OBJECTIVE: To compare the effectiveness of a McKenzie Method intervention in patients with sciatica with guideline-based patient education. DESIGN: Multi-centre, assessor-blinded, parallel-group, randomised trial. SETTING: Two tertiary hospitals providing operative spinal care. SUBJECTS: Sciatica patients with magnetic resonance imaging-confirmed lumbar disc herniation compressing a nerve root. INTERVENTIONS: The McKenzie group received specific back exercises for seven visits combined with an educational book, and the Control group received a single session of self-management guidance according to usual practices. MAIN MEASURES: The primary outcome was the number of surgical operations. Secondary outcomes were pain measured using the Visual Analogue Scale, disability using the Oswestry Disability Index and health-related quality of life using a RAND-36 questionnaire at baseline and 24-month follow-up. RESULTS: Altogether 66 patients, mean age of 43 years, of which 50% were females with long-lasting sciatica, mean 16 weeks, were randomised to two groups. Nineteen patients (29%) had surgery. There was no significant difference in surgery rates between the groups. Back and leg pain decreased, and disability improved in both groups. Health-related quality of life improved in six dimensions out of eight in both groups. There were no significant between-group changes in the patient-reported outcomes at the follow-up. CONCLUSIONS: Multiple sessions of McKenzie-based back exercises with a McKenzie-specific patient's educational book produced effects equal to guideline-based advice at long-term follow-up. However, the power of these results is diminished due to the small patient population and confounding factors.

Full text (sometimes free) may be available at these link(s):      help

• DOI
• PubMed
• PDF locator
• publisher