McKenzie Treatment for acute low back pain

What is the McKenzie Treatment?

The McKenzie Treatment approach involves the choice of a specific pain easing movement direction to treat a discal or loading type injury.

The technique depends on physiotherapy assessment and prescription as it is important to classify your problem before selecting a treatment. During a comprehensive physiotherapy assessment, I determine if your pain presentation  is optimal for this approach. Once I establish this I will show you how you can participate in your own recovery.

You will know treatment is working if sustained and repeated movements in specific directions reduce or centralise your pain. If this does not happen then another treatment approach will be better for you.

McKenzie  Treatment consists of hourly repeated list correction, relaxed extension – in lying and standing, and minimisation of discal loading during sitting.

Who will benefit from McKenzie Treatment ?

Research provides evidence that the McKenzie Treatment is better than other treatment techniques – if your signs and symptoms match a particular pattern. The program uses an extension direction sustained position or movement direction which is effective for some types of disc herniation/protrusion. The approach uses this directional preference to treat pain and limitation.

The beneficial effect may due to the disc being swollen and protruding, but importantly, there is no rupture of the external disc annulus. Intervention thus appears to facilitate a pressure change in the disc that takes some stress off sensitive tissues.

Research also demonstrates that McKenzie Treatment reduces pain and significantly improves function for up to 6 months after treatment. This is in comparison to other types of treatment in subjects classified as having lumbar derangement (see below). 

If you want to help yourself improve then following my directions and advice will be helpful.

McKenzie self-treatment empowers you to help yourself and to learn preventative measures and acute self-management for long-term care.   

If McKenzie Treatment is appropriate: 

Your pain will move more centrally ie. if it is felt on the side of your back, in your buttock or down your leg it should move closer to the spine as improvement occurs. If your leg pain or symptoms increase then stop the exercises and phone or email me.

Step 1 | List Correction

If you have a side list we will need to correct this prior to repeating extension. A list is when you notice that one of your hips appears to “stick out”. You may just look asymmetrical in the mirror. I can correct this in standing or lying and then show you how to self-treat at home.

As a Physiotherapist, I have a range of pain relieving options and techniques. I may also tape your back or fit a lumbar corset in the first few days to help you maintain a more upright position and minimise bending and slumping.

Many people cease treatment when their pain eases missing the vital part of rehabilitation which is to help you regain the ability and confidence to curl forward and do all your activities.

In Touch Tips for Acute back pain

  • Anti-inflammatories and Panadol may be useful in the first 48 hours
  • Practise, maintain and support the lumbo sacral lordosis (the gentle “c” shaped arch) at the base of your spine when sitting
  • Choose a taller rather than a lower seat and a firmer rather than soft slumpy couch
  • Your pain should centralise i.e. move into the centre of the spine if you are doing these things
  • For general pain, muscle spasm and pain relief try gently pelvic tilts (softly curl your back (the hollow should flatten a little). Later add one knee to chest flexion then curling in sitting and standing. Think of curling from your eyes and chin, then chest and abdomen on rather than straight from your hips.  

McKenzie Treatment for Low Back Pain

If the exercises we try at the time of your consultation ease and centralise your pain then you will be able to treat yourself on an hourly basis over the next few weeks.

At each consultation, I reassess the effectiveness of what you are doing and progress your self-treatment. Even when you become pain-free, an optimal approach will include helping you regain full quality motion in all directions. It is important to regain your confidence and ability to curl, flex, and be active.          

Self Treatment Exercises           

  1. Prone on elbows               
  2. Repeated extension as pain and movement improve
  3. Repeated backwards bend in standing
  4. List Correction in standing or lying on your stomach

The Dosage is x 3-5 repetitions of each exercise in x 2-3 sets. Initially every 30 min during the day (minimum of every hr). Later hourly and in addition to after sitting or bending activities.                

McKenzie Treatment is very successful for a specific pain presentation. My assessment will identify whether this is the optimal treatment approach for you.

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