I remain alert to the possibility of nonmechanical pain and need for referral to a physician for further medical evaluation. Assuming that at any given time nonmechanical pain has been ruled out, I determine the mechanical syndrome. Details about each follow. This classification scheme, although based on the available medical literature, remains another origination of McKenzie's. The client with a postural syndrome feels no pain when active and moving.
Clients tend to be under thirty and have sedentary occupations.
The pain can appear in the lower back, upper back, neck or all three areas and comes on with prolonged sitting or standing. On examination, the client appears asymptomatic with no loss of movement. With repeated movements, there is no pain. The only observable finding is poor sitting and standing posture. The symptoms may be elicited at the time of examination by getting the client to maintain a static slouched position until the pain is brought on.