Those living in Wichita Kansas may have back pain, neck pain, headaches, sciatica, disc pain, arm or leg pain, shoulder pain, elbow pain, wrist pain, hip pain, knee pain or ankle pain that will respond rapidly to directional exercises. Wichita Pain Center, Wichita Kansas

 Your Back or Neck Pain Could Be Rapidly Responsive, Slowly Responsive or Unresponsive to Conservative Care

You Won't Know Unless You're Tested

RAPIDLY RESPONSIVE pain is a phenomenon in which pain caused by joint or disc damage, called a Derangement[8], is significantly and rapidly decreased in response to a series of very specific directional repeated movements during the initial assessment process. The direction of movement that results in this response is called a Directional Preference,[2]. The assessment helps reveal if your pain is responsive or not responsive. This is an important determination, especially for those looking for conservative answers prior to having neck, back or extremity surgery. Not every painful condition is rapidly responsive. Some conditions respond slowly and some are not responsive at all and may be related to serious spinal or other pathology which needs referral. Each condition is unique and results vary. Joint derangements that could possibly be responsive to directional exercises can be the cause of back pain, lower back pain, neck pain, disc pain, radiating leg or arm pain, sciatica, radiculopathy, shoulder pain, elbow pain, wrist pain, hip pain, knee pain and ankle pain.

An Assessment Provides Answers About How Your Condition May Respond

Possible Results of Your Assessment at Wichita Pain Center, Wichita Kansas

 

 

"What is so impressive about RAPIDLY REVERSIBLE Pain is that this extraordinary phenomenon
helps solve most individuals' low back pain."
[5]

--Ronald Donelson, MD, MS Board Certified Orthopedic Surgeon
& Author of Rapidly Reversible Low Back Pain- An Evidence Based Pathway to Widespread Recoveries and Savings.
Results Can Vary

 

The Only Way To Know If Your Pain Is RAPIDLY RESPONSIVE Is To Be Tested...
Call To Schedule Your Assessment...

 316-530-1504

  

 

 Assessment Findings That May Indicate Rapidly Responsive Pain

1. The Centralization PhenomenonFor Those Suffering With Back or Neck Pain Radiating Into The Arm or Leg
When pain moves out of the arm or leg towards the center of the spine in response to the repeated movements test it is called Pain Centralization[3][4].  Read research on Centralization that suggests that when Centralization occurs, "it is a very accurate predictor of successful treatment outcome and reliably determines the appropriate direction of treatment exercise".

 2. Directional PreferenceIf during the repeated movements test a direction of movement is found to reduce or eliminate your back or neck pain, you have a "Directional Preference", which according to the Journal of Orthopaedic & Sports Physical Therapy, "implies a rapid improvement in patient symptoms in response to a specific (directional preference) exercise"[7] . Results may vary. Read research articles on directional preference. 

"Directional preference implies a rapid improvement in patient symptoms in response to a specific exercise"[7,8].
--Journal of Orthopaedic & Sports Physical Therapy
--Ronald Donelson, MD, Board Certified Orthopedic Surgeon

 

 



 "If a patient with lumbar or cervical pain (has a) Derangement[8] and can Centralize their symptoms in a short time after initiating (treatment),
the prognosis for a rapid and lasting improvement is very good[4]".

--Richard Rosedale PT, Dip. MDT, Robert Medcalf PT, Dip. MDT

Slowly Responsive Conditions

 Unresponsive Conditions

The McKenzie assessment not only discovers conditions that are either rapidly or slowly responsive, but can also identify other conditions that will not respond to conservative care, and need concurrent medical care or surgery. 

