Centralization phenomenon. Its usefulness in evaluating and treating referred pain.
In patients with low-back and radiating leg pain, a clinical phenomenon has been described known as "centralization," which occurs during a mechanical evaluation protocol described by McKenzie. Relocation of the most distal pain in a proximal or central direction characterizes the pain behavior when patients are assessed in this fashion. Centralization typically occurs rapidly and can be maintained. In a review of 87 such patients, centralization occurred in 76 (87%). Its occurrence during initial mechanical evaluation is a very accurate predictor of successful treatment outcome and reliably determines the appropriate direction of treatment exercise. Nonoccurrence of centralization accurately predicts poor treatment outcome and was a helpful early predictor of the need for surgical treatment.
Donelson
R
R
Department of Orthopaedics, State University of New York, Syracuse.
Silva
G
G
Murphy
K
K
D000328:Adult; D001416:Back Pain / Q000503:physiopathology* / Q000534:rehabilitation; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000503:physiopathology*; D010147:Pain Measurement; D010525:Peripheral Nerves / Q000502:physiology; D012677:Sensation / Q000502:physiology*