Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Kinesiotherapy for back pain

Full Text:


Back pain treatment is one of the most common problems in medical practice. The paper presents the theoretical and practical bases of physical therapy for people experiencing pain in the back and neck, considers in detail the main kinesiotherapy techniques used in modern rehabilitation, analyzes the principles of their selection for the most effective recovery of locomotor activity and for reduction of the severity of pain syndrome, and discusses the modes of motor activity. Hardware techniques that facilitate the implementation of complex therapeutic movements are considered separately. A rationale is provided for the importance of increasing motor activity and muscular strength and normalizing muscle tone, by restoring blood circulation and by reducing inflammation and pathological impulses from the affected spine. The possibilities of kinesiotherapy for acute and chronic nonspecific back pain, discogenic radiculopathy, and lumbar stenosis are discussed.

About the Authors

E. E. Achkasov
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
8, Trubetskaya St., Build. 2, Moscow 119991

G. N. Zadorina
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
8, Trubetskaya St., Build. 2, Moscow 119991

I. A. Lamkova
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
8, Trubetskaya St., Build. 2, Moscow 119991

V. S. Moskvicheva
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
8, Trubetskaya St., Build. 2, Moscow 119991


1. Pheasant S, Stubbs D. Back pain in nurses: epidemiology and risk assessment. Appl Ergonom. 1992;23(4):226-32. doi: 10.1016/0003-6870(92)90150-T

2. Hignett S. Work_related back pain in nurses. J Advanc Nurs. 1996;23(6):1238-46. doi: 10.1046/j.1365-2648.1996.13423.x

3. Sikiru L, Hanifa S. Prevalence and risk factors of low back pain among nurses in a typical Nigerian hospital. Afr Health Sci. 2010;10(1):26. doi: 10.4314/eajph.v6i1.45737

4. Smedley JF, Trevelyan F, Inskip H, et al. Impact of ergonomic intervention on back pain among nurses. Scand J Work Environ Health. 2003;29(2):117-23. doi: 10.5271/sjweh.713

5. Gladwell V, Head S, Haggar M, Beneke R. Does a program of Pilates improve chronic non-specific low back pain? J Sport Rehabil. 2006;15(4):338-50. doi: 10.1123/jsr.15.4.338

6. Rydeard R, Leger A, Smith D. Pilates-based therapeutic exercise: effect on subjects with nonspecific chronic low back pain and functional disability: a randomized controlled trial. J Orthopaed Sports Phys Ther. 2006;36(7):472-84. doi: 10.2519/jospt.2006.2144

7. Akarachkova ES, Zaitseva IA, Stryapunina NN, et al. An integrated approach to the treatment and prevention of back pain. Results of a 6-month study. Meditsinskii Sovet. 2012;(8):72-81 (In Russ.).

8. Burmistrov DA, Demin GS, Makushenko IE. Program to eliminate pain in the back in people of different ages. Uchenye Zapiski SPbGMU im. akad. I.P. Pavlova. 2010;17(4):64-7 (In Russ.).

9. Zhukov AD. Sportivnaya entsiklopediya sistem zhizneobespecheniya [Sports Encyclopedia of Life Support Systems]. Moscow: UNESCO; 2011. P. 15-7 (In Russ.).

10. Bonev L, Slynchev P, Bankov S, eds. Rukovodstvo po kineziterapii [Physiotherapy Guide]. Moscow: Meditsina; 1978. 358 p. (In Russ.).

11. Epifanov VA, Epifanov AV. Reabilitatsiya v nevrologii [Rehabilitation in Neurology]. Moscow: GEOTAR-Media; 2014. 416 p. (In Russ.).

12. Amanova EO, Koval'chuk VV, Minnullin TI, Khaibullin TN. Pain and increased muscle tone after a stroke as factors for reducing the rehabilitation potential. Multidisciplinary approach to patient management. Nauka i Zdravookhranenie. 2016;(6):111-22 (In Russ.).

13. International Vojta Society.Vojta Therapy: Reflex Locomotion. The Fundamentals of Vojta Therapy [online] (Accessed 20 Jun. 2019).

14. Ha SY, Sung YH. Effects of Vojta method on trunk stability in healthy individuals. J Exerc Rehabil. 2016;12(6):542. doi: 10.12965/jer.1632804.402

15. Neto J, Pastre CM, Monteiro HL. Postural alterations in male Brazilian athletes who have participated in international muscular power competitions. Revista Brasil Med Esporte. 2004;10(3):199-201.

