centralization and the correlation to discogenic pain

Critical Appraisal for a Reference-Standard Validity Study   P: For patients with chronic low back pain, with varying levels of distress, I: can the centralization phenomenon C: as compared to discography results O: provide diagnostic power for discogenic pain   Reviewer: Vincent Gutierrez, PT, MPT, cert. MDT   Search: Ovidsp with keyword terms “low back … Continue reading centralization and the correlation to discogenic pain


Response to Gifford 2002

I was given this article to read by a Physical Therapist that I respect. This article was meant to educate me on the concept of centralization. For those that have spent time with me know that I am all for being educated. I struggled with this article because it was full of opinion and anecdotal evidence. Also, … Continue reading Response to Gifford 2002

Back pain using MDT

“Low back pain is the worldwide leading cause of years lived with disability, with an estimated point prevalence of 9.4% and a lifetime prevalence of up to 39%” If three people are sitting together, the odds are that one of those three had back pain, has back pain or will have back pain. That kind … Continue reading Back pain using MDT

To slouch or not to slouch?

“Epidemiologic studies have shown that individuals in occupations that involve prolonged periods of sitting experience a high incidence of low-back pain” I don’t think that this surprises anyone, but as we continue to advance with technology, the jobs that require mostly standing are going away. Put the data into today’s terms. How many of us … Continue reading To slouch or not to slouch?

Post 86: back pain classification

“…it is often not possible to make a specific pathoanatomical diagnosis reliably for patients with low back pain (LBP)…85% to 95% of patients with LBP are diagnosed by their general practitioner as having nonspecific LBP”   This is very controversial. We know that back pain exists and exists as an epidemic in terms of how … Continue reading Post 86: back pain classification

Post 85: Can we predict what your MRI will show…before the MRI

“Patients who have lumbar discectomy with predominant leg pain at initial presentation are known to have a better result than patients with primarily low back pain without radiation” WHAAT!? You mean to tell me that patients with back pain only, don’t do well with a surgical approach? Yougottobekiddingme! Obviously I joke. We can predict that … Continue reading Post 85: Can we predict what your MRI will show…before the MRI

Post 84: Mckenzie (MDT) as a variable for back pain improvement

“Therapists using the McKenzie method classify patients based on repeated end-range trunk movement tests into 1 of 3 main syndromes: derangement, dysfunction and posture.”  There is a lot here even though they summarized it very succinctly. By the by, one of the authors, Jason Ward, has an awesome podcast called the Mechanical Care Forum that … Continue reading Post 84: Mckenzie (MDT) as a variable for back pain improvement

Lateral shift deformity

Crooked patients 1. “A lumbar lateral shift (LLS) is defines as a lateral displacement of the trunk in relation to the pelvis…repeatedly associated with discogenic pathology…McKenzie reported that 90% respond rapidly to manual correction.”   In school we learn the theoretical aspect of the shift, but when you see your first patient that is shifted … Continue reading Lateral shift deformity

Core stabilization compared to McKenzie method treatment

  “The condition has been identified as the leading contributor to ‘years of life lived with disability’ in the world including the United States.”   Big surprise, we are talking about back pain again. I see a majority of my schedule as back pain for the previous 8 years. There is no loss of people … Continue reading Core stabilization compared to McKenzie method treatment

key to unlocking pain

The Audrey Long article is commonly cited as one of the landmark articles for those of us that treat spines utilizing directional preference and centralization.  As well it should be! The results are unbelievable.  This researcher…I take that back…clinician performing research in the clinic published an article that, up until this time, was only speculation. … Continue reading key to unlocking pain