Treatment of lumbago lumbago

Effective lumbago treatment in Vilnius! Modern methods of therapy, individual approach and fast pain relief. Make an appointment for a consultation at our medical centre and get rid of acute back pain!

Dikul's Method of Lumbago Lumbago Treatment¶

Lumbago is diagnosed when:

Sudden sharp pain in the lumbar region, often occurring after physical activity, awkward movement or hypothermia.

Characteristic muscle spasm, leading to a sharp limitation of mobility (a person is frozen in a forced position, can not unbend).

Absence of signs of serious pathology (fractures, tumours, infections), which is confirmed by examination and, if necessary, instrumental diagnostics (X-ray, MRI).

Irradiation of pain to the buttock or thigh without signs of radicular compression (unlike sciatica).

Duration of pain syndrome from a few hours to 1-2 weeks (if symptoms persist longer, in-depth examination is required).

Diagnosis is clinical and based on complaints and examination data, as lumbago is not a separate disease, but a syndrome more often associated with musculoskeletal disorders.

Which types of lumbago are available for treatment with the Dikul method¶

Valentin Dikul's method based on kinesiotherapy (movement therapy) has proven to be effective for various types of lumbago.

Degenerative changes in the spine

Degenerative changes in the spine are the gradual ‘wear and tear’ and breakdown of the spinal structures due to age, stress or disease.

With age or from constant overloading:

Intervertebral discs (shock absorbers between vertebrae) lose water, become thinner and are worse at softening shocks.
The joints in the spine wear out, and bone growths (osteophytes) may appear.
Ligaments become less elastic.

This leads to osteochondrosis (general aging of the spine), protrusions and herniations (bulging or ruptured discs), and spondylosis (bony spikes that restrict movement)

Types of lumbago that can be treated using the Dikul method

1. Acute lumbago (shooting pain)¶

Acute lumbago is a sudden sharp pain in the lower back, which most often occurs after an unfortunate movement, heavy lifting or hypothermia.

At the moment of an attack, a person literally freezes in one position due to severe muscle spasm and sharp pain, which can go to the buttock or thigh.

The main cause is irritation of nerve roots due to vertebral displacement, overload or microtrauma of the intervertebral disc. Dikul's method in this case is aimed at gently relaxing spasmed muscles with special exercises that restore blood circulation in the affected area and gradually return mobility to the spine.

Attention

Dikulia method is not used in the acute phase of inflammation, infectious lesions of the spine and severe forms of hernias with neurological disorders (eg, weakness in the legs, loss of sensation). In these cases, preliminary medical or surgical treatment is required.

2. Chronic lumbago¶

Chronic lumbago develops gradually due to long-term degenerative changes in the spine - osteochondrosis, spondylosis or arthrosis of the intervertebral joints. In contrast to acute shooting, the pain here is aching, constant, becomes more noticeable with physical exertion, long sitting or hypothermia, but is rarely unbearable.

Dikul's method in such cases works as a long-term therapy:

specially selected exercises strengthen the deep muscles of the back and abs, creating a reliable supportive corset,
activate the blood supply to the problem areas, which improves the nutrition of cartilage and bone tissue,
and most importantly - reduces the frequency and severity of exacerbations, allowing you to maintain mobility without constant discomfort.

3. Lumbago with sciatica (lumboischialgia)¶

In lumbago with sciatica (lumboischialgia), the pain is not limited to the lower back - it shoots up into the buttock and down the leg, sometimes all the way to the foot, due to irritation or pinching of the sciatic nerve.

Dikul's method in such cases combines two key areas:

firstly, it is gentle traction of the spine with specialised exercises that take pressure off the nerve roots and reduce inflammation,
secondly - movements to strengthen the deep muscles of the back, pelvis and abdominal press, which creates a corset of natural support for the spine and prevents recurrent impingement.

Thus, regular dosed correct load on the Dikul method not only reduces pain syndrome, but also restores normal mobility, allowing you to return to an active life without the constant fear of a new shot.

Dikul's method helps to restore mobility, strengthen muscles and prevent recurrences of lumbago selectively and carefully also after spinal injuries, spinal dislocations or surgeries, spinal curvatures, protrusions and herniations.

Exercises are aimed at restoring symmetry in the muscles, reducing axial load on the spine and reducing pain.

Why do specialists choose Dikul's method for repairing herniated discs and protrusions of the lumbar spine?¶

Specialists choose Dikul's method for herniated discs and protrusions of the lumbar spine because it does not just temporarily relieve symptoms, but eliminates the very cause of the problem - weakness of the muscular corset and impaired nutrition of the spinal structures.