16. Souchard PE, Meli O, Sgamma D, Pillastrini P. Rieducazione posturale globale. EMC-Med Riabilitat. 2009;16(3):1-10. doi: 10.1016/S1283-078X(09)70207-X

17. Escobar JCZ, Rodriguez Fernandez AL, Martinez Cepa CB, Lopez Andrino J. Study of the relation between playing football and muscle shortening. Fisioterapia. 2004;26(6):340-8. doi: 10.1016/S0211-5638(04)73121-1

18. Lomas-Vega R, Garrido-Jaut M, Rus A, del-Pino-Casado R. Effectiveness of global postural re-education for treatment of spinal disorders: A meta-analysis. Am J Phys Med Rehabil. 2017;96(2):124-30. doi: 10.1097/PHM.0000000000000575

19. Huang C, Holfeld J, Schaden W, et al. Mechanotherapy: revisiting physical therapy and recruiting mechanobiology for a new era in medicine. Trends Mol Med. 2013;19(9):555-64. doi: 10.1016/j.molmed.2013.05.005

20. Vyshlova IA, Karpov SM, Shevchenko PP. The effectiveness of yoga in chronic pain syndrome in the lower back (review article). Sovremennye Problemy Nauki i Obrazovaniya. 2014;(6):1106 (In Russ.).

21. Scharrer M, Ebenbichler G, Pieber K, et al. A systematic review on the effectiveness of medical training therapy for subacute and chronic low back pain. Eur J Phys Rehabil Med. 2012;48(3):361-70.

22. Frolov A. Iogaterapiya: khatkha-ioga kak metod reabilitatsii [Yoga therapy: hatha yoga as a method of rehabilitation]. 2nd ed. Moscow: Orientaliya; 2016. 474 p. (In Russ.).

23. Vorontsov SA. Complex use of therapeutic gymnastics in sodium chloride water in combination with manual massage and sauna in the spa treatment of patients with coronary heart disease: Abstract of thesis ... Cand. Med. Sci.. Samara; 1999. 14 p. (In Russ.).

24. Zaworski K, Latosiewicz R. The effectiveness of manual therapy and proprioceptive neuromuscular facilitation (PNF) compared with traditional kinesiotherapy in the treatment of non-specific low back pain. Ann Phys Rehabil Med. 2018;61:e15. doi: 10.1016/

25. Macedo LG, Maher CG, Latimer J, McAuley JH. Motor control exercise for persistent, nonspecific low back pain: a systematic review. Phys Ther. 2009;89(1):9-25. doi: 10.2522/ptj.20080103

26. Kremer Yu. Zabolevaniya mezhpozvonkovykh diskov [Diseases of the intervertebral discs]. Ed. V.A. Shirokov. Moscow: MEDpress-inform; 2013. 472 p. (In Russ.).

27. Walter U, Hoopmann M, Krauth C, et al. Unspezifische Rü ckenbeschwerden. Medizinische und ö konomische Bewertung eines ambulanten Prä ventionsansatzes. Deutsches Ärzteblatt. 2002;99(34-35): A-2257.

28. Heymans MW, van Tulder M, Esmail R, et al. Back schools for nonspecific low back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine. 2005;30(19):2153-63. doi: 10.1097/01.brs.0000182227.33627.15

29. Nentwig CG, Krä mer J. Orthopä dische Schmerztherapie. Enke Verlag. 1999;83.

30. Van Tulder MW, Koes B, Malmivaara A. Outcome of non-invasive treatment modalities on back pain: an evidence-based review. Eur Spine J. 2006;15(1):S64-S81. doi: 10.1007/s00586-005-1048-6

31. Chou R, Qaseem A, Snow V, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147(7):478-91. doi: 10.7326/0003-4819-147-7-200710020-00006

32. Stochkendahl MJ, Kjaer P, Hartvigsen J, et al. National Clinical Guidelines for non-surgical treatment of patients with recent onset low back pain or lumbar radiculopathy. Eur Spine J. 2018;27(1):60-75. doi: 10.1007/s00586-017-5099-2

33. Dugan SA. The role of exercise in the prevention and management of acute low back pain. Clin Occupat Environ Med. 2006;5(3):615-32.

34. Ojha HA, Wyrsta NJ, Davenport TE, et al. Timing of physical therapy initiation for nonsurgical management of musculoskeletal disorders and effects on patient outcomes: A systematic review. J Orthopaed Sports Phys Ther. 2016;46(2):56-70. doi: 10.2519/jospt.2016.6138

35. Kamper SJ, Apeldoorn AT, Chiarotto A, et al. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain. Cochrane Database System Rev. 2014;(9):CD000963. doi: 10.1002/14651858.CD000963.pub3

36. Kamper SJ, Kongsted AK, Haanstra TM, Hestbaek L. Do recovery expectations change over time? Eur Spine J. 2015;24(2):218-26. doi: 10.1007/s00586-014-3380-1

37. Hong JY, Song K-S, Cho JH, Lee JH. An updated overview of low back pain management in primary care. Asian Spine J. 2017;11(4):653. doi: 10.4184/asj.2017.11.4.653

