The McKenzie Method for Mechanical Low Back Pain: A Systematic Review of the Literature with a Meta-Analysis Approach

Dr. Saurabh Anand, Dr. Puneet Jaiswal, Dr. Kumari Nidhi

Abstract: Background: The McKenzie Method of Mechanical Diagnosis and Therapy (MDT) is a classification - based intervention designed to subgroup patients with low back pain (LBP) to guide targeted treatment. The effectiveness of MDT in improving pain and functional outcomes in acute and chronic LBP populations remains under investigation. Objective: The purpose of this review was to assess how effective the McKenzie Method (MDT) is in alleviating pain and improving functional ability in individuals with either acute (less than 12 weeks) or chronic (more than 12 weeks) low back pain (LBP). Methods: A comprehensive search of six electronic databases was conducted to identify randomized controlled trials (RCTs) assessing MDT in patients with LBP. Independent reviewers screened studies, extracted data, and evaluated risk of bias. Meta - analysis was performed to compare MDT with other treatment approaches using standardized mean differences (SMD) and 94% confidence intervals (CI). Results: Out of 17 studies that fulfilled inclusion criteria, 11 provided data suitable for meta - analysis. In patients with acute LBP, MDT demonstrated no statistically significant benefit over other interventions for either pain reduction (P = 0.12) or functional improvement (P = 0.61For individuals with chronic LBP, the McKenzie Method demonstrated a notable improvement in reducing disability when compared to exercise alone (SMD = ?0.44). However, when compared with a combination of manual therapy and exercise, MDT showed no significant differences in outcomes related to pain or disability (P > 0.04). Conclusion: For acute LBP, current evidence of moderate to high quality suggests that MDT is comparable to other rehabilitative treatments in terms of reducing pain and disability. For chronic LBP, MDT appears to offer superior benefits compared to exercise alone, though not necessarily when compared to multimodal treatments such as manual therapy combined with exercise.

Keywords: Centralization, classification, directional preference, lumbar spine, McKenzie method, confidence interval (CI), Randomized controlled trials (RCTs)