The McKenzie Method is a technique used to evaluate the severity of spinal problems, diagnose a particular condition, and help in determining an appropriate treatment plan. This technique is frequently used to diagnose and treat pain in the lower back and neck. Furthermore, the McKenzie Therapy treatment approach for neck and back pain focuses on extending the spine through exercises that provide considerable pain relief and allow patients to resume their normal daily activities. The McKenzie Method was developed in the 1950s by Robert McKenzie, a New Zealand physical therapist (Machado, De Souza, Ferreira, & Ferreira, 2006; McKenzie & May 2003). Currently, this approach is being utilized worldwide and focuses on active patient engagement and self-management in the treatment of spine-related diseases. The McKenzie Method is frequently completed in three steps. These steps are assessment, treatment, and prevention and not just corrective exercises. This method is accomplished by teaching patients how to manage and control their symptoms and the importance of preventative care. The McKenzie Method is officially known as Mechanical Diagnosis and Therapy (MDT) or McKenzie Therapy.
McKenzie method and other management approaches
The McKenzie Therapy approach is widely accepted as an excellent back pain treatment method. McKenzie’s approach differs from other management approaches because this thoroughly researched, exercise-based method of assessment, diagnosis, and treatment evaluates patients comprehensively and clinically, without the need for any costly diagnostic imaging technique, for example, magnetic resonance imaging (MRI) and x-rays. The McKenzie Method’s therapeutic principles emphasize the body’s natural ability to heal itself and do not involve the use of heat, ultrasound, medicine, cold, surgery, or needles.
Additionally, the McKenzie Method permits patients to learn concepts and enables them to manage their own symptoms, perhaps reducing their reliance on medical intervention. It emphasizes self-treatment through posture adjustment and frequent end-range exercise motions (Simonsen, 1998). Other treatment procedure involves the use of expensive medications and require expensive diagnostic testing. McKenzie method is a complete package as it involves the diagnosis and as well as inexpensive treatment.
Moreover, the McKenzie Therapy approach for back and neck pain is defined by its ability to identify and classify nonspecific spinal pain into homogeneous groups. These categories are based on the similar responses of a patient’s symptoms when mechanical forces are applied (Lam et al., 2018) There are four subgroups: “postural syndrome, dysfunction syndrome, derangement syndrome”, and “other,” each with its own treatment approach (Storheil, Klouman, Holmvik, Emaus, & Fleten, 2016) Similarly, in the assessment and treatment of spinal pain, the McKenzie approach highlights the centralization phenomenon, in which pain emerges from the spine refers distally and migrates back toward the spine by targeted repeated motions (Lam et al., 2018) Following this examination, the physician will prescribe particular exercises and advise on which postures to adopt or avoid. According to the McKenzie approach, if the normal function is not restored, tissue repair will be inhibited, and the condition would persist. No other treatment option focuses on the centralization phenomenon. When pain is present in the leg or arm which then reduces into the back or neck, it is known as centralizing.
Numerous studies have also demonstrated that centralization is a good predictor of recovery while pain that does not centralize is associated with a poor recovery (Aina, May, & Clare, 2004; Werneke & Hart, 2005; Werneke & Hart, 2001) But McKenzie method is an approach of assessment and classification of lower back pain that is more reliable than any other type of management approaches (May, Littlewood, & Bishop, 2006).
SUPPORTING EVIDENCE IN FAVOR OF MCKENZIE THERAPY
There is moderate to high-quality evidence available that the McKenzie Therapy is highly effective against chronic low back pain. A recent study compared the McKenzie method to manual therapy to manage chronic low back pain. This study revealed that the McKenzie method is a successful treatment approach for short-term pain relief and also enhances function in the long term (Namnaqani, Mashabi, Yaseen, Alshehri, & interactions, 2019). Similarly, another comprehensive study investigated the effect of the McKenzie therapy in patients having “acute”, “subacute”, and “chronic” low back pain. The study revealed that the McKenzie method demonstrated better outcomes in pain relief for the short term and improved disability than active interventions for example physical exercise. The research also provided evidence that the McKenzie method reduced pain and disability compared with passive therapy for acute low back pain(Garcia et al., 2015).
