McKenzie classification of mechanical spinal pain: profile of directional preference Man ther Feb;13(1) 2006

Several reviews have been published regarding the typical findings using a movement classification analysis. This 2006 study presents these findings in a useful way i.e. IF you find that 75% of your patients have a “flexion” directional preference you have probably misinterpreted the examination (or have the most unusual patients in America!). Their findings show an average (from a cohort of 187 patients) 140/187 were “reducible derangements” (a disc that can likely reduce or be positively affected with sequential movements); 11/187 were “irreducible”. In a general sense this suggests that less than 10% of back patients have conditions which can’t improve with treatment, 75% will. 24/187 were classified as “other”…suggesting inflammation, postural or adherence etc.

98/140 (70%) were EXTENSION, (5%) FLEXION and (25%) LATERAL (or rotation or side-glide). Other studies also suggest a 3% or less prevalence of nerve adherence syndromes. These studies support the premise that mechanical evaluation of spinal patients using some sort of directional-preference is warranted. In our decompression classification we utilize these tests; however in the 10% of patients NOT demonstrating a DP axial traction therapy is usually the most sensible treatment. By fostering directional-preference findings we have found that traction-therapy works better and quicker.