  • Spinal Stenosis 
  • Spondylolithesis
  • Mechanically inconclusive- an unknown vertebral joint pathology that has inconsistent responses to test movements and assessment strategies.
  • Serious Spinal Pathology
    • Cauda Equina Syndrome- compression of sacral nerves by disc herniation or tumor that involves the bladder or bowel, especially urinary retention, saddle anesthesia and Sciatica.
    • Cancer- growth of malignant tumor in or near vertebrae. Seen in age >55 with history of cancer, unexplained weight loss, constant & progressive pain which is not relieved by rest.
    • Fracture- bony damage to vertebrae caused by trauma or weakness due to metabolic bone disease. Caused by significant trauma or trivial trauma with osteopenia.
    • Spinal Infection- infection affecting vertebrae or disc. Usually see a fever, constant severe back pain unrelated to movement.
    • Ankylosing Spondylitis- a systemic inflammatory arthropathy affecting spinal and other structures. Has common exacerbations and remissions of pain marked by morning stiffness with persisting limitation of all movements. Better with exercise but not relieved by rest. Positive blood tests ESR and + HLA B27.

References:

[1] The Lumbar Spine, Mechanical Diagnosis & Therapy. Vol 2. Robin McKenzie, Stephen May. Pg554. “The great majority of patients presenting with back problems do so because of derangements.”

[2] Spine (Phila Pa 1976). 2004 Dec 1;29(23):2593-602. Does it matter which exercise? A randomized control trial of exercise for low back pain. Long A1, Donelson R, Fung T. "...exercises matching subjects' DP (directional preference) significantly and rapidly decreased pain and medication use and improved in all other outcomes..."

[ii] Hefford C, McKenzie classification of mechanical spinal pain: profile of syndromes and directions of preference. Manual Therapy, 13.75-81,2007. Over 90% were classified with a mechanical syndrome and more than 80% with derangement.

[3] The Lumbar Spine, Mechanical Diagnosis & Therapy. Vol 2. Robin McKenzie, Stephen May. Glossary “Centralization” Pg709

[4]Overview of Supportive Studies: McKenzie Method® of Mechanical Diagnosis and Therapy® (MDT) Richard Rosedale PT, Dip. MDT, Robert Medcalf PT, Dip. MDT, Predicting Outcomes. The McKenzie Method also has an important asset in its ability to predict patient outcome through classification and the determination of Centralization. If a patient with lumbar or cervical pain is classified as a Derangement and can centralize their symptoms in a short time after initiating MDT, the prognosis for a rapid and lasting improvement is very good. 

[5] Ronald Donelson, MD, MS Rapidly Reversible Low Back Pain - An evidence based pathway to widespread recoveries and savings. Introduction pg 2. "There is also considerable evidence that validates this reversibility... This single LBP (low back pain) characteristic has the potential, if more broadly understood and utilized, to greatly improve the quality of care while dramatically reducing its cost.  What is so impressive about rapidly reversible LBP is that this extraordinary phenomenon helps solve most individuals' LBP."

[6]  The Lumbar Spine, Mechanical Diagnosis & Therapy. Vol 2. Robin McKenzie, Stephen May. Centralization -"The phenomenon by which distal limb pain emanating from although not necessarily felt in the spine is immediately or eventually abolished in response to the deliberate application of loading strategies. Such loading causes an abolition of peripheral pain that appears to progressively retreat in a proximal direction. As this occurs there may be a simultaneous development or increase in proximal pain. The phenomenon only occurs in the derangement syndrome.

[7] Journal of Orthopaedic & Sports Physical Therapy - Olivier T. Lam, PT • David M. Strenger, PT • Matthew Chan-Fee, PT• Paul Thuong G Pham, PT • Richard A. Preuss, PT, PhD • Shawn M. Robbins, PT, PhD.  Effectiveness of the McKenzie Method of Mechanical Diagnosis and Therapy for Treating Low Back Pain: Literature Review With Meta-analysis- "Directional preference implies a rapid improvement in patient symptoms in response to a specific exercise."

[8] Ronald Donelson, MD, MS. Rapidly Reversible Low Back Pain- An evidence based pathway to widespread recoveries and savings. P.75 "A derangement's characteristic signs are that of rapid changes in both a joint's mechanical behavior and its symptoms, just as happens when a knee meniscus tears, often referred to as an internal derangement of the knee."