to shore up the Nucleus back towards the center. This process allows scar tissue to build within the fibrous layers to seal off the layers and keep the Nucleus in the center. This is possible due to the fact that decompression is occurring when the spine and its associated muscles are completely relaxed. There is no spasm or splinting action in the spine to interfere with the decompression process. The re-setting of the Nucleus will result in a partial or total return of the normal disk height, improved movement and flexibility, reduction and elimination of pain and numbness, strengthening of muscles and body parts. How long a disk has been bulging, herniating and malfunctioning, will determine how much of the disk will heal properly. It is difficult, if not impossible to regain full 100% function of a damaged disk. The objective of the MUA is to 'gather' the disk material by leveraging the plane surfaces of the vertebrae above and below the disk displacement, and maneuvering the soft material to the center. The intent is to restore as much of the integrity and function as possible, and prevent deterioration of the disk over time. The procedure is performed in approximately 22 minutes. It is usually repeated 3 times on 3 consecutive days.

What patients are saying about the MUA combined with post-MUA rehabilitation...

Rebecca– MUA Date: April 2004
I suffered from daily migraines that were uncontrollable by normal medications. I also had constant stiffness in my shoulders and neck. The main reason I decided to go through the MUA procedure was because after reading and researching about the procedure, I found the success rate to be very high. That coupled with just the possibility of no longer suffering from chronic migraines was encouragement enough to go through the procedure. It has been nearly a year and I have no pain. This was the best choice I ever made regarding my health. I would recommend to anyone with migraines and chronic back pain – it has changed my life!

The MUA offers relief at an astounding 75% to 85% success rate for the following conditions:
1. Herniated, slipped and bulging discs with or without complications
2. Degenerative disc disease
3. A relapse or failure following surgery even with multiple levels of herniation
4. Facet syndromes
5. Sciatica

Manipulation Under Anesthesia uses a combination of specific short lever manipulations, passive stretches and specific articulate kinetic (body movement) maneuvers in order to initially break up fibrous adhesions and scar tissue around the spine and surrounding tissue. Then the post MUA rehabilitation allows the adhesion and scar tissue to reform with the vertebra in their more normal position.

The treatment is performed in a surgical center by our licensed physicians with specialized training and certification specifically for the procedure. A team approach is necessary and critical to a safe and successful outcome.

The team includes the anesthesiologist, the prime physician who performs the manipulation, and the first assistant, also a physician/chiropractor certified in Manipulation Under Anesthesia.

This is not a new or experimental procedure; this treatment has been part of the manual medical arena for more than 60 years. Manipulation Under Anesthesia is an established medical procedure with a CPT code designate of 22505. This is noted in the American Medical Association’s Current Procedural Terminology Publication.

Call (201) 387-2800 to schedule an appointment to see if M.U.A. is appropriate for you and your condition.

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