Moreover, another study was conducted to evaluate the impact of the McKenzie method on lumbosacral spine ailments and mobility range. McKenzie method therapy had a significant effect on the reduction of lumbosacral spine disorders. Prior to therapy, the average pain intensity evaluated by the VAS in the treatment group was 6.960 (0.978) but decreased to 1.480 (0.872) after three weeks of treatment. The McKenzie approach significantly improved movements such as hyperextension, flexion mobility range, and lateral transfer of the lumbosacral spine to the left. From this study, it can be concluded that the McKenzie approach promotes the lumbosacral spine mobility range. The McKenzie approach is more effective than kinesiotherapy and physical therapy at relieving pain and improving lumbosacral spine mobility (Plaskiewicz et al., 2013). From all the above-mentioned studies, it is safe to assume that McKenzie’s technique treatment significantly improves lumbosacral spine conditions.
Applications of McKenzie method
The McKenzie Method is used to treat acute, subacute, and chronic conditions of the extremities and spine. For example, the McKenzie Method is highly effective in the treatment of lower back pain, neck pain, and extremity pain.
The other conditions that McKenzie method helps treat iclude:
- Hip disorders
- Spinal stenosis
- Low back pain in pregnancy
- Low Back Pain
- Sacroiliac disorders
- Neck Pain
- Zygapophyseal disorders
- Post-surgical problems
Who Uses McKenzie Method?
The McKenzie Method is most commonly used by physical therapists but all healthcare providers licensed to perform rehabilitation, like chiropractors, can utilize the McKenzie Method. Dr. Royer is not currently certified but has taken coursework to use the McKenzie Method to evaluate and treat low back and neck pain disorders. He is the only chiropractor in the Sylvania and Toledo area to have received any training in McKenzie therapy.
References for McKenzie Therapy
- Aina, A., May, S., & Clare, H. J. M. t. (2004). The centralization phenomenon of spinal symptoms—a systematic review. 9(3), 134-143.
- Garcia, A. N., Costa, L. d. C. M., Hancock, M. J., de Almeida, M. O., de Souza, F. S., & Costa, L. O. P. J. P. t. (2015). Efficacy of the McKenzie method in patients with chronic nonspecific low back pain: a protocol of randomized placebo-controlled trial. 95(2), 267-273.
- Lam, O. T., Strenger, D. M., Chan-Fee, M., Pham, P. T., Preuss, R. A., & Robbins, S. M. (2018). Effectiveness of the McKenzie Method of Mechanical Diagnosis and Therapy for Treating Low Back Pain: Literature Review With Meta-analysis. J Orthop Sports Phys Ther, 48(6), 476-490. doi:10.2519/jospt.2018.7562
- Machado, L. A. C., De Souza, M. V. S., Ferreira, P. H., & Ferreira, M. L. J. S. (2006). The McKenzie method for low back pain: a systematic review of the literature with a meta-analysis approach. 31(9), E254-E262.
- May, S., Littlewood, C., & Bishop, A. J. A. J. o. p. (2006). Reliability of procedures used in the physical examination of non-specific low back pain: a systematic review. 52(2), 91-102.
- McKenzie, R., & May, S. (2003). The lumbar spine: mechanical diagnosis and therapy (Vol. 1): Orthopedic Physical Therapy.
- Namnaqani, F. I., Mashabi, A. S., Yaseen, K. M., Alshehri, M. A. J. J. o. m., & interactions, n. (2019). The effectiveness of McKenzie method compared to manual therapy for treating chronic low back pain: a systematic review. 19(4), 492.
- Plaskiewicz, A., Kochański, B., Kałużny, K., Jaworska, M., Hagner-Derengowska, M., Zukow, W., & Hagner, W. J. J. o. H. S. (2013). The efficacy analysis of the McKenzie method in the treatment of lumbosacral spine ailments. 3(14), 396-407.
- Simonsen, R. J. (1998). Principle-centered spine care: McKenzie principles. Occup Med, 13(1), 167-183.
- Storheil, B., Klouman, E., Holmvik, S., Emaus, N., & Fleten, N. (2016). Intertester reliability of shoulder complaints diagnoses in primary health care. Scand J Prim Health Care, 34(3), 224-231. doi:10.1080/02813432.2016.1207139
- Werneke, M., & Hart, D. J. J. o. r. m. (2005). Centralization: association between repeated end-range pain responses and behavioral signs in patients with acute non-specific low back pain. 37(5), 286-290.
- Werneke, M., & Hart, D. L. J. S. (2001). Centralization phenomenon as a prognostic factor for chronic low back pain and disability. 26(7), 758-764.