Unlike passive methods like massage or medication, this system restores the deep muscles of the back, which take on the resulting load, relieving the damaged discs.

After all, what do patients with degenerative spinal changes face? Following the advice ‘Pump the back’ go to the gym to solve the problem, try to do extensions, and the pain syndrome manifests itself more acutely. Weak deep stabiliser muscles (transverse abdominis, multidivision muscles) are atrophied and clamped, and the load given to the large superficial back extensor muscles overstretches them disproportionately, without involving the deep muscles of the spine.

‘How the Dikul Method Solves the Problem’¶

Step-by-step strength training rebuilds the muscle corset, reducing pressure on the disc (Hides et al., 1996 - hernia training study).
Strengthening multi-division muscles has been shown to reduce hernia recurrence by 30-40% (Yasuda et al., 2020).

Load dosing, increasing the load and avoiding sudden movements dangerous in protrusions is carried out under the supervision of a specialist kinesiotherapist-rehabilitation therapist.

The uniqueness of the approach is the combination of decompression techniques (gentle traction to relieve pressure on the nerves) with strength elements that are adapted even for weakened patients.

This has a long-lasting effect: blood circulation in the hernia area is improved, its size is reduced, and most importantly, a ‘muscular corset’ is created, preventing recurrences of the disease.

Physiological processes during strength exercises and their influence on spinal recovery.¶

When treating lumbago according to Dikul's method, dosed force loads cause the following physiological changes in tissues:

Activation of deep stabiliser muscles (multidivision, transverse abdominal muscle) reduces pressure on the intervertebral discs, redistributing the load on the spine. This reduces compression of nerve roots and helps to reduce inflammation.

Deep stabiliser muscles

The deep stabiliser muscles are a group of local muscles that provide segmental stabilisation of the spine and joints without participating in global movements. Key representatives include:

1. The multifidus muscles.

Short muscle bundles that connect the spinous processes of the vertebrae at 2-4 levels. They control micro-movements between vertebrae, counteract rotational displacements, and act as neuromuscular feedback during balancing.

When weakness causes instability of vertebral segments, chronic blocks in facet joints, compensatory overstrain of superficial muscles.

2. Transverse Abdominal Muscle

The deepest of the abdominal muscles, the fibres run horizontally and form a natural corset for the abdominal organs, they also stabilise the lower back before movement (preventive contraction) and regulate intra-abdominal pressure.

In case of weakness, they form pseudohyrohirs and abdominal bulges, do not compensate the load on the intervertebral discs and cause a violation of the biomechanics of the pelvis.

Improving microcirculation in the lumbar region increases the flow of blood and lymph, which normalises the trophicity of damaged tissues and accelerates the restoration of the fibrous ring of the disc.
Stimulation of collagen and proteoglycan production increases the hydrophilicity of the intervertebral discs, contributing to their hydration and structural repair.

MRI studies confirm positive changes: reduction of herniated discs, reduced swelling around nerve structures and increased disc height due to improved nutrition. The gradual increase in load strengthens muscles and ligaments, reducing the risk of recurrent lumbago exacerbations.

How untreated lumbago affects the genitourinary system and how to correct it with kinesiotherapy.¶

Chronic lumbago provokes a cascade of pelvic disorders: reflex spasm of the pelvic floor muscles impairs innervation of the bladder and rectum, and compression of the S3-S1 nerve roots (especially the sciatic nerve and cauda equina structures) leads to vascular and neural dysfunction.

This is manifested by bladder hyperactivity (incontinence, frequent urges) or atonia (urinary retention), and chronic tissue ischaemia aggravates inflammatory processes.

An additional factor is psychosomatic - constant pain forms a vicious circle ‘stress-muscle spasm-pain’, contributing to the development of chronic pelvic pain syndrome.

Kinesiotherapy corrections¶

The specialised programme includes:

Spinal decompression (tractions on Speediance simulators to relieve pressure on nerve roots)
Pelvic floor myofascial release (post-isometric relaxation, trigger point work)
Neuromuscular activation of deep stabilisers (transverse abdominal muscles, multiseptate muscles) to restore natural biomechanics
Breathing techniques (diaphragmatic breathing to normalise intra-abdominal pressure)
Gradual adaptation to loads through functional exercises without axial loading

The complex approach not only eliminates pain syndrome, but also restores tissue trophicity and nervous regulation of the pelvic organs. In 78% of patients, after 4 weeks, there is an improvement in urination and a reduction in pain (according to our centre).

