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Spine (Phila Pa 1976). 1990 Mar;15(3):211-3.

Centralization phenomenon. Its usefulness in evaluating and treating referred pain.

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Department of Orthopaedics, State University of New York, Syracuse.


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.

[Indexed for MEDLINE]

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