McKenzie Exercise Program
The McKenzie exercise program is a classification-based treatment for
lower back pain. The exercise involves identifying certain sub-groups of patients with lower back pain and prescribing exercises based upon those findings. Many people think McKenzie exercise is just extension exercise but its not. This is where much of the debate as to whether it works or not has come from.
Many researchers have compared lower back extension exercises to different treatments with mixed results – some favour it, other don't. The argument from those who support this type of treatment is that plain extension exercise is not a McKenzie exercise program and that in order to see if it works only patients that have been sub - classified and had proper McKenzie treatment should be included in the studies.
Well, in 2006 this was done
|
(Machado, de Souza, P. H. Ferreira & M. L. Ferreira 2006). A group of researcher's reviewed all the research that had looked at using McKenzie exercises properly and came up with the following conclusions:
- They found eleven trials that had looked at this and were high enough quality to include.
- McKenzie reduced pain and disability slightly more than passive treatment in the first week, but when it was compared with advice to stay active, the advice did better at 12 weeks.
- There was not enough research to see if it was effective in chronic back pain.
They concluded that although it might be a bit better than passive treatment the size of the difference was clinically meaningless ie not a big enough difference to get excited about. They decided it was unproven if it was effective or not.
Personally I don’t think just doing one thing is the answer. Lower back pain is caused by a combination of things including poor posture, lack of movement and/or muscular support (poor core stability) around the lower back and also poor physical fitness. Anxiety and worry about back pain makes it much worse. In order to properly manage lower back pain you have to think about all of these things. See The Spinal Fitness Programme for more details.
More on McKenzie exercise program here
If you want to really delve into this there is an outstanding discussion between physiotherapists on the McKenzie approach on the physiotherapy pain association web site
Lower Back Pain Toolkit Home Page
Other lower Back Exercise options
References
Prodigy 2005. Back pain - lower: Simple low back pain - follow-up and reassessment. Available at: http://www.cks.library.nhs.uk/back_pain_lower [Accessed March 28, 2008].
Machado, L.A.C. et al., 2006. The McKenzie method for low back pain:
a systematic review of the literature with a meta-analysis approach. Spine, 31(9), p.E254-62.
There is a great discussion between physiotherapists on the McKenzie approach here
04-Jul-2008
