I've been seeing a physical therapist recommended to me because she is trained in the McKenzie technique. I went on-line and read in Wikipedia about the fellow who started this method. But I couldn't really find any place that explained why this method works any better than other approaches.

The McKenzie method is one particular testing and treatment approach for neck and back pain. Robin McKenzie's idea is that if neck or back pain location or intensity level can be changed with some simple repeated movements, then it is possible to predict a favorable or unfavorable response to treatment using McKenzie principles.

McKenzie's movement testing called centralization requires the patient to move in a prescribed direction repeatedly. If the pain retreats from down the arm or down the leg to a central spot in the spine, this is a sign that specific movements can be used to treat the problem.

Rehabilitation specialists look to see if there's any evidence that the examiner can predict the final outcome based on symptoms observed during the exam. And secondly, they ask the question: is it possible to tell how well patients will respond to treatment based on how their pain responds to conservative (nonoperative) care?

Many physical therapists subscribe to this theory and are trained in the McKenzie technique. But there hasn't been enough evidence so far to prove the technique is a reliable predictor of long-term results. A recent review of all studies published to date confirmed that evidence is still very limited to support the idea that symptoms changed by repeated spinal movements point to a positive prognosis.

These results don't necessarily mean the McKenzie principles are NOT predictive. It's more the case that better research with high quality methods are needed to investigate this approach. Finding patient factors that can predict what will happen is a high priority among neck and back pain researchers.

Understandably, patients would like to know: How serious is my condition? What do my symptoms mean? How soon can I get back to work? Finding ways to predict the answers to these questions and figuring out what kind of treatment works best for each type of problem remains to be discovered.

Angeliki G. Chorti, MSc, et al. The Prognostic Value of Symptom Responses in the Conservative Management of Spinal Pain. In Spine. November 15, 2009. Vol. 34. No. 24. Pp. 2686-2699.



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