Manipulation Under Anaesthesia

MUA can rapidly improve shoulder function, relieve pain, and restore range of motion. MUA may be more cost-effective than arthroscopic release, and the UK Frozen Shoulder Trial found no significant difference in adverse event rates compared with other approaches. More than 80% of patients have shown improvement after MUA in previous reports. Tearing of the fibrotic capsule during forward flexion manoeuvres can usually be palpated or heard by the surgeon. During MUA, a brachial plexus block using 10 mL of 2% lidocaine is administered to the affected side. After MUA, pain is managed primarily with non-opioid analgesics, and routine intra-articular injections are not administered. If iatrogenic injury such as fracture or dislocation is suspected during MUA, the procedure must stop immediately and imaging must be performed. MUA is one of the main clinical treatments for adhesive capsulitis when conservative care is insufficient.