What is the McKenzie Method of Physical Therapy?

If you suffer from neck or back pain, then you may have heard of the McKenzie Method from your doctor or physical therapist. This form of physical therapy prioritizes patient empowerment and self-treatment. One of the key tenets of this technique is centralization which is the migration of pain from the extremities to the neck or back.

The McKenzie Method is much more than a set of simple treatments. It also utilizes assessment, classification and prevention components in an effort to optimize patient outcomes. Although the McKenzie Method is not successful in all neck or back pain cases, studies show that this treatment methodology can relieve symptoms in many chronic back pain patients.

History of the McKenzie Method

The McKenzie Method was originally developed by Robin McKenzie, a physical therapist in New Zealand, in the 1950s. The basis for the McKenzie Method came from a interaction with a patient in 1956 in which the patient lay face down on a treatment table that had been left elevated for a prior patient. The patient suffered from pain in the right lower back that extended through the leg to the knee.

Prior to that particular day, three weeks of physical therapy treatment had been administered without improvement, but upon adopting the position in which his back was overextended, the patient began to experience symptom relief. The pain in his leg disappeared and the pain in his lower right back moved to the center. Upon another session with the patient assuming the same prior position, all back pain was eliminated.

After this success, McKenzie formulated the McKenzie Method of Mechanical Diagnosis and Therapy (MDT) that uses simple movements and positions to improve back and neck pain. MDT quickly became the standard treatment modality for low back pain throughout the world.

In 1982, the McKenzie Institute was founded, and since then has produced 28 branches in nations around the world. The McKenzie Institute’s purpose is to perfect the procedures currently employed in the McKenzie Method.

The Philosophy behind the McKenzie Method

The basis of the McKenzie Method is that most musculoskeletal pain is not a result of a serious pathology like an infection or tumor. Instead, most such issues have a mechanical cause like a repetitive motion or incorrect posture.

The McKenzie Method identifies that mechanical flaw and tailors a treatment plan to remedy the issue. This plan emphasizes optimal results within an efficient framework of self-directed exercises. In other words, the McKenzie Method helps you discover the fastest way to correct your musculoskeletal issue using exercises and positions that you can perform on your own. This cost and time effective methodology is a primary reason why the McKenzie Method has earned so much support among medical providers and patients.

The Components of the McKenzie Method

The McKenzie Method consists of four essential steps:

  1. Assessment—your physical therapist will begin by taking your symptom history and evaluate your movements. She may ask you to assume certain positions and move in specific ways to determine what muscles, joints and other tissues are involved in the health issue. The physical therapist may ask you to repeat the motions in many slightly different ways as she tries to identify the exact nature of the problem.
  2. Classification—once the problem is well-defined, the clinician will classify the health issue and bring to bear the applicable therapies. In preparation for treatment, your physical therapist will explain the nature of your pain and how the pending treatments should help alleviate symptoms. Your therapist should work closely with you to develop a treatment plan that includes the appropriate treatments but is specifically tailored to you.
  3. Treatment—you and your physical therapist should work together to implement your treatment plan. Once you understand how to perform the various exercises and positions, as well as how to modify your self-management plan if necessary, you can limit the number of visits to the clinic. The emphasis is on empowering the patient to self-manage the therapies so as to maximize the number of independent sessions and minimize unnecessary interactions with clinical staff.
  4. Prevention—in addition to treating your current chronic pain, your therapist will also instruct you on how to prevent similar issues in the future. Your treatment plan should include an active self-maintenance component that helps limit risks of additional injury.

How Successful Is the McKenzie Method?

You may be somewhat skeptical of the McKenzie Method because it only uses exercises and positioning to treat a pain issue that may not have responded to more aggressive therapies including medications. However, there is mounting evidence that the McKenzie Method can be effective for some lower back pain patients. 

One study found that the McKenzie Method was not superior to all other treatments for acute lower back pain, but it did provide more pain relief than manual therapy and exercise. This study examined results for acute or short-term pain conditions.

However, when applied to chronic  pain conditions, the McKenzie Method did appear to reduce pain and disability more than other medical therapies, in at least one study. Other studies countered this conclusion by showing that the McKenzie Method was better at reducing disability but not pain than exercise alone.

Many of these studies have been criticized because they did not involve a placebo, which would be almost impossible because the McKenzie Method is a mechanical therapy. Additionally, many of the randomized test populations may have included patients with a variety of back and pain issues that may have resolved due any number of possible factors.

The conclusion of many health experts is that the McKenzie Method requires more rigorous study, but there is no consensus on how to conduct a truly empirical study of this kind of therapy.

There is no way of knowing if the McKenzie Method will work for you until you try it. In general, there are few risks associated with this therapy, and relatively low costs and time investment so there should be almost no reason not to try it.

Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care

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