The McKenzie Method for Lower Back Pain
At Integrative Physical Therapy of NYC, we use the McKenzie Method to resolve numerous lower back issues. You may have heard of this physical therapy technique in passing but never fully had it explained to you or experienced it. Well, allow us to help you with the former.
What is the McKenzie Method?
In 1950 the McKenzie Method was developed by a physical therapist, Robin McKenzie, as a tool to diagnose and treat lower back pain, as well as neck, mid-back, and extremity pain. In 1985 the McKenzie method gained wide acceptance as an effective program for back pain. The method stressed self-treatment through posture correction and repeated exercise movements at end-range performed with high frequency. (1) The McKenzie Method classifies lower back pain into 3 categories or syndromes;
Postural Syndrome
Dysfunction Syndrome
Derangement Syndrome
What is Postural Syndrome?
Postural Syndrome is caused by deformation of soft tissue or vasculature arising from prolonged postural stresses. This is commonly seen in patients who stay in one place for a long period of time, without moving. This scenario includes long hours of seated office work or standing. Treatment for postural syndrome usually involves moving the patient into pain-relieving positions and having the patient repeat these movements at a high frequency until the pain is abolished. (1)
What is Dysfunction Syndrome?
Dysfunction Syndrome is caused by the mechanical deformation of structurally impaired soft tissue. This deformation may be due to trauma, inflammation, or degenerative processes, causing tissue contraction, scarring, adhesion, or adaptive shortening. Patients with dysfunction syndrome may have been the victim of a mechanical injury such as a fall or car accident or may have been cast or splinted into a position for an extended amount of time. Dysfunction Syndrome causes the patient pain at the end range (limit) of movements, and treatment will involve tissue remodeling through an array of mobilization techniques and exercises that focus on the direction of the dysfunction/direction of pain. (1)
What is Derangement Syndrome?
Derangement Syndrome is the most commonly encountered pain syndrome, reported in one study to have a prevalence as high as 78% of patients. It is caused by an internal dislocation of articular tissue, causing a disturbance in the normal position of affected joint surfaces, deforming the capsule, and periarticular supportive ligaments. Patients with Derangement Syndrome may have had a fall or violent accident or simply moved in an unforeseen painful way such as sneezing, coughing, or doing the laundry/preparing a meal. A popular diagnosis within the derangement syndrome category would be lumbar disc protrusion, extrusion, or herniation with or without nerve involvement. Treatment for Derangement Syndrome focuses on repetitive movement in a singular direction that causes a gradual reduction in pain and/or nerve symptoms. (1)
How effective is the McKenzie Method?
The effectiveness of the McKenzie Method continues to hold true to present day. In a 2019 Systemic Review, the McKenzie Method was compared to generic manual therapy treatment to patients with Chronic Lower Back Pain (CLBP). The review revealed the McKenzie Method was effective in CLBP pain reduction and improved patient’s long term functionality at a greater rate than generic manual therapy. (2) In agreement with current evidence, patients at Integrative Physical Therapy of NYC have experienced positive outcomes with the continued use of the McKenzie Method as our primary diagnostic and treatment tool for lower back pain. For appointments or consultations, please contact our office in Manhattan at (212) 953-6040.
Mann, S. J., Lam, J. C., & Singh, P. (2023). McKenzie Back Exercises. In StatPearls. StatPearls Publishing.
Namnaqani, F. I., Mashabi, A. S., Yaseen, K. M., & Alshehri, M. A. (2019). The effectiveness of McKenzie method compared to manual therapy for treating chronic low back pain: a systematic review. Journal of musculoskeletal & neuronal interactions, 19(4), 492–499.
