The benefits of Pilates in the management of low back pain.

Let’s start with this: if you are currently experiencing low back pain or experience recurrent low back pain from time to time, you are not alone. This condition is an extremely common health problem.

Analysis of low back pain prevalence (the number of cases present in a population at a particular point or period of time) indicates that up to 20% of the population is experiencing this condition, while the incidence (number of new cases in a population over a particular period of time) of low back pain is as high as 7%1.

So, what are your options if you encounter this condition? There are numerous treatments available and it can sometimes be overwhelming to decide which one to pursue.

The best place to start is a thorough assessment of the problem to determine its most likely source. This will allow for establishment of an accurate diagnosis and development of a comprehensive care plan and evaluation of what results you can expect. The options for management will vary depending on the characteristics of the problem and the findings of this assessment, but at some point in time an active approach to increasing the resiliency of your body will be a key element in achieving resolution of your symptoms and in minimizing the likelihood and severity of future episodes.

Pilates is one of these active approaches and has been shown to provide effective reduction in pain and improvement of function when it comes to the low back2, 3. It can also produce improvements in muscle mass, flexibility, balance, and body awareness along with eliciting psychological benefits 4.

What is Pilates?

Pilates is a mind-body exercise that focuses on strength, core stability, flexibility, muscle control, posture, and breathing5. The exercises may be mat-based or involve the use of specialized equipment.

There are six basic principles of Pilates:

  1. Breathing
  2. Pelvic Placement
  3. Rib Cage Placement
  4. Scapular (shoulder blade) Movement & Stabilization
  5. Head and Cervical Spine (neck) Placement
  6. Lower Extremity Movement & Stabilization

A key focus of the intervention is on control and comfort of movement – this is particularly useful when managing the sometimes debilitating and stressful condition that low back pain can be.

One facet of Pilates that facilitates recovery in a unique manner is that it allows active access to body movement in a manner that feels safer for the nervous system – which can be especially beneficial as the central nervous system often enters into a heightened state of alertness and sensitivity when an injury and/or pain is present (this is especially true in the low back). This allows an individual to move in a more controlled and less painful manner earlier on in the recovery process of low back pain than some traditional exercise approaches might.

Also unique to Pilates is exercise on a equipment such as a Reformer: a specialized piece of Pilates equipment that uses springs to provide resistance and compression. This approach facilitates a decreased ability for the body to make use of faulty movement patterns and undesirable muscle compensations – which can often be the true source of an individual’s low back pain to begin with.

Pilates can be an effective method for recovering from low back pain in and of itself, but it can also serve as a bridge between rehabilitation and fitness conditioning. Whether you’re looking to recover from a bout of low back pain to get back to your normal day-to-day life or if you’re experiencing low back pain and are looking for a way to return to your chosen sport and activities, Pilates may be a viable option for you.

Curious whether Pilates might be able to help with your back pain? A great place to start is with an initial Physiotherapy assessment with a Clinical-Pilates trained physio. You can book an assessment with one of our Physiotherapists at Alaia HERE.

Peter Kosheluk, Registered Physiotherapist, Clinical-Pilates trained.


1. Fatoye, F., Gebrye, T. & Odeyemi, I. Real-world incidence and prevalence of low back pain using routinely collected data. Rheumatol Int 39, 619–626 (2019).

2. La Touche, R., Escalante, K. & Linares, M. Treating non-specific chronic low back pain through the Pilates Method. Journal of Bodywork and Movement Therapies Vol. 12, Issue 4, 364-370 (October 2008).

3. Quinn, K., Barry, S. & Barry, L. Do patients with chronic low back pain benefit from attending Pilates classes after completing conventional physiotherapy treatment? Physiotherapy Practice and Research Vol. 32, No. 1, 5-12 (2011).

4. Tolnai, N., Szabo, Z., Koteles, F. & Szabo, A. Physical and psychological benefits of once-a-week Pilates exercises in young sedentary women: A 10-week longitudinal study. Physiology & Behavior Vol. 163, 211-218 (September 2016).

5. Wells, C., Kolt, G. & Bialocerkowski, A.  Defining Pilates exercise: A systematic review. Complementary Therapies in Medicine Vol. 20, Issue 4, 253-262 (August 2012).