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Centralization phenomenon. Its usefulness in evaluating and treating referred pain
R Donelson1, G Silva, K Murphy
1Department of Orthopaedics, State University of New York, Syracuse.
Spine
|March 1, 1990
Summary
Centralization, a rapid pain relocation phenomenon during McKenzie mechanical evaluation, accurately predicts successful low-back pain treatment outcomes. Its absence indicates poor prognosis and potential need for surgery.
Area of Science:
- Orthopedics
- Physical Medicine
- Rehabilitation
Background:
- Low-back pain with radiating leg pain is a common condition.
- The McKenzie method is a widely used mechanical evaluation protocol.
Purpose of the Study:
- To evaluate the phenomenon of centralization during mechanical evaluation.
- To determine the predictive value of centralization for treatment outcomes in patients with low-back and radiating leg pain.
Main Methods:
- A review of 87 patients with low-back and radiating leg pain was conducted.
- Patients underwent mechanical evaluation using the McKenzie protocol.
- The occurrence and direction of pain centralization were assessed.
Main Results:
- Centralization occurred in 76 out of 87 patients (87%).
- Centralization during initial evaluation accurately predicted successful treatment outcomes.
- Nonoccurrence of centralization predicted poor treatment outcomes and the need for surgery.
Conclusions:
- Centralization is a reliable indicator of successful treatment for low-back pain with radiating leg pain.
- The McKenzie method's assessment of centralization can guide treatment exercise direction.
- Centralization assessment aids in early identification of patients requiring surgical intervention.