Back pain and other musculoskeletal pain can be both debilitating and frustrating, especially if it starts to interfere in work duties, daily activities, and quality of life. Imagine having the power to control your pain without the need for pain medication or surgery. Protocol teaches patients to do just that. Mckenzie exercises are specifically designed to treat various pain symptoms without invasive procedures.
The idea is simple: If a position, movement, or activity is causing the pain, then moving in the opposite direction may eliminate the pain. In particular, the McKenzie Method is a safe, effective, and self-directed option for low back pain and other musculoskeletal issues. The treatment principles are rooted in the body’s potential to repair itself without the need for medication, heat, cold, or surgery. Discover how trained practitioners teach patients to manage pain on their own with targeted movements and exercises.
Candidates for the McKenzie Method
An estimated 75-85 percent of Americans experience lower back pain at some point in their life. Both short-term and chronic back pain can be related to age, occupation, injury, overuse, pregnancy, poor posture, mechanical issues, or a chronic condition such as scoliosis.
It has become common practice for physicians to prescribe medicine or recommend surgery for various types back pain, but there are many alternative treatments that are equally effective. Physical therapy (PT) treatments like the McKenzie Method can provide effective relief for musculoskeletal pain. The McKenzie Method is especially recommended for patients with chronic conditions who seek effective relief. As movement experts, physical therapists empower patients with knowledge of how the body and pain works.
Often, patients are referred to PT after other tests come back normal. They report vague symptoms or generalized pain. Your physical therapist may use the McKenzie Method to assess musculoskeletal conditions such as back pain, neck pain, shoulder pain, knee pain, ankle pain, and more. Certified McKenzie clinicians are highly trained to determine if there is a “mechanical” reason for the problem.
Developed by expert physiotherapist Robin McKenzie in the 1950s, The McKenzie Method is a specialized assessment and treatment protocol for patients with:
- Acute lower back pain or sciatica
- Sacroiliac joint pain, arthritis, degenerative disc disease
- Muscle spasms and intermittent numbness in hands or feet
- Lumbar derangement or lumbar dysfunction
- Chronic conditions of the spine and extremities
- Poor mobility of the lumbar spine
Not all patients are good candidates for this type of therapy, especially those who have had back surgery. People who are self-motivated and want to live without pain do experience success when they follow a customized exercise regimen.
How the McKenzie Method Works
Therapists trained in the McKenzie Method do not use expensive diagnostic imaging to determine what may be causing a patient’s pain. Rather, a thorough examination and evaluation help identify mechanical problems in your musculoskeletal system.
The McKenzie Method involves four primary steps:
- Assessment: Your physical therapist (PT) will evaluate your condition by observing your posture, movements, and range of motion. They may ask you to perform specific exercises and note any changes in pain or discomfort to identify the source of your symptoms.
- Classification: Based on the assessment, your PT will categorize your condition into one of three syndromes:
- Derangement Syndrome: Pain caused by structural displacement, such as disc bulges.
- Dysfunction Syndrome: Pain from stiff or shortened tissues due to past injury.
- Postural Syndrome: Pain caused by prolonged poor posture without underlying structural damage.
- Treatment: Your PT will develop a personalized exercise plan focused on movements that reduce pain and restore function. These exercises often involve repeated motions that help realign joints, improve mobility, and strengthen supporting muscles.
- Prevention: Once symptoms improve, your therapist will teach you how to maintain progress and prevent future flare-ups through self-care techniques, postural corrections, and continued movement strategies.
Moreover, by following this steps, following the McKenzie Method can help:
- Determine if other testing is needed
- Gain an understanding of the patient’s symptoms and onset and movements that cause pain
- Identify an effective treatment relief plan, including prescribed exercises
- Provide suggestions for appropriate postures and behaviors to adopt or temporarily avoid outside the clinic
- Reduce symptoms and restore normal function
- Improve spine mobility, posture, and range of motion
- Educate patients to self-treat current issues and prevent flare-ups
By empowering patients with the knowledge and tools to manage their pain, the McKenzie Method offers a long-term, effective solution—particularly for those experiencing spinal, neck, and extremity pain.
McKenzie Method Exercises
For patients who can benefit, PTs teach patients how to manage pain on their own with customized stretches and exercises. Some of these exercises include:
- Prone lying, or lying flat on your stomach
- Prone props, or lie on your stomach and prop on your elbows
- Press-ups: Keep your back and hips relaxed, and then use your arms to press your upper back and shoulders up, similar to the upward dog yoga pose
- Low back side glide for sciatica
- Flexion rotation exercise for low back pain
- Standing lumbar extension
- Low back flexion
- Seated and standing lumbar flexion
Your therapist may work one-on-one with you for several sessions, while also showing you a variety of exercises and stretches to do as part of a home exercise program. Initial treatment sometimes involves hands-on manual techniques to aid your recovery. Working with a physical therapist can reduce pain, improve your overall mobility, and correct postural imbalances. Incorporating McKenzie exercises into an at-home exercise routine can quickly and safely reduce pain and improve your ability to move normally.
We’re Here to Help
If you experience short-term or chronic back pain, visiting a physical therapist can be restorative, educational, and truly life-changing. Contact Ivy Rehab for more information on overuse injuries, managing chronic pain, or to schedule an appointment to learn more about the McKenzie Method!
Article Reviewed by Holly Lookabaugh-Deur, PT, DSc, GCS, CEEAA
Holly Lookabaugh-Deur, PT, DSc, GCS, CEEAA is a practicing physical therapist and a partner and Director of Clinical Services at Ivy Rehab Network. Deur is board certified as a geriatric clinical specialist and certified exercise expert for aging adults with more than 35 years of clinical experience. She is certified as an aquatic and oncology rehabilitation specialist and serves as adjunct faculty at Central Michigan University and Grand Valley State University.
