The McKenzie Approach to Mechanical Spine Pain

"What is the McKenzie Approach?" "How is it different and how will it help my patients?"

DEFINITION:
In the McKenzie approach to mechanical spine disorders, physical therapy evaluation and treatment are based on a thorough history and movement testing.

  • A series of test movements and positions are applied in a controlled manner.
  • Symptom behavior is observed before, during, and after repeated movement testing.
  • The movements/positions which decrease or abolish the symptoms are used as treatment and as the home exercise program, which also includes education in correct posture and body mechanics.
  • If no movements or positions can be found to reduce, centralize, or abolish the symptoms, then other treatment options will be investigated prior to referring to the physician for further recommendations.

HOW IS IT DIFFERENT?

  • Mechanical therapy is superior to traditional therapy, i.e., hot packs, ultrasound, and massage, because it is a dynamic treatment approach which empowers the patient to self-treat vs. providing passive modalities.
  • It provides education to the patient about what causes their pain, how to treat themselves and how to prevent future occurrences.
  • It is cost effective in that a more efficient treatment can be provided using less treatment visits, without using costly modalities, while educating the patient how to self-treat.
  • It provides an evaluation tool to determine if the patient's symptoms will benefit from mechanical therapy or if they should be referred for further testing.

WHY USE MECHANICAL THERAPY?

  • Low back tends to be self-limiting:
    1. 42% of the patients are better in one week
    2. 86% of patients are better in one month
    3. 92% of patients are better in two months
  • While low back pain is self-limiting, it is also episodic, with recurrences becoming progressively more severe.
  • Treatment must be provided while the patient is symptomatic and can learn which movement produces symptoms.
  • Goals of mechanical therapy
    1. Reduce pain and deformity
    2. Maintain the reduction with education and posture
    3. Recover function
    4. Prevent further episodes