Background

The McKenzie Method, also known as mechanical diagnosis and therapy (MDT), is an alternative modality focusing on the spine, in which the practitioner assists a patient in learning exercises that alleviate pain. The McKenzie Method is also intended to improve range of motion of the spine, muscles, tendons, and other surrounding tissues that may be restricting the patient's movement. The long term goal of the McKenzie Method is to teach patients who are suffering from neck and/or back pain how to effectively manage symptoms, treat themselves, and reduce recurrence of pain.

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Effectiveness Effectiveness definitions

INSUFFICIENT RELIABLE EVIDENCE TO RATE

Back pain. Clinical research shows that applying the McKenzie Method results in improvement after 2 months, but not after 8 months, in patients with chronic back pain.

More evidence is needed to rate the McKenzie method for this use.

Natural Medicines rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

Dosing & administration

Adverse effects

Interactions with pharmaceuticals

None known.

Interactions with herbs & supplements

None known.

Interactions with foods

None known.

Interactions with lab tests

Interactions with diseases

Mechanism of action

The primary theory behind the McKenzie Method is that the exercises taught by the practitioner, and later practiced by the patient at home, may lessen or remove the strain in the spine that causes pain. Pain is thought to originate from the spine, and move into the neck, buttocks, or back. According to the McKenzie Method, when the body is restricted in movement, the tissues in that area strain to move, resulting in pain of "mechanical" origin. Centralization is the term practitioners of the McKenzie Method use to describe the elimination of pain. Theoretically, the pain will move towards the spine or "centralize" and then disappear. For instance, if a patient's pain is in the buttock, then the pain should move towards the spine and away from the buttock.

Musculoskeletal problems that are thought to improve from the McKenzie Method are classified into three categories: postural, derangement, and dysfunction syndromes.

Postural syndromes are usually experienced as pain that is located in a specific point on the back or the neck. These types of problems result from holding postures that put unnecessary strain on joints, muscles, and connective tissue.

Derangement syndromes occur when the disc between two vertebrae are repositioned or displaced with movement. In this class of syndromes, the nature of the pain changes with repeated motion. For instance, when a person bends down (a movement physical therapists call flexion) or straightens back up (a movement physical therapists call extension), pain may disappear from more distal areas and become more central, or the pain may become less intense.

Dysfunction syndromes involve scar tissue on the spine that results in limited movement and/or intermittent back pain. The scar tissue adheres to the spine, muscles, and tissue around the spine and limits the range of motion. The pain occurs when the scar tissues resulting from an accident or illness are stressed. Usually, such pain occurs when the patient attempts to use their full range of motion.