McKenzie assessment & centralization of pain from spinal origin

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1) The centralization phenomenon is the migration of low back and/or radiating pain to the spinal midline in response to specific positions or movements, for instance during a McKenzie mechanical assessment.
2) Pain location and the time to centralization still remains the controversial areas of centralization standardization.
3) Centralization correlates strongly with a positive discography and as a sign of diskogenic pain but an indicator that surgery is needed remains highly controversial.
4) Nevertheless, centralization may indicate a high likelihood of diskogenic pain and may provide therapeutic guidance.
5) Centralization is associated with better outcomes after nonsurgical treatment, even in patients with nerve root pain, its presence may constitute an argument against surgical treatment.
6) Finally, the McKenzie assessment may induce pain relief, albeit to a modest extent and for no longer than 3 months!!

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