​A Better System for Diagnosing and Treating Back and Neck Pain.

​A Better System for Diagnosing and Treating Back and Neck Pain.

Published by Dr. Tracy A Norris, DC, CCEP, Cert. MDT on Feb 22nd 2019

A Better System for Diagnosing and Treating Back and Neck Pain.

by Wichita Pain Center- Wichita, Kansas

In a US survey, the McKenzie Method of Diagnosis and Therapy (MDT) was deemed the most useful approach for managing back pain[xvi]. The defining difference from traditional healthcare methods and the McKenzie Method is multi-fold;

1) A high degree of inter-tester reliability in determining a diagnosis.

2) The most evidence-based system in the world for mechanical back pain.

3) Directional Preference- examinations are performed by evaluating the symptomatic and/or functional response (increased or decreased pain or range of motion) to different movements, called loading strategies. As an example, a patient that initially has lower back pain with radiating pain to the right lower leg, is asked to bend forward, then backward repetitively. One direction of motion will increase the pain, and the other direction will improve the pain. The direction of movement that causes improvement of pain and/or function is called directional preference.
4) Centralization Phenomenon- when a patient initially has pain down the arm or leg which is immediately or eventually abolished in response to the deliberate application of a repetitive directional movement (either bending forward, backward, sideways or rotation on both sides). The movement applies a directional pressure to the disc, and when applied long enough, or repeated often enough, will cause the abnormal disc tissue to heal and cause the arm or leg pain to progressively retreat up the extremity towards the spine.
5) Conceptual Disc Model- over many years of everyday postural stresses, strains and minor trauma, the integrity of the disc is impaired. The annulus fibrosus (part of the disc) develops fissures, cracks and tears and disc disruption, displacement and abnormal disc tissue can become symptomatic.
Research shows that pain emanating from the musculo-skeletal system (muscles, ligaments, discs and soft tissues around and within the joints) accounts for 97% of all musculo-skeletal cases[xvii], and up to 90% of those cases are RAPIDLY REVERSIBLE. This type of pain is called Mechanical Pain.

Optimal Clinical Management Approach To Back Pain

  1. Avoidance of bed-rest
  2. Encouragement to return to normal activity as soon as possible
  3. Active patient participation in their care in restoring full function by using learned self-management protocols and prescribed, specific exercises to affect and gain control over your own symptoms.


Tracy A. Norris, D.C.
Certified McKenzie Therapist (Cert.MDT)
Certified Chiropractic Extremity Practitioner (C.C.E.P.)
Wichita Kansas Chiropractor

Wichita Pain Center, LLC
(316) 530-1504

[xvi] (Battie et al. 1994)
[xvii] (Reference: Curr Pain Headache Rep. 2008 Dec;12(6):406-11. What is mechanical back pain and how best to treat it? Chien JJ1, Bajwa ZH)

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