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PSA: Be careful about doing McKenzie technique exercises! It made it worse for me because the physical therapist didn't do a good enough analysis! I encourage a

PSA: Be careful about doing McKenzie technique exercises! It made it worse for me because the physical therapist didn't do a good enough analysis! I encourage a thorough assessment that includes an MRI review of your spine first. The link posted above mentions it as well > Although most patients favor spinal extension, there are, however, patients who favor spinal flexion instead. For these types of patients, the repetitive extension based exercises can possibly lead to peripheralization which is the worsening of distal referred pain from repetitive motion. In contrast to centralization, peripheralization does not carry a good prognosis and is to be avoided. It is thus vital for clinicians to form an accurate assessment of the directional preference rather than assuming a patient will favor extension and thereby proceeding with therapy based on that assumption. EDIT: Just to clarify further, the potential side effects are not just "pain". In my case, doing a cobra pose causes me to piss myself and lose feeling in my legs. This can be catastrophic to some people. Please folks, do not just go off some rando on social media telling you "X will treat your neck/back pain!". You can end up seriously much worse than you started. You need to SEE what the problem is first and only an MRI and a trained physician can tell you what is appropriate for you.

PaulHoule 2y ago
Unfortunately the results you get from doing that are pretty variable. Not like you shouldn't go see a doc and get imaging and do all that (you should!) but every time I've gotten imaging done I've heard "you've got degeneration which is typical for somebody your age" -- my son just got an MRI for a work injury (paid for by Workman's Comp) and got told the same thing. Often your doc gives you an order to a PT and what sort of therapy you get from a PT is complete random and not evidence based. Imaging might turn up a specific cause (maybe a tumour) but it is usually inconclusive. Studies tend to show low correlation between degeneration seen and back pain and my doc was clear it was the same when I was having serious pain in my knee. You're right that centralization vs peripheralization is an important sign.
- y-c-o-m-b 2y ago
  Your chances of getting better are still greater than if you just willynilly self-treat without the support of those diagnostic tools. Yes for the majority of people, simple spine degeneration may not be a big deal and probably easily treatable at home with stretching and strength training exercises. There's degeneration, and then there's borderline myelopathy; you sure is hell don't want to make that worse (trust me) before you get a chance to see a medical professional. Myelopathy is insidious too, it can turn into a catastrophe without you realizing. One day it might be pain, the next it could be near paralysis. I agree, the quality of care received is very lacking (especially in the US, I don't think anyone would argue otherwise), but if you find a physical therapist that is actually willing to look at your MRIs to determine what the mechanics of your particular situation are and work with you on what feels good vs what makes things worse, you'll be far better off. They do exist, it might take time to find them. If you go into a PT clinic and they don't even look at your imaging, I'd go somewhere else.

PaulHoule 2y ago

Unfortunately the results you get from doing that are pretty variable. Not like you shouldn't go see a doc and get imaging and do all that (you should!) but every time I've gotten imaging done I've heard "you've got degeneration which is typical for somebody your age" -- my son just got an MRI for a work injury (paid for by Workman's Comp) and got told the same thing. Often your doc gives you an order to a PT and what sort of therapy you get from a PT is complete random and not evidence based. Imaging might turn up a specific cause (maybe a tumour) but it is usually inconclusive. Studies tend to show low correlation between degeneration seen and back pain and my doc was clear it was the same when I was having serious pain in my knee. You're right that centralization vs peripheralization is an important sign.

y-c-o-m-b 2y ago
Your chances of getting better are still greater than if you just willynilly self-treat without the support of those diagnostic tools. Yes for the majority of people, simple spine degeneration may not be a big deal and probably easily treatable at home with stretching and strength training exercises. There's degeneration, and then there's borderline myelopathy; you sure is hell don't want to make that worse (trust me) before you get a chance to see a medical professional. Myelopathy is insidious too, it can turn into a catastrophe without you realizing. One day it might be pain, the next it could be near paralysis. I agree, the quality of care received is very lacking (especially in the US, I don't think anyone would argue otherwise), but if you find a physical therapist that is actually willing to look at your MRIs to determine what the mechanics of your particular situation are and work with you on what feels good vs what makes things worse, you'll be far better off. They do exist, it might take time to find them. If you go into a PT clinic and they don't even look at your imaging, I'd go somewhere else.