Abstract

Background. Diagnosis of lumbar sciatica is based on classical neurological examination and radiographic imaging. In literature, McKenzie described detailed functional tests concerning pain response during mechanical procedures. Centralisation of pain confirmed during examination informs the examiner that conservative treatment is indicated. Contrary to that peripheralisation of symptoms, it confirms that derangement is irreducible. The aim of the study was to show that the method of functional exa­mination enables diagnosis of centralisation or peripheralisation of pain among chronic patients with sciatica. The additional aim was to determine the factors identified from objective evaluation which determine further treatment of these patients. Material and methods. 200 patients with low back pain and sciatica were precisely analysed. There were 84 men (42%) and 116 women (58%), age between 13-79 years (43.0±13,65). Peripheralisation of pain was found in 65 patients (group A), and centralisation – in 135 persons (67.5%). Statistical analysis showed that significant differences between groups included: lateral shift, SLR test, sensory and motor deficits.Conclusions. 1. Precise analysis showed that among chronic patients with disc disease clinical tests lead to centralisation or peripheralisation of pain. 2. Peripheralisation was statistically more often accompanied with lateral shift, neurological deficits and low results of straight leg raise (SLR) test.

Key words:

chronic pain, Low Back Pain, McKenzie method