McKenzie PT vs. Chiro Manips: The Most Recent RCT

Reference:Petersen T et al The effect of the McKenzie method as compared with that of manipulation for patients with clinical signs of disc-related persistent low back pain. A Randomized controlled trial. 7th Interdisciplinary World Congress on Low Back & Pelvic Pain. November 2010, Los Angeles, USA

In November 2010 I had the amazing opportunity to participate in the 7th Interdisciplinary World Congress on Low Back & Pelvic Pain, held in Los Angeles. Needless to say, it was a mentally exhausting week. Over a hundred speakers from around the world presenting their latest research studies.

Although this study has not been yet published (likely in 2011), I am giving you a sneak preview.

This was a relatively large RCT looking at finally answering the question, which is more effective for patients with disc-related persistent low back pain, the McKenzie approach provided by physiotherapists or spinal manipulations provided by Chiropractors? And here are the results in a nutshell…

Result #1: Both groups showed clinically meaningful improvements in pain and functional scores.

Result #2: The Physiotherapy group had statistically significantly greater improvements pain and functional scores as compared to the chiropractic group at 2-month and 1-year follow up!


Result #3: The difference in pain scores may not be clinically important, as it was on average only 1.5 on the VAS to the advantage of the Physiotherapy group.

Result #4: The numbers needed to treat (NNT) with the Phsyio group was 7.
Translation: For every 7 patients, 1 would have success with the McKenzie method who would not have achieved this response with manipulation.

Clinical Relevance: If I personally had a 6-month-old discogenic back pain, I?d choose the McKenzie approach in case I am the 7th patient!

Posted on: December 26, 2010

Categories: Lumbar Spine

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