Cure For Low Back Pain?
The McKenzie method is a common technique system aimed at treating lower back pain. Here we discuss what it is, when it should be used, and whether it works...
The McKenzie Method
The McKenzie technique system is a primarily self-treatment method of relieving lower back pain. It was developed in the 1950s by a physiotherapist in New Zealand, called Robin McKenzie.
The story goes that Robin asked a patient to get changed and lie on the table whilst he left the room. When Robin came back some minutes later, he found the patient lying face down on the bench. The patient got up, declared "I don't know what this bit of kit is (referring to the bench), but it sure works!", and was cured of his back pain and sciatica.
This prompted Robin McKenzie to try this approach with other patients suffering from sciatica. Anecdotally, the results of this trial were very good at relieving leg pain in particular. Over a number of years Robin McKenzie experimented with and refined his method, before establishing the McKenzie Institute; a teaching establishment for physiotherapists, osteopaths, surgeons and chiropractors.
The McKenzie Method has been refined over a number of years, progressing from simply requesting patients to hyperextend their low backs to include a number of other movements, dependant on physical exam. These can include leaning to one side, bridging over pillows, bending forwards and so forth.
The McKenzie Method has also been applied to neck pain and whiplash, however research does not suggest the McKenzie Method is very successful for these complaints.
Nevertheless, there is an abundance of evidence supporting the use of McKenzie Methods in the treatment of lower back pain, and in particular sciatica. Some studies even suggest that the McKenzie Method may be superior to spinal manipulation in certain subgroups of patients.
The types of patients who respond well to McKenzie treatment are those who have peripheral pain, commonly referred to as sciatica, as a result of disc bulges in the lumbar spine.
The rationale that has been suggested is centred on the idea of being able to "suck" the protruding part of a disc back in-between the vertebrae by creating a vacuum effect. At the time of writing, this author cannot find and has never seen any studies that confirm or deny this effect.
Whilst there is little evidence concerning the responses of different populations (ie. Ages, genders, races, sporting activities etc), it would seem sensible that above a certain age McKenzie exercises would lose their effectiveness, given that intervertebral discs lose their pliability with time.
Furthermore, there may be a limit to the long term usefulness of the McKenzie Method due to its increasing lumbar mobility. Broadly speaking, the more mobile the spine, the more likely it is to get injured.
Our chiropractors are trained to use the McKenzie Method, and are incredibly well placed to decide when it is indicated, and which other treatment techniques to use alongside. Additionally, as a result of the depth of their undergraduate training and having the most rigorous continuing professional development requirements in the medical community, they are able to offer patients a vast choice of other treatment methods for lower back pain and sciatica when the McKenzie technique is not indicated, or has been unsuccessful.