Understanding the McKenzie Method for Lower Back Pain
Lower back pain affects nearly everyone at some point of adult life. Many studies show that one year following the initial attack of lower back pain, 50 percent of patients were still complaining of recurring attacks or persistent symptoms interfering with normal daily activities or work. As a result, management of lower back pain must focus on the long-term benefits of self-management and personal responsibility in preventing and controlling symptoms, which is the treatment philosophy of the McKenzie Method.
The McKenzie Method of Mechanical Diagnosis and Therapy (MDT) is a highly researched method of assessment and treatment of musculoskeletal problems including pain in the back, neck and extremities. When treating patients, MDT therapists use four steps: assessment, classification, treatment and prevention.
Unique to the method is the assessment, which uses a well-defined algorithm to aide in the classification of back pain and to establish a cause and effect relationship between the patient's symptoms and movement patterns. During this assessment, the patient performs a series of specific and orderly movements to determine his or her optimal treatment strategy, in hopes of centralizing (a term used to describe the reversing and returning of symptoms to the center of the spine) and abolishing his or her symptoms. Once the underlying disorder/problem is identified, treatment is designed based on the patient's response.
During the treatment phase, the McKenzie Method requires the patient to perform individualized exercises, which have been found to aid in the reduction and centralization of pain. For instance, one patient may work on shifting his hips to the right followed by bending backwards, yet another patient may work on lying down and bringing her knees toward her chest. The key is that the patient, not the therapist, performs the exercises. In some cases, additional forces may be required with the assistance of a therapist, but once the patient is able to control his or her own symptoms, therapist assistance is no longer needed. Much education occurs during the treatment phase. For example, patients may be taught about sitting posture, driving posture, standing posture, movement during household tasks, sleeping positions, body mechanics and exercise progression. The goal is for the patient to be able to perform these activities with fewer symptoms and know how to prevent further injury.
The last phase of the McKenzie Method is prevention, which focuses on the patient's ability to successfully treat his or her own symptoms. The McKenzie Method provides patients with hands-on experience, which teaches them how to safely and effectively treat the current problem, quickly manage pain themselves, and minimize the risk of recurrence.
Get Ambas, P.T., M.D.T., is a physical therapist at MyMichigan Health.
