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Can the McKenzie method help lower back pain?

Q: I've had chronic low back pain for years. My daughter was helped by a treatment called the McKenzie method. Could this help me too?

A: The McKenzie method is a unique way to assess and treat patients with low back pain (LBP). It doesn't work for everyone, but you'll know early on if you are a good candidate for the treatment.

Most McKenzie practitioners are Physical Therapists who have taken special training to use this method. The therapist will take a history and perform special tests to find out what patterns of movement make you better or worse. Movements are repeated at the end of the full range of motion until symptoms are improved.

The direction of spinal motion that decreases or relieves pain is referred to as unidirectional preference. Knowing this information guides the therapist in showing you how to manage your own pain. You'll be given specific exercises to perform. You'll be shown what positions and movements to avoid for now. And you'll be instructed in correct postures to help with the healing process.

Patients for whom symptoms cannot be centralized with this technique may have a poor prognosis. Centralization means that symptoms going down the back into the buttock and leg retreat. In other words, the pain moves to the central portion of the low back region. Over time (and sometimes right away), the pain gets less and goes away.

The therapist will work with you to find the best treatment for your situation. If the McKenzie approach isn't successful, there are other treatment methods to use. The therapist is trained to use many different approaches. Current evidence supports treatment of LBP patients based on classification and subgroups. The McKenzie approach includes a method by which the therapist makes this decision.

Stephen May, MSc, and Ronald Donelson, MD, MS. Evidence-Informed Management of Chronic Low Back Pain. In The Spine Journal. February 2008. Vol. 8. No. 1. Pp. 134-141.