LBP Prevention And McKenzie

This article was reviewed and written by Regina K, DPT.

Lower back pain is a major health issue with significant socioeconomic implications in many western countries. Studies show that exercise and remaining active lifestyle significantly reduces the number of recurrence is in lower back pain population.

With exercise being a commonly prescribed intervention, in particular physical therapy, there has been a growing movement that recognizes the role of the McKenzie method in treating lower back pain. Within the McKenzie framework, directional preference exercises are one such intervention with preliminary data demonstrating its effectiveness in the management of lower back pain. With increasing costs, both in terms of healthcare and loss of productivity, there’s a clear need for effective and timely management which will ensure recovery and avoid chronicity. In the McKenzie method, repeated movements in specific directions are used to determine the direction of movement which positively or negatively affects the patient’s symptoms.

The McKenzie method has good evidence to support it’s a validity reliability and generalizability among skilled practitioners who are trained in assessment and treatment techniques using this method once the preferred direction of movement for a patient is determined. It informs individual patient management.

Worldwide, clinical guidelines for the management of a lower back pain identify exercise as a key treatment options. Many studies that studied directional preference exercises have demonstrated there was a significant positive effect in function and pain reduction. An additional benefit of directional preference exercises is that patients learn how to treat themselves. Although, many studies suggest remaining active, it is important to perform exercises, which have directional preference and are specific and individualized for each person with lower back pain.


1. Macedo L, Bostick G, Maher, C, Exercise for Prevention of Recurrences of Non-Specific Low Back Pain, Phys Ther, 93(12):1587-1592, 2012.
2. Bigos SJ, Holland J, Holland C, Webster JS, Battie M, Malmgren JA, High-quality controlled trials on preventing episodes of back problems: systematic literature review in working-age adults., Spine J, 9:147-168, 2009.
3. Dunsford A, Kumar S, Clarke S, Integrating evidence into practice: use of McKenzie-based treatment for mechanical low back pain., J Multidisciplinary Healthcare, 4.393-402, 2011.
4. Donelson R, Improving spine care using Mechanical Diagnosis and Therapy., SpineLine, October 19-26, 2012.

How Outreach Can Help

We provide in-home Physical Therapy, Occupational Therapy, and Speech Therapy to individuals that have a difficult time getting/going to an out-patient rehabilitation facility on a consistent basis, prefer not to go to a facility, or those that are more effectively treated within their home.

We also have an out-patient clinic at 1110 2nd Avenue in the Sutton Place/UES area where we provide therapy for those who are adamant about receiving care in a clinic setting. Our evaluations are 45 minutes and treatments are one-to-one with an ample amount of treatment time per client (no double bookings allowed.)