38. Qaseem A, Wilt TJ, McLean RM, et al. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-30. doi: 10.7326/M16-2367

39. Van Middelkoop M, Rubinstein SM, Kuijpers T, et al. A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain. Eur Spine J. 2011;20(1):19-39. doi: 10.1007/s00586-010-1518-3

40. Koes BW, van Tulder M, Lin CWC, et al. An updated overview of clinical guidelines for the management of non-specific low back pain in primary care. Eur Spine J. 2010;19(12):2075- 94. doi: 10.1007/s00586-010-1502-y

41. Airaksinen O, Brox JI, Cedraschi C, et al. Chapter 4 European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15:s192-s300. doi: 10.1007/s00586-006-1072-1

42. Bogduk N, McGuirk B. Causes and sources of chronic low back pain. Medical management of acute and chronic low back pain. An evidence-based approach. Pain Res Clin Manag. 2002;13:115-26.

43. Pillastrini P, Ferrari S, Rattin S, et al. Exercise and tropism of the multifidus muscle in low back pain: a short review. J Phys Ther Sci. 2015;27(3):943-5. doi: 10.1589/jpts.27.943

44. O'Connor SR, Tully MA, Ryan B, et al. Walking exercise for chronic musculoskeletal pain: systematic review and meta-analysis. Arch Phys Med Rehabil. 2015;96(4):724-34. doi: 10.1016/j.apmr.2014.12.003

45. Hendrick P, Te Wake AM, Tikkisetty AS, et al. The effectiveness of walking as an intervention for low back pain: a systematic review. Eur Spine J. 2010;19(10):1613-20. doi: 10.1007/s00586-010-1412-z

46. Geneen LJ, et al. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. 2017. CD011279-CD011279.

47. Baranowski AP, et al. International Association for the Study of Pain (IASP) classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms. 2011.

48. Bernstein IA, Malik Q, Carville S, Ward S. Low back pain and sciatica: summary of NICE guidance. BMJ. 2017;356:i6748. doi: 10.1136/bmj.i6748

49. Budithi S, Dhawan R, Cattell A, et al. Only walking matters – assessment following lumbar stenosis decompression. Eur Spine J. 2017;26(2):481-7. doi: 10.1007/s00586-016-4881-x

50. Issack PS, Cunningham ME, Pumberger M, et al. Degenerative lumbar spinal stenosis: evaluation and management. JAAOS J Am Acad Orthopaed Surg. 2012;20(8):527-35. doi: 10.5435/JAAOS-20-08-527

51. Inoue G, Miyagi M, Takaso M. Surgical and nonsurgical treatments for lumbar spinal stenosis. Eur J Orthopaed Surg Traumatol. 2016;26(7):695- 704. doi: 10.1007/s00590-016-1818-3

52. Covaro AA, Manabe N, Bobinski L, et al. The importance of the occipitocervical area in patients with ankylosing spondylitis analysis of a cohort of 86 cervical fractures in surgically treated patients. J Craniovertebr Junct Spine. 2017;8(4):374. doi: 10.4103/jcvjs.JCVJS_115_17

53. Burton AK. How to prevent low back pain. Best Pract Res Clin Rheumatol. 2005;19(4):541- 55. doi: 10.1016/j.berh.2005.03.001

54. Bhadresha A, Lawrence OJ, McCarthy MJH. A comparison of magnetic resonance imaging muscle fat content in the lumbar paraspinal muscles with patient-reported outcome measures in patients with lumbar degenerative disk disease and focal disk prolapse. Global Spine J. 2016;6(04):401-10. doi: 10.1055/s-0036-1583290

55. Paalanne N, Niinimä ki J, Karppinen J, et al. Assessment of association between low back pain and paraspinal muscle atrophy using opposed-phase magnetic resonance imaging: a population-based study among young adults. Spine. 2011;36(23):1961-8. doi: 10.1097/BRS.0b013e3181fef890

56. Suri P, Fry AL, Gellhorn AC. Do muscle characteristics on lumbar spine magnetic resonance imaging or computed tomography predict future low back pain, physical function, or performance? A systematic review. PM&R. 2015;7(12):1269-81. doi: 10.1016/j.pmrj.2015.04.016

57. Goubert D, De Pauw R, Mira Meeus M, et al. Lumbar muscle structure and function in chronic versus recurrent low back pain: a crosssectional study. Spine J. 2017;17(9):1285-96. doi: 10.1016/j.spinee.2017.04.025

58. Steffens D, Maher CG, Pereira LSM, et al. Prevention of Low Back Pain: A Systematic Review and Meta-Analysis. JAMA Intern Med. 2016;176(2):199-208. doi: 10.1001/jamainternmed.2015.7431

For citation:

Achkasov E.E., Zadorina G.N., Lamkova I.A., Moskvicheva V.S. Kinesiotherapy for back pain. Neurology, Neuropsychiatry, Psychosomatics. 2019;11(2S):33-39. (In Russ.)

Views: 22

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)