Manipulation Under Anesthesia

Manipulation Under Anesthesia (MUA)

Manipulation Under Anesthesia is a conservative treatment alternative for chronic pain patients. Spinal manipulation under anesthesia is a procedure that primarily originated with the osteopathic profession and has been utilized for the treatment of spinal pain since the late 1930’s. Spinal manipulation under anesthesia is a procedure that is intended for patients that suffer from sometimes acute but mostly chronic musculoskeletal disorders. The procedure is extremely beneficial for the patient that has muscle spasm accompanied with pain and joint range of motion loss. The individuals have also been unresponsive to conservative care. Ones pain may be from a disc bulge / herniation, chronic sprain / strain, failed back surgery, and other musculoskeletal issues. These types of patients typically respond well to chiropractic manipulation / physical therapy / exercise, but the relief may only be temporary ( days – weeks). Manipulation under anesthesia consists of many of the same techniques utilized in a typical chiropractic office but with the advantage of having the patient fully relaxed. The procedure typically takes a total of 20 min. Inquire if you feel you are a candidate. Reach out to our conservative care specialist at insight to inquire more about Manipulation Under Anesthesia (MUA).

Meet Our Manipulation Under Anesthesia Team

Vincent Rampersaud, M.D.

Medical Director for MUA

Dr. Vince Rampersaud trained in orthopedic surgery with special interest in hand and spine surgery. He attended the University of Virginia Medical School and completed his residency at the Detroit Medical Center. He has been a respected member of southeast Michigan’s medical community since 2004, and beginning in 2009 he further specialized his practice in interventional pain management. He has practiced both in corporate as well as solo practices.

Keith Denning, DC, FACMUAP

Chiropractor, Director of Chiropractic

Dr. Keith Denning has been a board certified chiropractic physician in Michigan for over 20 years. He specializes in non-surgical decompression and manipulation under anesthesia.

Dr. Denning completed his undergraduate work from Purdue University in biomechanics in 1996. While attending Purdue, he was the lead laboratory instructor for several human anatomy/physiology courses as well as biomechanics courses at the university.

Dr. Denning then went on to complete his doctorate at Sherman College in 2000. He then completed his externship in Indiana before opening practice in Michigan in 2001. Dr. Denning is board certified and fellowship trained in manipulation under anesthesia, and is one of the top performing and most in demand MUA physicians in the country.

Justin Jwad, DC, FACMUAP

Dr. Justin Jwad is a native to the Michigan area, born and raised in West Bloomfield. He graduated from Brother Rice High School class of 2005. Dr. Jwad completed a Bachelor of Science in Health Psychology at Wayne State University in Detroit. Following his passion for helping people feel better and becoming pain-free, Dr. Jwad attended Chiropractic School at National University of Health Science in Illinois. He graduated with his Doctorates Degree in Chiropractic in 2015 and became board certified. He completed over 200 hours of Chiropractic Sports training, part of the DACBR program. Dr. Jwad completed certifications in Level 1 Titleist Performance Institute certification in Golf mobility and injury prevention. Amongst all his certifications, he also completed additional training in Graston Technique, Kinesio-Tape Technique, relieving musculoskeletal symptoms, and facial sling dysfunctions. The latest certification Dr. Jwad has acquired is Manipulation Under Anesthesia. Following the Certification, Dr. Jwad completed a fellowship program in Manipulation Under Anesthesia.

During chiropractic school, Dr. Jwad grew to love Eastern Medicine (Chinese Medicine), which included acupuncture, cupping, and medicinal herbs. Dr. Jwad enrolled in the Acupuncture Masters Program. In 2016 he graduated with his Masters degree in Acupuncture. This program also included an amazing and humbling internship at Cook County, Stroger Hospital, performing Medical Acupuncture as part of the hospital’s pain and anesthesia department. Dr. Jwad has also earned certifications in Cosmetic Acupuncture Technique, Hijama, and Cupping/Guasha Technique. Dr. Jwad also performed further training apart of the Michigan Medical Acupuncture Association becoming a certified Diplomat of Acupuncture D. Ac in Michigan. Dr. Jwad works with different levels of injuries from traumatic injuries to sports-based injury prevention and recovery treatments.

Siva K. Sripada, D.O.

Anesthesiology & Pain Management

Dr. Siva Sripada is board-certified in anesthesiology as well as in pain management. He completed his medical training at the University of North Texas HSC in Fort Worth, Texas. He then went on to complete his anesthesia residency at Parkland Hospital in Dallas, Texas.

After working as an anesthesiologist in the greater Dallas area, he went back to receive his subspecialty training in pain management from Texas Tech University in Lubbock, Texas. Dr. Sripada has been working exclusively as a pain management specialist in the southeast Michigan area for over 10 years. He is dedicated to providing a variety of treatment options for his patients to help them manage chronic pain.

Make an Appointment

To schedule an appointment, contact our office at (810) 275-9366 or fill out the form below.

Hours of


Monday, Wednesday, and Thursday
9 a.m. to 5 p.m.

8 a.m. to 5 p.m.

8 a.m. to 12 p.m.

“Our relationships with our patients are second to none.”

Next Lecture Series

Topic: “Evaluating Serum from Covid-19 Patients for Psychotomimetic Autoantibodies”
Speaker: Kevin Jones, Ph.D, Assistant Professor in the Department of Pharmacology at the University of Michigan Medical School
Date: Thursday, November 19th, 2020 | 8:30am EST

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The staff is very professional. The building is nice and modern. Dr. Tarabishy is very understanding and cares about your well being!  -Deisheha
Dr. Shah saved my son’s life.  -Anonymous Reviewer
An amazing experience! The staff was so caring and understanding. Dr Tarabishy's patience and compassion helped me through my procedure. I'm so blessed to be their patient!  -Kevin