Radiculopathy, or sciatica, is present in numerous cases of low back pain. Most people describe sciatic pain in the lower back and legs as tingling, a crawling sensation, numbness, a mild burning sensation, pins and needles, shooting pain, or an electric feeling around the hip or down the leg.
Some healthcare professionals use a concept called centralization. The basic idea behind this concept is that, during recovery, the pain moves up from the leg toward the lower back.
During this process the back pain may feel stronger for a while, which practitioners of the method see as a sign that the approach is working. When the leg pain and symptoms are reduced, centralization is taking place. In the majority of cases, back pain doesn’t increase much according to self-reported VAS (pain scale) scores.
Centralization is a basic concept in the McKenzie method of assessment and treatment, and evidence that supports this hypothesis would add credibility and relevance to the method.
In 2008, Werneke performed a study to check whether the centralization reported by patients was an indicator of positive results or not.
Patients with cervical and lumbar syndromes were treated with different methods, not just with McKenzie. The final results were interesting – just 17% of patients showed symptoms related to centralization. These results were probably affected by the type of treatment these patients followed, the time frame in which they had the treatment, and the type of injury they had.
Centralization was more common in patients who had more severe symptoms, and in patients who were younger and had better health in general.
In patients who had lumbar symptoms, non-centralization was linked to reduced ability on functional task testing and significantly higher pain scores. In people with cervical pain, non-centralization was linked to higher pain ratings, but all other indicators were the same.
The number of visits didn’t affect the final results. In other words, centralization likely helps predict pain status and functional status in those with lumbar pain.
Piriformis syndrome, sciatica, and lower back pain can be very painful, and even though many people have the symptoms associated with these conditions, the methods used to manage them are different.
Robin A. McKenzie was a well-known physical therapist who focused on pain linked to disc issues. This kind of pain often starts from the glutes and goes all the way down to the toes, affecting the entire leg. The sensation can be described as tingling or numbing pain that can be felt regardless of position – standing, lying down, or sitting. It can be felt even when walking.
The exercise presented in this video is called the McKenzie press. Many people use it to ease the pain and to centralize it in the lower back.
Medical disclaimer: The video in this article doesn’t provide medical advice. The content in this video is not designed to be a replacement for any professional healthcare diagnosis, treatment, or advice. Consult a licensed healthcare professional before you perform any of these exercises.
Via Spine Health
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always talk to your doctor about any health concern.