mckenzie method

“But I’ve Been Told I Need Surgery” (and how McKenzie Method can help you)

Chris LorangThe Research, Your Best Life

“But I’ve been told I need surgery.”

This is a statement we hear from patients a lot. And sometimes it is true. But more often than not, we help our patients improve their mobility and pain to the point where back or neck surgery is no longer necessary.

We believe surgery should be considered as a last resort, only after failure to improve with conservative care. Seeking out conservative care like chiropractic and physical therapy can save time and money with healthcare. 

mckenzie method

VIDEO: Dr. Chris LoRang demonstrates three McKenzie Method exercises. Click to view on Instagram.

Don’t just take our word for it

The McKenzie Method has been shown to be an excellent conservative care option. For example, after the implementation of McKenzie based spine care into a Danish county, lumbar disc surgeries were reduced by 50 percent (13).

What can we do for you?

Drs. LoRang, Schreyer, and Hartley are well versed in the McKenzie Method, with over 250 combined hours of training in this approach. If you have pain or a condition that doesn’t seem to be getting better, allow us to give you a thorough assessment to help expedite your treatment journey.

What is it?

The McKenzie Method (MDT) is a classification system developed by a physical therapist out of New Zealand, Robin McKenzie. Making a proper diagnosis is one of the most challenging tasks a physician faces as a healthcare provider. If a proper diagnosis is not established, patients can be left wondering: What’s wrong with me? What’s causing my pain? 

Many individuals go extended periods of time with vague labels or blanket terms for their pain, such as low back pain or sciatica. But what does that really mean or tell you about your condition? Getting an accurate answer about your pain decreases uncertainty and bolsters confidence about what you’re experiencing.

The McKenzie method is a thorough assessment of the musculoskeletal system that seeks to differentiate sources of pain and accurately classify it into one of four categories: derangement, dysfunction, postural, or other. Derangement is by far the most common, with about 90 percent of cases falling into this category (1). Fortunately, derangements can be treated with confidence and most get better quickly (2-5).

More accurate classification leads to an earlier prognosis and better outcomes for you. The goal of the assessment is to find a direction of movement that ultimately reduces symptoms/pain. This system has been shown to be extremely reliable when used by highly trained McKenzie clinicians (6-9). Meaning we can have a high degree of certainty when classifying and making a diagnosis.

With a clinicians’ direction, you do a series of movements to stress test the body. Your response to each movement clues us into your condition. The beauty of this assessment is that it also doubles as the treatment; when a movement is found that improves symptoms, this movement is repeatedly performed. This movement not only helps to reduce your pain, it gives you the tools to help manage your condition.

Why is this important?

Back pain is the #1 cause of disability globally and 50-80 percent of the adult population will experience back pain at some point in their life (10). This means that there is a strong chance you will, at some point in your life, experience back pain. Perhaps you already have. Back pain by nature is episodic; it comes and goes. We want to reduce these occurrences and empower you to manage your pain going forward.

This method of assessment has been shown to be effective at treating not only spine-related conditions, but those in the arms and legs as well.

What else can McKenzie Method help with?

  • Low back pain
  • Sciatica
  • Lumbar Radiculopathy
  • Cervical Radiculopathy
  • Neck pain
  • Headaches
  • Shin splints
  • Carpal tunnel
  • Suspected rotator cuff tear
  • Suspected labral tear

 These are conditions that are not uncommon for many individuals. The McKenzie Method has been shown to be an effective tool for treating these conditions as well (11-12).

Now is the time to reach out

We can help. And if our team of clinicians can help, you very well might be able to avoid that surgery. And if in the end, your surgery is still necessary, you’ve at least tried the best evidence-based conservative treatments. Call us at 515-421-4018, email, or book online.


  1. Otero J. Bonnet et al. (2016). Neck Pain: Prevalence of Mckenzie’s Syndrome and Directional Preference, Kinesither Rev, 16:2-10.
  2. Werneke M, Hart DL. Centralization phenomenon as a prognostic factor for chronic LBP and disability. Spine. 26;7:758-65. 2001
  3. Skytte L, et al. Centralization: Its prognostic value in patients with referred symptoms and sciatica. Spine.30;11:E293-9. 2005
  4. Werneke M, et al. Association Between Directional Preference and Centralization in Patients with Low Back Pain. J. Ortho. Sports Phys. 41:22-31. 2014
  5. Heidar Abady A, et al. Application of the McKenzie system of Mechanical Diagnosis and Therapy (MDT) in patients with shoulder pain; a prospective longitudinal study. J Man Manip Ther 25:5:235-243. 2017
  6. Kilpikoski S, et al. Inter-examiner reliability of LBP assessment using the McKenzie method. Spine. 15;27. 2002
  7. Clare HA, et al. Reliability of McKenzie classification of patients with cervical or lumbar pain. JMPT. 28. 2005
  8. Heidar Abady A, et al. Inter-examiner reliability of diplomats in the MDT system in assessing patients with shoulder pain. JMMT 22; 4. 2014 
  9. Willis S, et al. Inter-rater reliability of the McKenzie System of MDT in the examination of the knee. JMMT 25;2. 2017
  10. Hartvigsen, J., Hancock, M. J., Kongsted, A., Louw, Q., Ferreira, M. L., Genevay, S., Hoy, D., Karppinen, J., Pransky, G., Sieper, J., Smeets, R. J., Underwood, M., Buchbinder, R., Hartvigsen, J., Cherkin, D., Foster, N. E., Maher, C. G., Underwood, M., van Tulder, M., … Woolf, A. (2018). What low back pain is and why we need to pay attention. The Lancet, 391(10137), 2356–2367.
  11. Heidar Abady, A., Rosedale, R., Chesworth, B. M., Rotondi, M. A., & Overend, T. J. (2018). Consistency of commonly used orthopedic special tests of the shoulder when used with the McKenzie system of mechanical diagnosis and therapy. Musculoskeletal Science and Practice, 33, 11–17.
  12. Rosedale, R., Rastogi, R., Kidd, J., Lynch, G., Supp, G., & Robbins, S. M. (2019). A study exploring the prevalence of Extremity Pain of Spinal Source (EXPOSS). Journal of Manual & Manipulative Therapy, 28(4), 222–230.
  13. Rasmussen C, et al. Rates of Lumbar Disc Surgery Before and After Implementation of Multidisciplinary Nonsurgical Spine Clinics. Spine 30;21:2469-73. 2005

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