I’ve spoken about the McKenzie system before– see here. It is one of the most researched areas within physiotherapy, and I have summarized a great article by Stephen May and Richard Rosedale, where over 50 clinicians from 15 different countries assessed and treated over 750 patients who had spinal pain.
Data was analyzed for several variables:
- Spinal area- lumbar, thoracic, cervical
- Syndrome Classification- Derangement, Dysfunction, Postural or OTHER subgroups
- Stability of classification from initial assessment to discharge- Yes/ No
- Number of treatment sessions
- Loading strategy, if appropriate- extension, flexion, lateral
Main Results: Over 64% of patients had lumbar pain and were classified predominantly as having a derangement (75.3%). The predominant directional preference was extension (82.5%), followed by the lateral principle at 12.9%. The stability of the classification to remain the same from initial assessment through discharge was 85%. In the 15% who altered their classification, no details were given on how the classification changed. Almost 23% of patients were classified as one of the McKenzie OTHER subgroups, with Mechanically Inconclusive (6.7%) or Mechanically Unresponsive Radicular Syndrome (6.0%) being most common, and the rest representing seven OTHER subgroups. Fifty-five percent of patients were seen in four sessions or less; with a mean number of sessions of 4.9.
Conclusions: This might sound confusing, but for those clinicians who treat people with back pain, it confirms previous studies’ results in classifying patients with a derangement about 75% of the time, and establishes that the majority are extension responders. Once people can be classified into a group of similar responders, there is a clear path on how to treat this pain effectively and efficiently.
If you have been struggling with back pain, have a thorough assessment from a clinician who is Credentialed in the McKenzie System of Mechanical Diagnosis and Therapy (MDT). You can find one in your area here.