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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.
Massage therapy has been found to be more effective for acute low back pain than no treatment; the benefits were found to be limited to the short term [118] and there was no effect for improving function. [118] 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 review stated that yoga can be recommended as an additional therapy to chronic low back pain patients. [2] A 2022 Cochrane systematic review of yoga for chronic non-specific low back pain included 21 randomised controlled trials and found that yoga produced clinically unimportant improvements in pain and back-specific function.
Manual therapy, or manipulative therapy, is a treatment primarily used by physical therapists and occupational therapists to treat musculoskeletal pain and disability. It mostly includes kneading and manipulation of muscles, joint mobilization and joint manipulation .
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.
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