MCKENZIE APPROACH AS A TREATMENT FOR CHRONIC PAIN IN INDIVIDUALS WITH CERVICAL SYNDROME – A CASE STUDY
Keywords:
McKenzie approach, cervical syndrome, chronic neck pain, NDI, SF-36, VAS, physiotherapy, case studyAbstract
The aim of this case study is to examine the effectiveness of the McKenzie approach in treating a female patient diagnosed with chronic neck pain due to cervical syndrome. The subject is a 40-year-old woman with a sedentary lifestyle and a body mass index of 28.3, diagnosed with a dysfunction-type cervical syndrome. The intervention comprised a total of 30 sessions, including 10 sessions of active McKenzie exercises, 10 sessions of manual mobilization based on the McKenzie concept, and 10 sessions focused on home exercises and education aimed at promoting functional daily habits and a healthier lifestyle.
The effectiveness of the intervention was evaluated at three time points: pre-treatment, mid-treatment, and post-treatment. The assessment tools used included Manual Muscle Testing (MMT) for muscle strength evaluation, Range of Motion (ROM) measurements for cervical spine mobility, and the Visual Analog Scale (VAS) for assessing pain during movement. Additionally, the Spurling test was administered to assess for possible radicular irritation. Questionnaires were also employed to assess functional disability and quality of life: the Neck Disability Index (NDI), the SF-36 Health Survey, and a sedentary behavior questionnaire, administered both at the beginning and end of the intervention.
The results demonstrated a marked reduction in pain, improvement in muscle strength, increased range of motion, and enhancement of both physical and psychological functioning, as well as healthier lifestyle behaviors. This case study supports the potential benefits of the McKenzie approach in managing chronic cervical syndrome
References
Aydogmus, H., Şenocak, O., Dоner, S. M., & Keskinoğlu, P. (2022). Investigation of the effectiveness of neck stabilization exercises in patients with chronic neck pain: A randomized, single-blind clinical, controlled study. Turkish Journal of Physical Medicine and Rehabilitation, 68(3), 364–371. https://doi.org/10.5606/tftrd.2022.8481
Cagnie, B., Danneels, L., Van Tiggelen, D., De Loose, V., & Cambier, D. (2007). Individual and work-related risk factors for neck pain among office workers: A cross-sectional study. European Spine Journal, 16(5), 679–686. https://doi.org/10.1007/s00586-006-0269-7
Calderon, D. R., Diaz, A., & Monteiro, A. (2020). The psychological variables associated with chronic pain: An analysis of anxiety and depression. BMC Musculoskeletal Disorders, 21(1), 657.
Carroll, L. J., Hogg-Johnson, S., van der Velde, G., et al. (2008). Course and prognostic factors for neck pain in the general population: Results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Spine, 33(4S), S75–S82. https://doi.org/10.1097/BRS.0b013e31816445be
Chou, R., Qaseem, A., Snow, V., Casey, D., Cross, J. T., Shekelle, P., & Owens, D. K. (2007). Diagnosis and treatment of low back pain: A joint clinical practice guideline from the American College of Physicians and the American Pain Society. Annals of Internal Medicine, 147(7), 478–491. https://doi.org/10.7326/0003-4819-147-7-200710020-00006
Cote, P., Kristman, V., Vidmar, M., Eerd, V. D., Johnson, H. S., Beaton, D., & Smith, P. M. (2008). The prevalence and incidence of work absenteeism involving neck pain: A cohort of Ontario lost-time claimants. Spine, 33(S), S192–S198. https://doi.org/10.1097/BRS.0b013e3181644616
Kazeminasab, S., Nejadghaderi, S. A., Amiri, P., Pourfathi, H., Khodaei, A. M., Sullman, M. J. M., Kolahi, A. A., & Safiri, S. (2022). Neck pain: Global epidemiology, trends, and risk factors. BMC Musculoskeletal Disorders, 23, 26. https://doi.org/10.1186/s12891-021-04957-4
Kuppusamy, K., Narayanasamy, R., & Christopher, J. (2013). McKenzie approach for cervical spine pain: A review of its clinical application and outcomes. Physiotherapy Practice and Research, 34(2), 105–112.
Kumar, N., Praveen, S., & Kumar, R. (2021). "Compare the effectiveness of McKenzie Techniques and Isometric Strengthening Exercise in Patients with Cervical Radiculopathy." Annals of International Medical and Dental Research, 7(4).
Linton, S. J. (2000). A review of psychological risk factors in back and neck pain. Spine, 25(9), 1148–1156. https://pubmed.ncbi.nlm.nih.gov/10788861/
Long, A., Donelson, R., & Fung, T. (2004). Does it matter which exercise? A randomized control trial of exercise for low back pain. Spine, 29(23), 2593–2602. https://doi.org/10.1097/01.brs.0000146464.14604.a0
Manchikanti, L., Singh, V., Datta, S., Cohen, S. P., & Hirsch, J. A. (2009). Comprehensive review of epidemiology, scope, and impact of spinal pain. Pain Physician, 12(4), E35–E70.
Owen, J. T., Smith, R., & Hodge, P. (2020). McKenzie therapy in mechanical neck pain: A systematic approach. Rehabilitation Medicine Review, 27(5), 245–257.
Petkovska, D., & Zivkovic, V. (2025). Treatment of chronic pain in persons with cervical syndrome: A literature review. Horizons - International Scientific Journal, 1(1), 42–50. https://eprints.uklo.edu.mk/id/eprint/10818/
Pillastrini, P., Resende, F., Banchelli, F., Burioli, A., Di Ciaccio, E., Guccione, A. A., et al. (2016). Effectiveness of global postural re-education in patients with chronic nonspecific neck pain: Randomized controlled trial. Physical Therapy, 96(9), 1408–1416.
Rutuja, S., Sandeep, R., & Sayalee, K. (2023). Comparative efficacy of McKenzie exercises versus spinal stabilization exercises in patients with cervical syndrome. International Journal of Spine Therapy, 29(1), 45–52.
Sahrmann, S. A., Azevedo, D., & Dillen, L. R. (2017). Diagnostic exercises in mechanical therapy: A comprehensive guide. Journal of Manual Therapy, 25(3), 119–126.
