I would have to agree with Sam. There is very little evidence on the
efficacy of McKenzie therapy in the treatment of LBP with neuro signs.
Most research studies have concentrated on derangements 1-4, hardly any
have studied derangements 5 and 6. The studies documenting the natural
resolution of such problems are greater in number. Seems to make most
sense to follow advice of reducing inflammation in the first instance
with graduated exposure to aggravating activities. There's a very good
article in the newsletter of the Physiotherapy Pain Association in Dec
2002 challenging the fear avoidance behaviour encouraged by the McKenzie
approach. Well worth a read.
Karen Fechter
-----Original Message-----
From: - for physiotherapists in education and practice
[mailto:[log in to unmask]] On Behalf Of Sam Bowden
Sent: 24 January 2003 12:02
To: Karen Fechter
Subject: Re: LBP & neuro signs dilemma
Frank
Why on Earth would you say that these problems are best treated by
McKenzie
trained physiotherapists? I can't understand that at all...is there a
new
piece of evidence I don't know about? It sounds like the advice given is
very sensible and I am aware of no reason to send the patient on
anywhere
at present! There are many therapists out there with no McKenzie
credentials who would treat this patient using best available knowledge
of
pain mechanisms and do an excellent job.
How is he supposed to learn if every time he gets an interesting patient
he
refers them on? (anyway who would get the credit if this patient
spontaneously resolves)?
sam bowden
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