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Effectiveness of the McKenzie Method for Treating Low Back Pain

Mechanical Diagnosis and Therapy (MDT), most often referred to as the McKenzie method, was developed in the 1970’s as a system to classify musculoskeletal back and neck pain patients into homogeneous subgroups to facilitate treatment. MDT remains one of a number of therapy approaches to back pain that has been exposed to research scrutiny from in its inception.

An accidental development in pain reduction from spinal positioning spawned a highly useful research subject for orthopedists and physiotherapists alike for the next 50 plus years.

The most recent iteration of these research projects came from Lam et al in the June 2018 edition of the Journal of Orthopedic and Sports Physical Therapy. Using meta-analysis, they examined the effectiveness of MDT in improving pain and disability in patients with back pain of less than 12 weeks duration and those with pain greater than 12 weeks.

The studies reviewed were all randomized controlled trials across six databases. With multiple investigators utilizing controls for bias the standardized mean differences were calculated to compare the effects of MDT to other therapeutic interventions in both acute and chronic low back pain.

17 studies met the inclusion criteria with 11 yielding valid data for analysis. In chronic low back pain patients there was a significant difference in disability with results favoring MDT over exercise alone. Manual therapy with exercise gave comparable outcomes to MDT for pain and disability.

The salient conclusion of the review was that in patients with low back pain over 12 weeks duration, “there was moderate to high quality evidence that MDT is superior to other rehabilitation interventions for reducing pain and disability….”

For feedback please contact Hercules Grant PhD at