Mechanical Diagnosis and Therapy (MDT), also known as the McKenzie Method, is a reliable assessment process that has been widely used all over the world for over 30 years to treat spine and joint pain. During your initial evaluation, a certified MDT clinician is trained to determine if physical therapy is appropriate or if a referral back to your MD is necessary. If physical therapy is right for you, your MDT clinician can provide an accurate prognosis for your recovery within 1-3 visits. Your MDT clinician will also encourage self-management which can very rapidly lead you back to your normal way of life. As a result, expensive imaging such as X-rays and MRIs are often unnecessary in determining the source of your pain. Patients, doctors, and clinicians everywhere should become educated on the effectiveness of the MDT method and only resort to more invasive procedures like an epidural steroid injection (ESI) or surgery if MDT fails due to the high cost and risks that are involved in those types of procedures. For this reason, MDT is the preferred method of assessment and treatment for myself and other certified MDT clinicians at Function Better.
Your initial visit will consist of a thorough history about your symptoms and how they behave to help your physical therapist understand the problem. You will then perform a series of tests and positions with your physical therapist asking you about your symptoms before, during and after each movement. When a specific movement or position is found that helps to reduce your pain and/or allows your range of motion to improve, this becomes part of your treatment. You will then be responsible for performing the exercise(s) at home to assess its effectiveness in controlling your pain or improving your function. Each follow-up visit then becomes a “re-assessment,” with modifications (progressions, regressions, additional exercises, etc.) being made to your home exercise program as needed to progress your recovery forward. A key feature of MDT that separates it from other commonly used treatment methods is that you, the patient, are actively involved throughout the assessment and treatment process. Rather than relying on someone else doing something to you to reduce your pain, as you would see with clinicians using modalities such as ultrasound, you are educated on ways to treat yourself independently. This not only helps you learn to self-manage your symptoms during therapy, but also teaches you how to prophylactically prevent future episodes from ever happening again upon being discharged. This also provides a safety factor because you, the patient, are in control of everything that happens to yourself. There will be times where a hands on approach is used by your physical therapist but this only happens when it is deemed necessary in order to elicit change and for your physical therapist to better understand your condition.
Overall, MDT is a safe and reliable assessment process that leads to a fast and accurate diagnosis and treatment plan. Ultimately, the goal upon discharge is that you, the patient, has a full understanding of your condition, what causes your condition, and that you are given the correct “tool(s)” to control your condition if/when it occurs in the future.
Post Author: Dr. Kevin Smith, PT, DPT, Cert. MDT