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McKenzie method may have greater success than spinal manipulation for treatment of back pain
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Although there were no statistically significant baseline variables or predictors of patients’ response to either the McKenzie method or spinal stimulation therapy for back pain, researchers found the probability of success using the McKenzie method appeared to be superior.
The study included 350 patients with chronic low back pain who were randomly assigned to receive treatment with spinal manipulation or the McKenzie method for their pain. The researchers theorized possible effect modifiers were severity of leg pain, pain-distribution, age, duration of symptoms nerve-root involvement and centralization of symptoms. Number of patients reporting success at 2 months follow-up was the study’s primary outcome measure, and dichotomized predictor values were tested based on a prespecified analysis plan.
At the 2-month follow-up, no predictors were found to produce a statistically significant interaction effect, according to the researchers. However, the probability of success was consistently in favor of using the McKenzie method, as the method was found to be superior to spinal manipulation across all subgroups.
According to the researchers, their most apparent finding was that patients with nerve root involvement had a 1.89 times greater chance of being treated successfully with the McKenzie treatment than those with no nerve root impingement compared with the patients treated with spinal manipulation. The variable of peripheralization also exceeded the clinically important success rate of 15%; however, this was factor did not reach significance, according to the researchers. – by Robert Linnehan
Disclosure: The researchers report no relevant financial disclosures.
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