What Is The McKenzie Method For Back Pain?
The Secret To Back Pain Relief Or Just Another Theory...
In This Article –
- What Is The McKenzie Method For Back Pain?
- Video Explanation
- The 4 Stages Of The McKenzie Method
- Self-Assessment Criteria
The ‘McKenzie Method’ – Sound practical advice for a different way of treating your back pain – or just another self-named attempt to sell some book…. here we decide.
What Is The McKenzie Method For Back Pain?
The Mckenzie method is perhaps one of the more well-known of the alternative methodologies for treating back and neck pain. But much of this is confused with the idea that it’s just another exercise program that people can do anywhere.
While it’s flexibility does remain a benefit, the differentiating factor with the Mckenzie method is that it approaches treatment from the perspective of four key stages – Assessment, Classification, Treatment and Prevention.
The Mckenzie Method for back pain is formally named The McKenzie Method of Mechanical Diagnosis and Therapy (MDT) which perhaps gives away more about it’s focus. Designed by New Zealand physiotherapist Mr Robin McKenzie, it’s own website claims it is ‘internationally acclaimed’ and perhaps the fact that you are reading about it and I am writing about it some 30 years later, lends real credence to the claim.
The McKenzie method’s own website https://www.mckenzieinstitute.org/patients/what-is-the-mckenzie-method/ recommends use of an MDT (Mechanical Diagnosis and Therapy) clinician (which it would of course) – but it also concedes that they same can be achieved by yourself. The site claims that MDT clinicians are trained to assess and diagnose all areas of the musculoskeletal system, but given that there is no formal ‘MDT’ qualification, any doctor or physio could diagnose the same and how you treat it (whether you try the McKenzie Method) is largely up to you.
Fundamentally, the concept of the McKenzie method relies on two key elements – firstly acceptance that other pain (leg, arm, hip etc) can be linked back to bulges in the disks in your back. They call this ‘centralisation’. Secondly that the way you or you physician decide if this is the case, if the McKenzie method is right for you and the course of treatment that you follow is based on four key stages.
It is quite complicated to explain the concept of centralisation, so I’ve included this Youtube video (not one of ours) as I believe it is the best way of explaining the theory of centralisation.
Hopefully, now you could answer the question ‘what is the McKenzie Method for back pain?’ To explain it in more detail, we can look at the 4 stages that McKenzie himself designed for it –
The Four Stages Of The McKenzie Method –
Assessment – A detailed history is taken about your symptoms and how they behave. There is nothing unusual here – any doctor would do the same.
Where the McKenzie method is perhaps different is in it’s insistence that you perform the same motion on numerous occasions. How your symptoms change during the process of repeatedly performing the same action, then gives the observer the chance to classify your problem
Classification – These are too complex with too many variants to detail here, but suffice to say that based on your results from the assessment you will be put in to one of three ‘syndromes’ with a fourth group containing ‘other’ – that is patients who suffer because of pathologies, or non-mechanical causes.
Treatment – This is when the McKenzie method actively encourages you to carry out self-management at home. Based on the category you fell in to, you would be prescribed a number of exercises to do at home. The reason for the focus being at home? Simple – the McKenzie method relies on making many repetitive actions in a short period of time, but then carried out many times during the week. This simply wont happen if left to a single appointment with a therapist, so it is essential that you carry out the exercises at home.
Prevention – The theory here is that if you can learn how to self-treat your back pain, then you can learn what to avoid next time to stop it happening again. Similarly once you have a treatment plan of activity for when your back flares up again, then even if it catches you out, you can still start the treatment immediately and start getting better again.
Self-Assessment Criteria For The McKenzie Method
As mentioned earlier, the McKenzie method is all about self-management and if you don’t have an MDT clinician nearby (and who does???), then you will have to self-assess. To do this, you need to answer a whole set of questions including –
Do you feel better when on the move?
Does your back pain feel better when you are walking?
Do you have pain free periods during the day?
Do you feel worse if you sit for long periods?
Is the pain confined to areas above your knee or below your elbow?
Does your lower back feel better when you lie face down?
Is your pain associated with one particular activity?
Do you feel worse after prolonged periods of bending down?
Have you had more than one episode of back pain over the last few months or years?
The claim then is that if you answered yes to more than for of the above, then the McKenzie method will definitely work for you. If you answered yes to 3, then it’s more borderline and should be referred to an ‘MDT clinician’ (if only we all knew one).
Does The McKenzie Method Work? The Evidence…
So then….what is the mckenzie method for back pain (and could it work for you?)
Well, like several of the alternative therapies, it is difficult to answer for sure. A review of studies published in 2006 entitled Does McKenzie Therapy Improve Outcomes for Back Pain? concluded that it was effective, but with reservations.
To be fair, patients being treated with the McKenzie method were only measured against other patients undergoing similar back pain treatments – so in essence to be effective meant it actually had not just to be effective, but to be more effective than other treatments.
Unfortunately, while the data in the short-term showed an improvement with the McKenzie method that surpassed other treatments, in the medium term of 3-12 months, there was no difference and beyond 12 months there was insufficient data.
It is also difficult not to be reminded that the ‘McKenzie Method’ like other techniques named after their originators (The Feldenkrais method and The Alexander technique to name just two) are all ultimately trying to sell themselves.
Answering yes to four of the so-called qualifying questions does not mean the McKenzie method is best for you, since the same could be said for a host of physical therapies.
“Does your back hurt more than once a year? Yes – oh well I must be the perfect candidate for y
our private treatment then…..” and so on (please note the heavy sarcasm).
The criteria has to be as general and open as possible or no one would consider themselves right for the treatment and it would gradually slide in to complete obscurity.
As to whether it really works? I’m in the process of reading some more of the literature around it. The theory of ‘centralisation’ is not new to back pain (the McKenzie method is over 30 years old so it couldn’t be), but it does have sound physical reasoning behind it.
Indeed, the only clinical data available would suggest it is at least as effective as the other physical therapies.
The Last Word –
For helprelievepain.com the jury is out and we will be sending a survey out to get feedback from those people that have tried it. I will report back an update to this as soon as we have some responses.
If you have tried it please leave a comment below and sign up to our membership – it’s completely free and your input would really benefit our community at large (plus we pay for some of our review panels)!
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