The McKenzie Method, also known as Mechanical Diagnosis and Therapy (MDT), is currently one of the most well-known methods for diagnosing and treating spinal and limb pain syndromes. The study aimed to analyze the self-observations of the symptom characteristics in comparison with directional preference (DP) in the therapeutic procedures.

Material and methods:
A study was conducted based on the therapeutic records of patients treated by MDT. The study was carried out on a group of 302 patients. The analysis of the symptoms in self-observations of the patient was conducted. The data were compared using various schemes: gender, age range, type of work, classification, positional preferences, and applied directional procedures.

Patients more commonly indicate the movements that increase symptoms. The individuals treated with the extension DP reported an increase in pain symptoms during sitting, bending, and standing. The majority of patients were classified into the D3 group and treated with an extension-based approach. With increasing age, the number of individuals classified as D1 decreased, while those classified as D5 increased. In the oldest age group, the number of other than extensional therapeutic DP increased.

Patients are not able to indicate the movements that decrease the symptoms while the movements that increase the symptoms are better recognized. Certified physiotherapists should educate about the centralization phenomenon and directional preference. While extension movements generally lead to a reduction in reported pain symptoms, they are not the only movements that can centralize symptoms and should not be applied without a thorough examination of the patient.

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