McKenzie Method and Functional Training in Back Pain Rehabilitation. A Brief Review Including Results from a Four-Week Rehabilitation Programme

Abstract

Musculoskeletal back pain is a major health problem: it is a leading consumer of health care funds, early retirement and compensation payments. Despite the urgency of back pain problems, it has been difficult to develop satisfactory treatment methods. The McKenzie approach is a method for analysis and treatment of pain through repeated, standardized movements and positions. Training of functional abilities has been shown to reduce pain and increase return to work. The aim of this study is to describe the results of a four-week musculoskeletal pain programme using the McKenzie method in combination with training of functional activities. All 40 patients participating in the study had a diagnosis of back pain. Before and after the rehabilitation, all patients answered a questionnaire concerning work situation, clinical symptoms and return to work, and participated in a clinical investigation according to McKenzie. The results showed a reduction in back pain symptoms and in the number of patients using analgesics after rehabilitation. The number of patients with deviations in posture and movements in relation to normal standing posture was also reduced. A derangement syndrome was found in 36 patients; 24 received the diagnosis of lumbago ishias. Of the former 36 patients, 25 had a lateral shift, which decreased to ten patients after rehabilitation. A decreased number of patients had produced pain after rehabilitation, and an increased number of patients could centralize their pain, indicating positive effects from the McKenzie treatment. Generally, a change from permanent to intermittent or no pain was shown; 14 patients were totally free from pain after the rehabilitation. The results also showed that 28 patients either returned to work, applied for work or resumed studies after the rehabilitation.