McKenzie treatment for back pain is a popular concept in physical therapy, developed by renowned therapist Robin A. McKenzie in the 1960’s. McKenzie likes to differentiate itself from other forms of physical therapy, but in my experience, is strikingly similar in most points of comparison. Additionally, I take personal insult to one of the main concepts of the system, which is centralization of pain, and feel this is one of the only true factors separating McKenzie from other forms of back pain exercise therapy. Unfortunately, this is not a compliment.
Let's take a look at the McKenzie system of PT and determine what it is really all about.
McKenzie exercise therapy consists of 3 main parts of treatment.
The first protocol is assessment. McKenzie practitioners feel they go above and beyond to try and assess where the pain is actually coming from. I feel every type of doctor and therapist does the same thing, so this is truly a moot point. If anything, McKenzie adheres mostly to the usual structural scapegoats used to mistakenly diagnose pain, so in that respect there is nothing new here at all… Just more of the same old potential mistakes.
Next, McKenzie teaches to treat the pain using a variety of back exercises and stretches. This is nothing more than basic physical therapy.
Last, the system teaches prevention of future pain, which is great in theory, but I have seen no evidence that it works at all. In fact statistics show back pain is likely to return, McKenzie or not.
As previously mentioned, McKenzie does differ from other types of physical therapy in that it teaches practitioners and patients alike to centralize their pain. This means to try and move pain from the limbs into the back. The ideology behind this practice is stated that back pain is better tolerated than limb pain. I find this the single most ridiculous and insulting statement ever.
Obviously, these practitioners do not have back pain themselves, or they would understand that back pain is far more debilitating than any limb pain could ever be. When my back pain was at its worst, I would have cut off a limb or 2 just to be free of it. At some times in my life, I had back, neck and limb symptoms. I can function very well even with the most agonizing sciatica in my legs and feet. I can do fine with the neck issues. However, when the lower back goes acute, there is no remedy for the torture.
I am sure many of you agree, based on your own experiences. Actually, I know that you do, since your countless letters tell exactly this. I can not understand how anyone would want to centralize pain in the postural muscles, compared to the auxiliary ones which do not control basic movement and positioning. This, to me, is pure ignorance.
I know several McKenzie practitioners and truly like them. They are good therapists and nice people, but as far as buying into their rhetoric; forget it. I see little positive difference between the McKenzie system and any other form of physical therapy, or any exercise therapy, and have to concentrate on the one nonsensical point of distinction, which is this silly centralization theory.
If this article comes off as particularly strong and biting (even for me), then so be it. I am just telling it like it is (from my perspective), as this is my responsibility to my readers.
I welcome any McKenzie practitioner to write up a forum submission telling me what else differentiates them for “normal” physical therapists. I should mention that among medical modalities used to treat back pain, I do like physical medicine methods, including McKenzie, better than most. So I do have some nice things to say.