Spine therapy by McKenzieMechanical Diagnosis and Therapy (MDT) – a physiotherapy method developed by the physiotherapist Robin McKenzie, the aim of which is to examine, treat and prevent back pain. In recent years, the method has been extended to cover the peripheral joints.
In the sixties, the New Zealand therapist R. McKenzie developed a program of research and treatment of patients suffering mainly from lumbar and cervical spine pain. He divided spine disorders into three main groups, taking into account the cause and degree of degenerative changes in the area of the spine and major joints, the so-called syndromes:
- The postural syndrome – refers to disorders of the posture, i.e. tissue-articular structures which are not damaged in any way, but only subjected to static overload (e.g. long careless seating position; it usually affects people performing office, mental work)
- The dysfunction syndrome – when the static overload covers tissues and structures damaged in some way, e.g. by adhesions, contractures, scarring, and the like.,
- Structural syndrome – this is the main focus of this method. It is related to the structures located within (intervertebral disc, the annulus fibrosus) and outside (facet joints, periradicular adhesions) the vertebral segment; depending on the mechanism of the injury and pain model, the therapy consists in finding an appropriate healing motion.
The author has developed a treatment program, in which apart from the procedures performed by the therapist, the patient’s motor activity, exercise and self-therapy at home is also of importance. The exercises are dominated by low, mostly lying positions. Active movements are repeated several times at different planes, but in a specific direction that does not cause pain. A lot of importance is attached to the recommendations that protect the spine against further injuries and overload. McKenzie puts great emphasis on prevention.
This method is popular with the therapists because of the detailed medical history and clinical examination.
Indications for the treatment with McKenzie method:
- cervical, thoracic and lumbar spine pain syndrome
- acute and chronic discopathy
- sciatica, brachial neuralgia
- dysfunction syndrome
- treatment of disorders of the spine mechanics,
- treatment of disorders of the peripheral joints and limbs.
- treatment of dysfunctions which result from incorrect postures in the daily life, past injuries and degenerative changes.
Contraindications to the treatment with the McKenzie method:
- A serious spinal pathology,
- Cauda equina syndrome,
- Tumors (primary, secondary)
- Symptoms of spinal cord compression,
- Infection,
- Tuberculosis,
- Inflammation (Ankylosing spondylitis, Gout, Crohn’s disease, shingles, rheumatoid arthritis)
- treatment with steroids
- Circulatory diseases, eg. hemophilia, anticoagulants, postoperative conditions,
- grade 3 and 4 spondylolisthesis
- Pregnancy (1st trimester)
- Paget’s disease,
- Joint dislocation
- Diabetes,
- Psychological problems,
- Cervical spine fracture or instability of the upper cervical ligaments,
- Dizziness (vestibular disorders, vascular insufficiency, vertebrobasilar insufficiency)
Sursa – physiopol.com
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