Local experience in the treatment of low back pain using the McKenzie method

Tadeusz Guranowski, Włodzimierz Kuliński, Zbigniew Lipiec

Tadeusz Guranowski, Włodzimierz Kuliński, Zbigniew Lipiec – Local experience in the treatment of low back pain using the McKenzie method. Fizjoterapia Polska 2002; 2(3); 185-193

Abstract
Background. The goal of our study was to evaluate the value of the McKenzie program in reducing pain symptoms in patients with low back pain. Material and methods. The research involved a group of 25 patients (12 men and 13 women) ranging in age from 23 to 74 years. The patients were referred for treatment on the basis of subjective complaints, neurological and functional physical examinations, additional tests, and a test sheet developed by McKenzie, according to which the so-called „functional degree of damage” to the intervertebral disk was assessed on a scale from 1 to 7. The group included both inpatients in neurological and neurosurgical departments and outpatients. After preliminary examination all these patients were included in the group of persons with structural disturbances. The patients were treated under the McKenzie program for 10 days in the Rehabilitation Department (second examination). For the next three weeks the patients continued the program at home. In addition, they were instructed as to the proper manner of performing activities of daily living. A follow-up test was performed after 30 days (third examination). The effectiveness of the program was evaluated on the basis of the clinical status of the patients, evaluated both subjectively and objectively.Results. An analysis of the results indicates that the McKenzie Method we used had a favorable impact on reducing pain complaints and improving the patients’ functioning. In the experimental group 23 patients reported subjective improvement; Lasseque’s sign disappeared in 9 of 15 patients; pain complaints were reduced and nerve root pain radiation was eliminated in 13 patients; in 2 cases the application of the program did not lead to improvement. Conclusions. The McKenzie Method used in the conservative treatment of low back pain deserves particular attention. The transparent and rapid diagnostic methods and high effectiveness confirm the advisability of its application in the therapy of patients with low back pain.

Key words:
McKenzie method, lumbar spine, rehabilitation

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The analgesis effectiveness of continuous and fractionated doses of laser radiation in the rehabilitation of patients with chronic pain syndrome in the lumbo-sacral spine

Jolanta Kujawa, Anna Cink, Kamila Gowrys, Ireneusz Pieszyński, Jan Talar

Jolanta Kujawa, Anna Cink, Kamila Gowrys, Ireneusz Pieszyński, Jan Talar – The analgesis effectiveness of continuous and fractionated doses of laser radiation in the rehabilitation of patients with chronic pain syndrome in the lumbo-sacral spine. Fizjoterapia Polska 2004; 4(3); 237-244

Abstract

Background. Due to the complex etiopathogenesis and the diversity of treatment approaches, spinal pain syndromes constitute a serious medical problem. The chronic pain and functional disturbances accompanying discopathy have motivated a search for more effective physiotherapeutic methods, such as McKenzie’s method of biomechanical diagnosis and treatment and laser therapy. The goal of the present study was to evaluate the analgesic effectiveness of continuous and fractionated doses of laser radiation in chronic lumbo-sacral pain syndrome. Material and methods. Our research involved 88 patients with chronic spinal pain syndrome qualified for McKenzie kinesitherapy. All subjects received kinesitherapy according to the authors’ method, selected according to the biomechanical diagnosis, along with 10 laser therapy procedures. Group A (43 patients) received a continuous dose of 9 J per point, while Group B (45 patients) received a fractionated dose of 3J + 6J per point. 37 points in the lumbo-sacral region were irradiated. Results. Group B showed a significantly greater decrease in pain intensity on the VAS scale (0-10 points), and in pain frequency. Both groups were found to have a reduced deficit in range of movement according to the McKenzie Institute lumbar checklist. Conclusions. Laser therapy with fractionated doses proved to be more effective in pain relief than continuous doses. The method of dosing laser radiation had no effect on improved range of movement in the lumbar spine. Biomechanical treatment using the McKenzie method combined with laser therapy significantly reduces pain and improves the range of movement in patients with chronic lumbar pain syndrome.

Key words:
discopathy, McKenzie method, kinesitherapy, biomechanical diagnostics
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Centralisation and peripheralisation of symptoms according to McKenzie Method among patients with chronic low back pain

Aleksandra Truszczyńska

Aleksandra Truszczyńska – Centralisation and peripheralisation of symptoms according to McKenzie Method among patients with chronic low back pain. Fizjoterapia Polska 2011; 11(4); 351-356

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
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Effectiveness of manual therapy in pain syndromes originating from the cervical spine

Mariana Szczepaniuk, Zbigniew Śliwiński, Kamil Markowski, Grzegorz Śliwiński

 

M. Szczepaniuk, Z. Śliwiński, K. Markowski, G. Śliwiński – Effectiveness of manual therapy in pain syndromes originating from the cervical spine. Fizjoterapia Polska 2020; 20(1); 170-179

Abstract
Introduction. Cervical pain is a common problem worldwide and is increasingly prevalent. The structure of the cervical segment, as well as its biomechanics, contributes to this. The highest number of cases has been observed among professionally active people, however, the most vulnerable are people practicing a profession involving long-term sitting in one position for several hours. The spine is often overloaded due to long periods of remaining in unnatural and uncomfortable static positions. Pain is most often the result of changes in the paravertebral tissues occurring on a structural background. This problem affects 60–90% of the population and occurs in people aged 25–65. The main methods of treating pain syndromes include: kinesitherapy, i.e. movement therapy, physical procedures and various special methods, including the McKenzie method, PNF or manual therapy.
Objective The objective of the study was to assess the effectiveness of treating people with pain syndromes originating from the cervical spine with various physiotherapy methods.
Material and methods. The PubMed database was searched electronically using keywords such as ‘manual therapy’, ‘PNF’, ‘McKenzie method’, ‘pain syndromes’, ‘cervical spine pain syndrome’, ‘cervical spine’, ‘neck pain’, ‘neck pain therapy’ and the relevant studies were examined. Twenty-two publications were found, containing treatment of cervical spine pain syndromes using various methods, which were further analyzed. These articles were published between 2006 and 2019. Based on the analysis of titles and abstracts, five studies were excluded. Then another three studies were excluded based on the analysis of full texts. In total, 8 studies were excluded. Finally, the analysis of data contained in 14 studies was performed.
Results. It has been observed that pain is one of the most common symptoms of cervical spine disorders. Most often it is assessed using the VAS visual-analog scale. Based on the analysis of 14 studies, it is found that after the application of special physiotherapy techniques, pain is reduced.
Conclusions. Based on the analysis performed, it is concluded that the most commonly used method of measuring pain in patients before and after therapy is the VAS visual-analogue scale. After analyzing the results of selected studies, it can be clearly stated that special methods have a beneficial effect on reducing pain in patients with cervical pain syndrome, based on the average values before and after therapy.

Key words:
cervical spine pain syndrome, McKenzie method, PNF method, manual therapy

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