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The McKenzie protocol also now includes flexion protocols and stresses the importance of differentiating whether flexion or extension improves patient's symptoms. As a result, McKenzie principles are used by many physical therapists in the treatment of low back pain, whereas Williams Exercises are no longer taught as a physical therapy protocol.
The McKenzie method is a technique primarily used in physical therapy.It was developed in the late 1950s by New Zealand physiotherapist Robin McKenzie. [1] [2] [3] In 1981 he launched the concept which he called "Mechanical Diagnosis and Therapy (MDT)" – a system encompassing assessment, diagnosis and treatment for the spine and extremities.
Spinal manipulation appears to provide similar effects to other recommended treatments for chronic low back pain. [57] There is no evidence it is more effective than other therapies or sham, or as an adjunct to other treatments, for acute low back pain [58] "Back school" is an intervention that consists of both education and physical exercises.
For chronic low back pain, massage therapy was no better than no treatment for both pain and function, though only in the short-term. [118] The overall quality of the evidence was low and the authors conclude that massage therapy is generally not an effective treatment for low back pain. [118]
Studies have demonstrated the usefulness of cognitive behavioral therapy in the management of chronic low back pain, producing significant decreases in physical and psychosocial disability. [36] CBT is significantly more effective than standard care in treatment of people with body-wide pain, like fibromyalgia.
Waddell's signs are a group of physical signs, first described in a 1980 article in Spine, and named for the article's principal author, Professor Gordon Waddell (1943–2017), a Scottish Orthopedic Surgeon. [1] [2] Waddell's signs may indicate non-organic or psychological component to chronic low back pain.
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