Clinical Bottom Line: Although there is a trend in the research we evaluated that seems to favor McKenzie method over other interventions, the evidence is not strong. Based on the ten studies we evaluated, we cannot say with confidence that the McKenzie-based therapy in the treatment of nonspecific low back pain (LBP) is superior to all other interventions in our clinical question.
Clinical Scenario: During our clinical affiliations, we had the opportunity to work with manual physical therapists who were certified McKenzie therapists. A large percentage of the patients at these clinics presented with spinal pain and were treated using McKenzie-based protocol. Although not every patient was a success story, there were a large proportion of patients that had a significant decrease in their pain and disability. Many had experienced numerous episodes of back pain over the years and had been to physical therapists, chiropractors, and massage therapists with no relief. Patients were pleased to have a better understanding of their pain and were even more satisfied with the fact that they had the knowledge and skills to do something about it.
Our Clinically Answerable Question: Population: Our population of interest is adults, 20-65 years of age, with acute or chronic nonspecific LBP. Intervention: We wish to determine the efficacy of the McKenzie-based therapy for the treatment of nonspecific LBP. Comparison: Our comparison group is patients with nonspecific LBP treated with typical physical therapy interventions to include manual techniques, modalities, patient education, and specific exercises including strengthening and stretching. Outcome: We wish to measure outcomes by decreased pain and disability, as well as an increase in functional outcome scores.
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