I've had a couple clients referred by local neurosurgeons to a particular physical therapist who is certified in the McKenzie's Protocol, and I decided to investigate this personally. I've got chronic neck pain from various horse-related accidents over the years, and am always searching for ways to increase my range of motion. I also want to decrease the pain and stiffness that extends from neck into the right scapula. Being able to turn my neck better is essential for my riding, as well as my driving.
I know that long hours seated in front of the computer adds to the problem, and the older I get, the more important it is to get up every half hour, stretch and walk around a bit. But stretching on my own, and even the addition of a weekly yoga class hasn't been enough since I re-injured my neck in Ireland during an unlucky fall from a horse. I also added a massage from a highly trained masseuse once a month to keep my back and neck more mobile and comfortable, but that also is not enough.
I made an appointment with the certified McKenzie evaluator and therapist two weeks ago, and I had a second appointment last week. The McKenzie Method (sometimes called the McKenzie Protocol is described in detail in several books written by founder Robin McKenzie back in the early 1980's. Robin McKenzie's is a physiotherapist from New Zealand who developed his own treatment methods for spinal disorders. I purchased two of his books, Treat Your Own Neck, and 7 Steps to a Pain-Free Life: How to Rapidly Relieve Back and Neck Pain. These books, available at Amazon.com, are easy to read. If you need to borrow my copies and promise to return them, call my office and ask my assistant to send me reminders to bring the book to the office for you.
The first book states that it is meant for people with straightforward recurring mechanical problems, and that self-treatment exercises taught by a certified therapist are the key to maintaining neck pain. I do think it is important to invest in at least a couple of sessions with a certified therapist to make sure that the exercises are safe and right for you. The therapist will also want your doctor to prescribe this particular therapy for you (and to get your insurance to cover the sessions if you no longer have an open claim.)
McKenzie emphasizes that there are two types of stresses that can occur to cause neck pain: 1) an accident that results in overstretching of the ligaments and other soft tissue that hold the cervical vertebra together from an outside force, and 2) overstretching caused by postural stresses that place less severe strains on the neck over longer time periods. It is this second type of stress, the one that we exert on our self that can be self-treated for the prevention of neck pain.
Examples of the exercises in the book prescribed for me by the McKenzie therapist include retracting the neck back into the chin, extending the neck backwards, side bending of the neck, and laying on an examining table with the neck extended off the edge of the table. While the book walks the reader through the exercises, and they are very simple, I strongly advise that you first have a certified McKenzie therapist walk you through them.
After the first week of doing neck retraction exercises, I had increased neck pain and even less mobility from placing my neck in very different positions After the second session, the neck pain was improved, and I had a little less pain, but range of motion was still very limited. Then, I miraculously got better about remembering to do the exercises the prescribed 5 times a day. I also became more aware of my posture as I sat at my computer. I also remembered to pick up a new bedside lamp at Home Depot so that I had better light as I continued my bad habit of reading in bed late at night. In other words, I started to take some personal responsibility for making my neck better instead of simply whining about it.
Today, I'm back at work, in front of the computer, but I don't have pain extending into the right shoulder and scapula for the first time in months. The neck pain is lessened, although I still hear a lot of snap,crackle and pop when I go through the range of motion checks. Whether the improvement is due to these particular exercises, my remembering to actually do some stretching and exercises, or a wonderful, relaxing Christmas with my friends and family, I really don't know. But, I intend to give these exercises a good try, and will return to see the therapist tomorrow.
I remain optimistic that this therapy will also keep my clients off the operating table. The number of injured workers who tell me they "want to be fixed" by a surgery concerns me. While I'm not a doctor, I see many people with chronic neck and back pain that might be able to significantly help themselves manage their pain with some guided, concerted effort on their part . Exercises require consistent effort (although these are very easy ones). This isn't a quick fix, but it might be a huge relief once I train myself to do them daily. I will keep you posted. Feel free to post a comment if you have experience with the McKenzie Method exercises.