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The McKenzie protocol also now includes flexion protocols and stresses the importance of differentiating whether flexion or extension improves patient's symptoms. As a result, McKenzie principles are used by many physical therapists in the treatment of low back pain, whereas Williams Exercises are no longer taught as a physical therapy protocol.
The McKenzie method is a technique primarily used in physical therapy.It was developed in the late 1950s by New Zealand physiotherapist Robin McKenzie. [1] [2] [3] In 1981 he launched the concept which he called "Mechanical Diagnosis and Therapy (MDT)" – a system encompassing assessment, diagnosis and treatment for the spine and extremities.
Massage therapy has been found to be more effective for acute low back pain than no treatment; the benefits were found to be limited to the short term [118] and there was no effect for improving function. [118] For chronic low back pain, massage therapy was no better than no treatment for both pain and function, though only in the short-term. [118]
The femoral nerve stretch test can identify spinal nerve root compression, which is associated with disc protrusion and femoral nerve injury. It can reliably identify spinal nerve root compression for L2, L3, and L4. [2]
The straight leg raise is a test that can be performed during a physical examination, with the leg being lifted actively by the patient or passively by the clinician. If the straight leg raise is done actively by the patient, it is a test of functional leg strength, particularly the rectus femoris element of the quadriceps (checking both hip flexion and knee extension strength simultaneously).
Patients that experience light to mild symptoms are commonly treated through physical therapy, which involves stretching and strengthening the lower back, abdominal (core) and leg muscles. [19] Common stretches used include the knee to chest stretch, posterior pelvic tilt, neural stretching of the legs, hip-flexor stretch and lower trunk rotation.
Nerve gliding physical therapy is beneficial in reducing pain intensity, bringing short-term improvements. [8] This treatment was found to manage neural tissue through specific postures and movements of the parts in pain. The stretch reduces nerve mechanosensitive that relieves discomforts, eventually leading to the normal function of the body.
Waddell's signs are a group of physical signs, first described in a 1980 article in Spine, and named for the article's principal author, Professor Gordon Waddell (1943–2017), a Scottish Orthopedic Surgeon. [1] [2] Waddell's signs may indicate non-organic or psychological component to chronic low back pain.