Sciatica is a common condition often described as leg pain, but also numbness, tingling or weakness that starts in the lower back and travels down the leg, along the sciatic nerve.
Sciatic and lower back pain can range from mild to debilitating, where a person is unable to walk or sit properly.
As far as treatment goes, there are several methods used to relieve sciatic pain. One of the most recent treatments includes a concept called centralization, which aims at moving up the pain in the lower back while healing.
This treatment, however, intensifies the pain at first, but this is only an indication that the treatment is working. It often happens that back pain doesn’t intensify much because of the so-called self-reported VAS.
Centralization is actually the basic concept in the McKenzie method of treatment and assessment of sciatic pain.
A study conducted by Werneke in 2008 examined the symptoms reported by patients following centralization and categorized them as those that give positive results and those that not.
Other methods aside from the McKenzie were used on patients suffering from cervical and lumbar syndromes.
As found by the study, only 17% of patients showed symptoms linked to centralization. Other factors such as the type of injury, the time frame in which the treatments were done and the type of treatments these patients had undergone also affected the results.
All in all, it was undeniable that centralization had significantly better results in patients with more severe symptoms, and patients that were younger and enjoyed better overall health.
Non-centralization, on the other hand, was associated with reduced ability on functional task testing and considerably higher pain results in patients with lumbar symptoms. In people with cervical pain, non-centralization was related to higher pain levels, excluding all other indicators, which were the same.
It’s also worth mentioning that the final results weren’t influenced in any way by the number of visits. Namely, centralization is believed to help the prediction of pain status and functional status in those with lumbar pain.
As Robin A. McKenzie was a well-known PT and an experienced specialist with particular focus on reduction of pain linked to disc issues, he set to find a different solution to this debilitating condition, described as pain that starts in the glutes and travels all the way down the leg reaching the toes.
The thing is McKenzie came up with an exercise, called “the press up,” which has proved extremely beneficial for reducing and centralizing this pain in the lower back.