The McKenzie Method®, also known as mechanical diagnosis and therapy (MDT), is an alternative modality in which the practitioner assists a patient in learning exercises that alleviate pain originating from the spine. The McKenzie Method® may also be helpful for individuals who experience pain in parts of their body other than their spine, such as in the neck, buttocks, or back. This is because the McKenzie Method® often cites the spine as the origin on the pain, which may be felt in other areas or structures of the body.
The McKenzie Method® treats back pain that is caused when force is applied to an area of the spine in one direction. The force occurs when the physical structures of the spine, muscles, tendons, and other surrounding tissues do not permit the patient's body to move as freely as it should. When the body is restricted in movement, the tissues in the area of the discomfort strain to move, resulting in pain. This type of pain is said to have a "mechanical" origin. 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 the pain. The patient moves to neutralize the strain; this movement aids in the restoration of the area of discomfort. Advocates of this modality usually describe the McKenzie Method® as more than a set of exercises to treat neck and back pain; it is an approach to treating discomfort and restricted movement.
In the 1960s, the physical therapist Robin Anthony McKenzie in New Zealand noted that a subset of his patients experienced significant pain relief when the spine was extended as the part of a treatment. Often, these patients were able to return to normal daily activities. Physical therapists who practiced the methods developed by McKenzie founded the McKenzie Institute in 1982. Today, this organization is headed in New Zealand, and has branches in 25 other countries, including the United States. Each of these centers provides seminars and courses to teach the McKenzie Method® of mechanical diagnosis and Therapy®. Robin Anthony McKenzie has written several books that provide information about coping with back and neck problems from a self-help perspective. A recent book written by McKenzie discusses extremity problems in the arms and legs and their treatments using the McKenzie Method®.
This modality may be used to treat any number of back, spine, muscle, bone, or joint disorders. In order to determine if the McKenzie Method® will relieve a patient's pain or improve their mobility or range of motion, the patient attempts several of the exercises designed to reduce the sensation of pain. If the pain moves towards the spine or is eliminated, then the patient may be an appropriate candidate for the McKenzie Method®. Centralization is the term practitioners of this modality use to describe this movement or elimination of pain. The McKenzie Method® classifies musculoskeletal problems that may benefit from this treatment into three categories, which are discussed below in the Technique section.
The clinical trials on the McKenzie Method® have been varied. More research is needed before a firm conclusion can be drawn.
In the patient's first appointment, the practitioner assesses the patient's pain and assigns the symptoms to one of several categories of spinal dysfunction. Usually, if the patient's pain and spinal-related problems do not have a mechanical origin, the McKenzie Method® may not be a useful treatment for that individual. In these cases, the practitioner refers the patient to another practitioner who relieves pain and symptoms due to spinal problems that are not mechanical in nature. Because of the immediate assessment procedures that take place in the first appointment, patients avoid spending money on a procedure that may not benefit them.
MDT, mechanical diagnosis and therapy, spine.