Centralization

CENTRALIZATION:

One approach to the management of radicular symptoms (sometimes called "sciatica") is called Mechanical Diagnosis and Therapy (MDT).  The goal of this program is to teach you how to prevent further exacerbations, and give you tools to use yourself so that if you have another exacerbation, you know how to treat it.

The key concept in an MDT program is the concept of CENTRALIZATION.

 This means that you want to pull symptoms out of your foot, leg, thigh, and buttock, and INTO your back.

- This process is called centralization because you are moving your symptoms toward the center of your body

- The goal is to move disk material away from your nerve root

- Sometimes when you perform this initially, it may actually make your back pain worse.  That is ok.  Eventually, in addition to pulling pain into your back, the goal is to make your back pain disappear.

- If the pain, instead of going into your back, goes AWAY from your back and into your buttock, thigh, leg or foot, that is called PERIPHERALIZATION.  That is not a good sign, and suggest that the disk material is pushing on your nerve root.

Sometimes, after your symptoms have improved, your therapist may work on additional strategies to help strengthen your core and prevent you from an exacerbation.

- These exercises are sometimes called LUMBAR STABILIZATION or CORE STRENGTHENING exercises.

- These are very helpful exercises. However, the concept of centralization is still the priority, because if your symptoms start to peripheralize, than means you may soon have an exacerbation of your symptoms.

- Please let your therapist or chiropractor know if you start having peripheralization, as that means you need to shift the focus back to centralization.