The Effectiveness of the McKenzie Method as a Paradigm for Treating Adults with Neck Pain: A Systematic Review with Meta-Analysis

Objective(s) To examine the effectiveness of the McKenzie Method of Diagnosis and Treatment (MDT) as an evaluation and treatment paradigm in adult patients with neck pain to improve patient outcomes. Data Sources A systematic review and meta-analysis was performed using PubMed, ScienceDirect, MEDLINE, CINAHL, Web of Science, and Google Scholar. Full search terms included “McKenzie method” OR “McKenzie approach” OR “McKenzie treatment” AND “neck pain” in each database. Study Selection Inclusion criteria was use of McKenzie MDT, Level I randomized control trials (RCTs), adults, and outcomes of pain (0-10 scale) and disability (Neck Disability Index). Exclusion criteria included lower level of evidence studies, articles without full text, concurrent thoracic symptoms, and non-English text. Article screening was performed by multiple authors. Data Extraction Articles were examined for full text and relevance by multiple authors. Data extraction included first author, year of publication, intervention, control group, number of patients, average pain scores with standard deviations, average Neck Disability Index score with standard deviations, and follow-up time. Data Synthesis A total of 11 RCTs met final selection criteria from 1,955 articles on initial search with 289 patients receiving McKenzie MDT out of 677 total patients. For meta-analysis, there was a small but statistically significant improvement in pain (1.14/10 points) in patients receiving McKenzie MDT versus control (p< 0.02). There was no significant improvement in NDI score between McKenzie MDT versus control (p=0.19). For severity of pain, there was a significant improvement in moderate or severe pain (2.06/10 points; p< 0.01), but not in mild to moderate pain (p=0.84) when comparing McKenzie MDT to controls. Conclusions McKenzie MDT has small but statistically significant improvement in neck pain compared to controls, especially in patients with moderate to severe neck pain. Use of McKenzie MDT did not provide any significant improvement in disability compared to control. This study is the first systematic review with meta-analysis on the effectiveness of McKenzie MDT for adult patients with neck pain. Author(s) Disclosures The authors have no relevant disclosures to make known.