Centralization Phenomenon

x-rays for chiropractic

“Centralization phenomenon as a prognostic factor for chronic low back pain and disability.”


It would be very helpful to know – early on – if someone with a sudden onset of low back pain and leg pain is at risk for chronic disability and prolonged pain. While many studies have investigated psychological, work-satisfaction, and various physical measures, none have had any predictive value. One early measure of possible long-term improvement and/or disability is the phenomenon of Centralization, which is the movement of pain out of the leg as the first step in the healing process. This study asks: Does Centralization seen early on, predict a positive long-term outcome?

How this study was done

This study used one group of patients who were treated over the course of seven visits and then followed-up with a year later. Over that course of seven visits, patients were assessed and classified using the McKenzie method, and given home-based exercises between sessions. At each session, their symptoms were tracked and, if it occurred, centralization was noted.

What we learn from this research

What was found was in those patients where the centralization phenomenon occurred, their one-year follow-up reports were much more favorable than those that didn’t centralize. This means that if we can get the pain to move out of the leg early in treatment, a positive long-term outcome is more likely. This measure was also found to be more relevant than all other psychosocial variables, which makes it extremely useful in a clinical setting.


American Back Center