In patients with low back pain for more than 6 weeks presenting with centralization or peripheralization of symptoms, the McKenzie method is slightly more effective than manipulation when used adjunctive to information and advice, say authors of an article published in the November issue of Spine.
A total of 350 patients with low back pain (>6 weeks) with centralization or peripheralization of symptoms with or without signs of nerve root involvement were enrolled in this randomized controlled trial. The main outcome was the number of patients with treatment success defined as a reduction of at least 5 points or an absolute score below 5 points on the Roland Morris Questionnaire. Secondary outcomes were reduction in disability and pain, global perceived effect, general health, mental health, lost work time, and use of medical care.
Both treatment groups showed clinically meaningful improvements in this study. At 2 months follow-up, the McKenzie treatment was superior to manipulation with respect to the number of patients who reported success after treatment (71% and 59%, respectively). The number needed to treat with the McKenzie method was 7. The McKenzie group showed improvement in level of disability compared with the manipulation group reaching a statistical significance at 2 and 12 months follow-up. There also was a significant difference of 13% in the number of patients reporting global perceived effect at end of treatment. None of the other secondary outcomes showed statistically significant differences.
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