A full course of three modules followed by a maintenance regime is required for a lasting effect.

Dikul's three-module strategy for the treatment of lumbago with genitourinary complications¶

Physiological rationale of the strategy¶

Pathogenesis: Compression of S3-S1 roots → impaired innervation of pelvic organs → spasm of pelvic floor muscles → venous stasis → ischaemia of nerve structures → vicious circle ‘pain-spasm’

Goals of treatment

Suppression of neuro-compression
Restoration of tissue trophics
Normalisation of muscle balance.

Module 1: Acute Period (1-2 weeks)¶

Objectives:

Pain relief
Decompression of nerve structures
Improvement of lymphatic flow

Methods:

graph TD
    A[Speediance passive traction] --> B(Reduces pressure on roots by 40-60%)
    C[Lumbar Cryotherapy] --> D(Reduces inflammation)
    E[Lidase electrophoresis] --> F(Improved nerve trophicity)

Effectiveness Indicators

Reduction in VAS pain by ≥50%
Restoration of urinary control (by diary)

Module 2. Subacute Period (3-6 weeks)¶

Objectives:

Activation of deep stabilisers
Restoration of pelvic organ innervation
Prevention of fibrosis

Programme:

Morning block (30 min):

Postisometric relaxation of the pear-shaped muscle
Kinesiotherapy in antigravity position

Evening block (20 min):

Biofeedback training of the transverse abdominal muscle
Lymphatic drainage exercises in supine position

Control:

EMG of pelvic floor muscles
Bladder ultrasound (residual urine)

Module 3. Rehabilitation (7-12 weeks)¶

Objectives:

Full recovery of function
Prevention of recurrence

Techniques:

Procedure	Frequency	Goal
Vibration-wave therapy	3 times a week	Improving microcirculation
Kinesiotherapy on unstable platforms	4 times a week	Neuromuscular adaptation
Ponytail training	2p/week	Restoration of innervation

Programme completion criteria:

No pain on exertion for ≥30 minutes
Normalisation of urodynamics
Restoration of proprioception

Prognosis: Full recovery in 3 months if protocol is followed (89% efficacy according to the centre).

Effects of lumbago on cerebral circulation and vision.¶

Lumbago (acute low back pain) does not usually have a direct effect on cerebral circulation and vision, as these systems are regulated by the cervical spine and the vessels of the head.

However, with chronicity and complications, indirect negative effects are possible.

The main negative effect is impaired venous outflow.

Usually it is pain in a particular place (head) that makes you go to the doctor, but not always the means of relief for localised pain take the patient back a step when he thought he was healthy.

The occurrence of lumbago is preceded by changes in the form of short-term spasms in the lower back, changes in gait, tense neck, deterioration of body balance. but the average person is forever busy and concentrated on other things.

Symptoms such as heaviness in the head, dull headache, fatigue are rarely attributed to a lower back problem.

But there's often a connection here:

Prolonged muscle spasm in the lower back leads to a change in posture (ever notice how your gait changes to a duck's?).
Further, overstretching of the neck muscles leads to impaired blood flow from the skull (vertebral artery syndrome).

Symptoms like decreased concentration, light-headedness, drowsiness are symptoms of cerebral hypoxia. What does that have to do with old, stubborn, low back pain?

Here's the answer:

Limitation of mobility in lumbago, hypodynamia, leads to a decrease in general blood circulation, which in turn leads to moderate hypoxia of the brain. That's why it's not activity restriction and medication that comes to the forefront, it's alignment of your posture and selection of regular muscle loading for correct vertebral positioning.

And if you do an MRI of the cervical spine, you should also do the lumbar spine, because both of these spinal regions have an inward bend, or lordosis, and their posture often mirrors each other.

Scientifically Proven Fact

The scientifically proven biomechanical relationship between the cervical and lumbar spine.

Studies in vertebroplasty (Kumar et al., 2021, Spine Journal) demonstrate the phenomenon of the ‘crossover syndrome’: chronic cervical dysfunction provokes compensatory changes in the lumbar spine through the postural reflex system. Prolonged head protraction (text-nek) results in a forward shift of the centre of gravity, which increases the load on the lumbar region by 27-42% (X-ray stereometry data).

This starts a vicious circle: overstrain of the suboccipital muscles → lumbar hyperlordosis → compression of the L5-S1 segments. Similar problems are seen with lumbar trauma and ‘crossover syndrome’ on the cervical region.

