McKenzie Therapy for Mechanical Low Back Pain and Sciatica
Sciatica Pain Relief from Exercise?
Of the many frustrations back pain and patients with sciatica face, the lack of a standardized or uniform treatment approach is high on the list. Especially for those patients with longer-lasting symptoms of sub-acute pain (lasting between six and twelve weeks) or longer than twelve weeks (chronic back pain), treatment approaches are very inconsistent.
While the McKenzie Method is successful with treating acute low back pain, it is also very helpful for those patients with sub-acute and chronic back pain.
McKenzie Method Assessment and Treatment
One of the benefits of the McKenzie Method (or McKenzie Therapy) is that it is a standardized approach to both the assessment and treatment of low back pain and/or leg pain (sciatica). The McKenzie Method is not simply a set of exercises; it is a defined algorithm that serves to classify the spinal problem so that it can be adequately treated.
The McKenzie Method is grounded in finding a cause and effect relationship between the positions the patient usually assumes while sitting, standing, or moving, and the generation of pain as a result of those positions or activities. The therapeutic approach requires a patient to move through a series of activities and test movements to gauge the patient’s pain response. The approach then uses that information to develop an exercise protocol designed to centralize or alleviate the pain.
While there are certainly other forms and schools of physical medicine, this first article discusses the components of the McKenzie assessment and summarizes the experience of a typical patient whose pain classification reflects that he or she would benefit from McKenzie exercises.
In the next article we’ll go over the classification types.
Sciatica Assessment
Correct assessment or mechanical diagnosis is the key to prescribing effective back pain exercises. Without the aid of a good assessment, there are no McKenzie exercises; there are just exercises, the efficacy of which is questionable.
The McKenzie assessment consists of taking a patient history and performing a physical exam. Both are used to gauge the degree of impairment as well as identify any red flags that might be contrary to exercise-based treatment (e.g. fracture, tumor, infections, or systemic inflammatory disease).
During the McKenzie physical examination, patients are taken through provocative loading strategies (movements) that help classify the patient and determine the best treatment approach. The movements are intended to either increase or decrease symptoms. For example, patients may be asked to perform single and/or repeated flexion or extension movements forward and backward.
These movements are done to ‘end range’ – the point at which the patient’s range is limited for any reason – and are done in both standing and lying positions. Lateral flexion movements may also be performed. These loading strategies may abolish symptoms, identify symptoms that occur only in certain positions, or cause symptoms to become either more central or peripheral. Once a directional preference is identified, the patient is classified and various McKenzie exercises prescribed for therapy.
It is important to note here, that should lateral flexion exercises be necessary the amount of reps necessary goes significantly up.
Dr. Bailey has taken the low back McKenzie Protocol Course and since doing so, he has seen great results with patients inside and outside the office. Many patients get significant relief by the end of one session. Give us a call today to see if McKenzie Exercises are right for your low back pain and sciatica.
No comments:
Post a Comment