What is MDT?
The McKenzie Method of Mechanical Diagnosis and Therapy is an evidence-based assessment and management protocol for patients with spinal and extremity problems. Mechanical Diagnosis and Therapy has been shown to be a reliable assessment system to categorize patients into mechanical sub groups in order to address and treat their problems appropriately. The McKenzie Method is globally recognized as a leading treatment approach for back, neck and extremity disorders.
The MDT assessment enables clinicians to triage patients accurately and efficiently, particularly those with pain of spinal origin, to the appropriate services required. The assessment also identifies non-mechanical pain or contra indications to therapy where immediate referral to a particular medical specialty is necessary. Research has shown that the majority of patients with mechanical spinal pain respond well to specific exercises and experience fewer symptoms when treated with exercises individualized to the patient.
McKenzie Method Therapy for Spinal Disc Herniations and Other Disc Related Conditions
For the purposes of this article we will discuss the effectiveness of the McKenzie Method for patients with spinal disc herniations or other disc related problems. Between each bone of the spine, or vertebrae, there is a spinal disc. The spinal disc is a ring of cartilage that is filled with a jelly-like substance. With constant mechanical pressure on the spine this jelly can push outwards against the cartilage leading to what we call a disc herniation. These herniations are also known as a compressed or slipped disc. If the disc herniation pushes far enough outward it can press up against the spinal cord or the nerves that exit the spinal cord. This is typically referred to as a pinched nerve. For example, if the pain extends from the lower back down to the leg it is generally referred to as sciatica. Patients with disc herniations that do not cause a pinched nerve generally causes localized low back pain which may or may not radiate from the local region. If the disc pinches a nerve then it can cause radiating pain into the arm if the problem is in the neck or into the leg, “sciatica”, if it is in the lower back. There may also be associated numbness, tingling, pins, needles, burning or in severe cases muscle weakness.
How We Use MDT At Physio Logic
Using the McKenzie Method, we can accurately determine the proper treatment and exercises that will be helpful in eradicating pain and promoting healing. For example, we will discuss a patient who presents with lower back pain that radiates down the back of their leg with numbness and tingling into their leg and foot. A specialized exam will be used to determine the proper exercise that will try to centralize the patients pain to their lower back and provide pain relief in the leg. If this can be achieved then the exercises will be given to the patient as well as postural advice, sleeping modifications, workstation ergonomics, etc. At Physio Logic, along with the proper home exercises, the patient will be prescribed a course of chiropractic care, spinal decompression, physical therapy and/or acupuncture to decrease pain, increase strength and flexibility and promote healing to the herniated disc. In cases where medical management is necessary, a physician may prescribe medication or injections to reduce inflammation so that the proper rehabilitative treatment can take place. Using the McKenzie Method, rapid reduction of pain will occur in 50-70% of cases and integrating care with all the specialties listed above can result in healing of herniating discs in a majority of patients.
By Dr. Stephen Szaro