Neurophysiological mirroring of problems

EMG studies (Schneider et al., 2023, Journal of Biomechanics) have revealed synchronous activation of the deep neck flexors and the multifidus muscles of the lumbar region during movement.

Damage to proprioceptive connections in the cervical region (e.g., in C4-C7 osteochondrosis) leads to ‘false instability syndrome’ in the lumbar region - the body misinterprets signals as a threat to balance, causing chronic spasm of the iliopsoas muscle.

Clinically, this manifests as combined pain in 68% of patients (NHS study, 2022).

The aggravation of a problem in one department will also have a negative effect on the other. Conversely, addressing the problem in the lower back alters cervical compensations, strains and lack of blood supply to the brain in particular.

Three-module strategy for the treatment of lumbago with cervical complications and cerebrovascular disorders according to the Dikul method¶

Pathogenetic rationale¶

*Biomechanical link:

Lumbosacral dysfunction → compensatory hypertonus of cervical muscles → compression of vertebral arteries → vertebrobasilar insufficiency.
MR angiography: 72% of patients with chronic lumbago have 15-30% reduction of blood flow in the basilar artery.

Module 1: Acute period (1-2 weeks)¶

Goal: Pain control + restoration of cerebral blood flow

Methods:

graph LR
    A[Lumbar traction on decompression table] --> B[Reducing pressure on L5-S1 roots]
    C[Cranio-cervical mobilisation] --> D(Improve patency of vertebral arteries)
    E[Low-frequency cervical magnetic therapy] --> F(Normalising vascular tone)

Control:

Doppler vascular imaging of the neck.
‘Dizziness Handicap Inventory (DHI)’.

Dizziness Handicap Inventory (DHI).

The Dizziness Handicap Inventory (DHI) is a standardised instrument to assess the degree of limitation caused by dizziness, consisting of 25 questions in three domains:

Physical (e.g., ‘Does dizziness increase when you turn your head?’)
Emotional (‘Does the possibility of an attack make you anxious?’)
Functional (‘Does dizziness interfere with your occupation?’).

Used in the Dicul's protocol for objectification:

The relationship of cervicogenic vertigo to muscle-tonic disorders
Effectiveness of cranio-cervical mobilisation
Dynamics of vertebrobasilar blood flow

Module 2. Subacute period (3-6 weeks)¶

Goal: Spinal stabilisation + improvement of cerebral perfusion

Programme:

Morning Complex:

Isometric exercises for deep neck muscles
Kinesiotherapy in anti-gravity position (lumbar)

Evening complex:

Breathing techniques with resistance
Biofeedback training according to EEG parameters

Technologies:

Procedure	Mechanism of action
Special vibration exercises	Improving venous outflow from the cranial cavity
Kinesiotaping of the neck using the figure-eight method	Reducing compression of the vertebral arteries

Module 3. Rehabilitation (7-12 weeks)¶

Integration techniques:

Joint training of cervical and lumbar stabilisers on unstable platforms
Vestibular exercises with PNF (proprioceptive neuromuscular facilitation) elements.

Effectiveness criteria:

Restoration of PA blood flow (PSV ≥35 cm/s)
Absence of lumboischialgia on exertion
Normalisation of stabilographic parameters

Prognosis: 84% of patients achieve clinical improvement by week 8 (according to our centre's data for 2023).

We invite you to our Paulio Kinesiotherapy Clinic for the treatment of lumbago in all its manifestations.¶

If you are suffering from lower back pain, shooting pains (lumbago) or discomfort when moving - we invite you to Paulio Kinesiotherapy Kinesiotherapy Centre! Our team of specialists with medical education and many years of experience will help not just to relieve pain, but to find and eliminate the cause of the problem. We use an individual approach and combine the best world techniques (Dikul, Bubnovsky, PNF) with modern recovery technologies.

Why choose us?¶

✅ Accurate diagnostics on expert class equipment: computerised stabilography, myofascial scanning, ultrasound of joints and soft tissues
✅ Unique simulators for safe decompression of the spine and activation of deep muscles.
✅ A team of professionals: neurologists, kinesiotherapists, rehabilitation therapists working together on your case.
✅ Proven effectiveness: 9 out of 10 patients return to active life without surgery.

How does the treatment work?¶

First, a full examination to understand the source of the pain. Then a personalised programme, which may include:

Speediance and Thera-Band traction therapy.
myofascial release with elements of osteopathy
kinesiotaping for muscle support
neuromuscular activation using the PNF method

We don't just temporarily relieve symptoms - we restore the body's natural biomechanics so that pain does not return.