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Manipulations mainly consist of professionally directed manual care to problem areas, whether the problem is in ligaments, muscle or joints; the result of which may be improvement in posture, easing discomfort while performing daily tasks and locomotion and the enhancement of the sense of well-being.

M. U. A has been utilized in manual medicine for over 50 years. Increased participation of chiropractors on hospital medical staffs and with medical physicians has made both the facilities and training more available for performing this way of caring for patients.

Chiropractors constitute the group who most actively practice M. U. A. Currently M. U. A certification courses offered through accredited chiropractic Universities  are recognized by malpractice insurance carriers for inclusive coverage. It has been important to regulatory agencies, academic institutions, professional associations and organizations and malpractice carriers to recognize appropriate training programs. Towards that end, specific criteria have been adopted to establish credible certification course offerings. Standards and protocol establishing credible certification training programs are recognized by the National M. U. A Academy of Physicians and the International Academy of M. U. A Physicians and are subscribed to by the accredited academic institutions offering post graduate certification in Manipulation Under Anesthesia

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