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Our evaluation and treatment methods are based on the McKenzie Method of Diagnosis and Therapy®, a comprehensive, evidence based system of examination, evaluation, diagnosis, prognosis, intervention and prevention strategies aimed at patient education and independent self-management of pain. According to the McKenzie Institute, this process is "cost-efficient treatment, minimizing the need for expensive tests or procedures: no needles, no injections, no surgery".
Understanding How Your Pain Behaves With Different Movements and Positions Is Key To Determining The Appropriate Treatment
A unique feature of the McKenzie assessment process is taking the time to completely understand the way your pain behaves during different movements and positions such as sitting, bending, standing, walking, lying down or rising from sitting, or which activities such as golf, vacuuming, gardening, or sports cause the pain. In developing a complete understanding of what causes pain, we have also identified important clues as to which movements, positions or activities which may be useful during self-treatment. Patients will learn from our doctors how to self-evaluate their condition, and how to treat their pain with our guidance and oversight.
The Journey From Initial Evaluation to Self-Management of Your Back & Neck Pain
Step 1: Active Patient-Involved Medical History
You will be actively involved as the centerpiece of information that is gained during the initial medical history. This information allows our doctor to began to understand how pain affects your daily life. How pain affects your work, your home life and your recreational life. These are all pieces of information that paint a picture of what is causing your pain and how your pain can be treated. Watch the animated video and see our fictional patient, Andrew's medical history.
Step 2: Active Patient-Involved Examination
Our emPower Self-Treatment Program For Pain™ is based on the McKenzie Method of Diagnosis and Therapy® assessment, which has been found to be "a reliable and safe method to make a diagnosis that makes the correct treatment planning possible". The main difference to most other assessments is the use of a repeated movements test, rather than evaluation of a single movement. The repeated movements test will provide the doctor with critically important information necessary to determine whether there is a particular direction of repeated movement that improves your pain, called a "Directional Preference". This may mean that moving in one direction may provoke and worsen the pain, and moving in the opposite direction may improve or eliminate the pain. The McKenzie assessment explores these different positions and movements, how the patient performs them, and the response to these movements. Interpreting this information, the doctor determines which of the movements and postures becomes the treatment used in your self-management program, if any. If repetitive movements are found to have no effect on the pain, other treatment avenues must be explored. Watch the animated video see our fictional patient, Andrew's examination.
Step 3: Patient-Involved Self-Treatment/Return of Function/Prevention
If a Directional Preference is found to positively affect your back, neck or extremity pain, you will be actively involved in repeatedly performing this movement every few hours until your re-assessment in 1-2 days. During this process you will begin to learn how to assess yourself and manage your own treatment program at home, monitored by our Certified doctor. If in a short period of time your pain is not reducing, the doctor may need to add hands-on techniques until you can self-manage, however the goal is to always return to patient-managed care. The aim is to be as effective as possible in the least number of sessions. Treatment that you can perform five or six times a day is more likely to be effective in a shorter period of time than treatment administered by the clinician once or twice per week. The emphasis is on you, the patient, being actively involved. This can minimize the number of visits to the clinic. By learning how to self-treat your current pain condition, you gain knowledge on how to minimize the risk of recurrence and be able to rapidly deal with symptoms if they do recur.
 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..."
 Indian J Palliat Care. 2017 Jan-Mar; 23(1): 36–40. A Comparison of the Effects of Pilates and McKenzie Training on Pain and General Health in Men with Chronic Low Back Pain: A Randomized Trial. "The distinctive characteristic of this method is the principle of initial assessment. This principle is a reliable and safe method to make a diagnosis that makes the correct treatment planning possible."
(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... The McKenzie Method of MDT continues to be one of the most researched conservative approaches to musculoskeletal problems available
Stynes S, et al. Classification of patients with LB-related leg pain: a systematic review. BMC MSK Disorders 17:226, 2016- This review found that centralization and directional preference had been reported in 62 studies. The majority of evidence was supportive of these responses as being reliably assessed and associated with a good prognosis.
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