What Are the Green Flags of Back Pain?

Green flags in back treatment. Have you heard about them?

We associate green with meaning go. When driving a car, the green light means go. Red means we have to stop, unless we want to cause an accident and possibly get killed. When crossing a street, if the "green man" flashes, it means that we can proceed but it is always wise to look out just in case.

So what does a green light in back pain treatment mean? Well, a therapist therapist trained in the McKenzie Method performs a repeated movement assessment to determine the most appropriate exercise for a patient that results in an immediate reduction in pain. In some cases, the pain may move from a more peripheral location (i.e. in the arm or leg) to a more central location. If this occurs, a McKenzie therapist calls this a green light and it means the patient is performing the correct exercise, in the right direction and that the pain will resolve quickly.

The phenomenon of pain moving to the center is known as "centralization." It was first observed back in the 1950's when New Zealand Physiotherapist Robin McKenzie asked a patient who was suffering from back and leg pain to lie on a treatment table with his back in an extended position. The amazing thing about this story is that at this time the so-called experts thought that this was a bad position for backs. Not so for this lucky patient of Robin's, he was the best he'd been in over 3 weeks after laying in this position. The patient also remained better once he stood up.

From this one event back in the 1950's, Robin McKenzie then went on to develop the McKenzie Method over the next 10-20 years. The important thing to note is that he never went about to invent a method but it was his open mind and questioning nature that allowed him to question everything that he had learned and develop a system that now helps millions of people around the world.

So, back to exercise, back pain and green lights! A green light in back pain treatment means the pain is reducing or centralizing as you perform or repeat the same exercise. It is wise to remember the level of pain and location before you start. The pain may increase or decrease during the performance of the one exercise, however, the essential element is "what is the pain like one you have finished the exercise." If the pain is less or has moved to a more central location, it means a green light and you can keep repeating that one exercise or movement every few hours in order to resolve the pain. There is no need to perform other exercises. Actually, if you perform the opposite exercise, the pain may increase, worsen and peripheralize (i.e. spread further into the limb.) This is a red flag and you should not be doing this exercise.

Therefore, remember when doing exercise for your back pain, a green light means go, go, go!