McKenzie Lumbar Classification System Flashcards
What is the following provisional MDT classification: Loading strategies centralize or make symptoms better?
Derangement
What is the following provisional MDT classification: Pain only produced at limited end range?
Dysfunction
What is the following provisional MDT classification: Pain only on static loading, no effect of repeated movements?
Postural
What is the following provisional MDT classification: Not consistent with the 3 McKenzie Syndromes?
Other
What are the “Other” provisional MDT classification diagnoses that are possible? (8)
chronic pain syndrome, inflammatory, mechanically inconclusive, mechanically unresponsive radiculopathy, post surgery, SIJ, spinal stenosis, trauma
What are the “serious pathologies” to rule out for a patient with LBP that would require referral?
Category
Clinical Findings (red flags)
Clinical Examples
Cancer:
Age > 55, history of cancer, unexplained wt loss, progressive, not relieved by rest
Cauda equina syndrome/cord compression:
Bladder retention, bowel incontinence, saddle anesthesia, global or motor weakness in legs, clumsiness in legs
Spinal fracture:
History of severe trauma, older age, prolonged steroid use OR young & active with sport related low back pain
Compression fracture, pars interarticularis fracture
Spinal related infection:
Fever, malaise, constant pain, all movements worsen
Epidural abscess, discitis
Vascular:
Vascular disease, smoking history, family history, age > 65, male > female
Abdominal aortic aneurysm
Describe Chronic Pain Syndrome.
Pain influenced by psychosocial factors or neuropsychological changes: persistent widespread pain, aggravation with all activity, disproportionate pain response to mechanical stimuli, inappropriate attitudes or beliefs about pain
Describe Inflammatory back pain.
It is inflammatory arthropathy: constant pain, morning stiffness, excessive movement exacera=bated symptoms
Describe Mechanically Inconclusive back pain.
It is from an unknown musculoskeletal pathology: all other classifications excluded, symptoms affected by positions of movements BUT no recognizible pattern identified OR inconsistent symptomatic and mechanical responses on loading
Describe Mechanically Unresponsive Radiculopathy back pain.
It is radicular presentation consistent with unresponsive nerve root compromise: radicular symptoms accompanies by varying degrees of neurological signs and symptoms, no centralization and symptoms don’t remain better after any repeated movements, positions, or loading strategies
Describe Post-Surgery back pain.
It’s presentation relates to recent surgery: recent surgery and still in post-op protocol.
Describe SIJ/Pregnancy related pelvic girdle pain.
Pain-generating mechanism emanating from the SIJ or symphysis pubis: 3 or more SIJ pain provocation tests, excluded lumbar spine and hip
Describe spinal stenosis back pain.
It is symptomatic degenerative restriction of spinal canal or foramina: older with history of leg symptoms relieved with flexion and exacerbated with extension, longstanding loss of extension
Describe Trauma or Recovering Trauma back pain.
Recent trauma associated with onset of symptoms: recent trauma with constant symptoms.
Describe the “New” Derangement Sub-classification System. (4)
The system includes:
(1) description (not classification)
(2) reducible or irreducible
(3) severity indicator, related to location (i.e. central and symmetrical, unilateral and asymmetrical to knee, unilateral and asymmetrical distal to knee)
(4) directional preference
