Developed in the 1960s by New Zealand physical therapist Robin McKenzie, the McKenzie Method has rapidly become popular around the world for treating back pain, particularly for those with degenerative disc disease and other disc-related back pain.
Extension exercises are a core part of McKenzie Method treatment plans
One of the reasons we like the McKenzie Method is it starts with a non-invasive and relatively inexpensive physical assessment and ultimately leads to a self-administered program that a patient can use without constantly returning (and paying) for repeated visits to the clinic.
The McKenzie Method itself can be broken down into three steps: assessment, treatment, and prevention.
Assessment
When a patient first visits with a McKenzie Method provider, a comprehensive assessment is conducted to identify the source of the physical problem. Unlike conventional methods like x-rays and MRIs, the McKenzie Method focuses on actual physical limitations to movement and the related pain response.
During an assessment, the provider will instruct the patient to repeatedly perform a series of movements, such as a standing backbend. At first, the movement may increase discomfort and pain, but as the movement is repeated it frequently reduces the pain or causes the pain to center closer to the source (such as a central point in the lower back) as opposed to pain radiating into the buttocks or leg farther from the source. This centralization of pain is an important diagnostic clue for developing a treatment plan that patients can use themselves to eliminate back pain and related symptoms like sciatica.
McKenzie Method assessments have been clinically proven to be as reliable as diagnostic imaging at finding the source of back pain. What really sets the McKenzie Method assessment apart though is how reliable it is at determining right up front the likelihood of a patient benefitting from the McKenzie Method so time and money isn’t wasted on ineffectual treatment. In fact, the assessment itself often leaves the patient feeling less pain than before they walked in the provider’s office.
Treatment
The McKenzie assessment classifies pain syndromes into three broad categories: Postural Syndrome, Dysfunction Syndrome, and Derangement Syndrome. The treatment exercises prescribed are based on the syndrome and the patient’s response to movement.
Postural Syndrome is caused by… you guessed it, poor posture. If you sit slouched over a laptop screen all day long, repeated movements are not likely to improve pain symptoms, but simply correcting posture may lead to immediate relief. Treatment in this case is fairly simple. Providers will help the patient identify what positions cause pain and the proper posture to assume to feel better.
Dysfunction Syndrome is typically the result of some form of internal scarring or adhesive tissue adherence that makes full end-range movement difficult and painful. Specific exercises are then prescribed to gradually remodel the internal tissue to restore range of movement and eliminate pain.
Derangement Syndrome is the most common classification diagnosed. Patients with derangement syndrome tend to prefer some movement patterns over others and are likely to experience a reduction or centralization of pain during certain bending (flexion) or straightening (extension) movements. The patient’s response to the assessment movements are used to establish corrective exercises.
Prevention
Patients may need to visit a McKenzie Method provider multiple times to establish their treatment program, particularly for those with more difficult problems to treat requiring assistance to perform the corrective exercises and techniques.
However, once the patient understands how to self-treat their own problem, they can continue improving and preventing back pain and other symptoms on their own with the prescribed exercises and positions. And that’s the whole point… minimizing the number of doctor visits by helping patients help themselves.
I will offer one word of caution. Depending on the provider, too much focus on physical causes of back pain alone may prevent complete elimination of your condition. For the same reason I cannot wholeheartedly endorse Robin McKenzie’s Treat Your Own Back Pain book (see my video review of the book below).
Instead of the book, I recommend contacting an actual McKenzie Method provider near you. You can find one through the McKenzie Institute International provider directory.
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I can speak from experience that the basic idea of this method works. I have not actually tried the Mackenzie Method, but I went to a chiropractor who gave me a general assessment and then created a specific plan for getting rid of my degenerative disks in my spine and my consequent general back pain. I’ve been on the plan for a little over a year and am very happy with it. From what I can tell, this is a very similar approach to the Mackenzie Method.
This functional approach to treating the dysfunction causing the back pain is an even more effective tool when combined with a functional exercise rehab program that trains muscles to work together better, rather than isolating one muscle (ex:bicep curl)