Over a lifetime, around 80% of Americans experience back pain and it becomes more common with age. An achy back is costly in terms of quality of life and the burden it places on the wallet. A study found that the medical costs incurred by people without back pain averaged $3, 516 in 2005 while people with back pain spent $6,096 per year.
Pilates is a form of low-impact exercise that focuses on strengthening the core muscles that make up your back, hips, and abdominal muscles. Joseph Pilates created it in the 1920s. After developing the core movements, he opened a Pilates studio in New York City, and it became a sensation among health and fitness-conscious New Yorkers. The exercises are built around mat work, focusing on breathing and isometric exercises, where you maintain tension on a muscle without lengthening it.
Proponents of Pilates believe it improves flexibility and muscle endurance while strengthening core muscles. Some people with back pain believe Pilates helps control the discomfort and stiffness that so many back pain sufferers experience. Is there scientific evidence that Pilates is an effective treatment for back pain?
Is Pilates Effective for Back Pain?
Reports of improvement in back pain among people with Pilates movements are one thing, but it’s even better to have actual science. In one study, researchers analyzed data from multiple databases. The goal was to compare Pilates as a treatment for lower back pain versus other types of treatment, other forms of exercise, and no treatment.
The results? The study concluded that Pilates as a treatment for lower back pain is more effective than minimal physical exercise, and there’s little evidence that one Pilates program offers advantages over another. Another study of 39 adults found that those who participated in a series of 15 Pilates sessions reported less pain and could carry out more of their daily activities. They even experienced an improvement in their ability to walk without pain. So, there is evidence that Pilates helps with back pain.
Why Pilates Helps Back Pain
The reason experts believe Pilates is an effective treatment for back pain is it emphasizes core-strengthening movements. When your core muscles are strong and well developed, they stabilize your spine and protect against back pain. Plus, studies show movement is a better prescription for back pain than bed rest. Lying in bed or sitting worsens lower back pain by causing muscle stiffness and atrophy of the muscles that support your back.
The movements that Pilates emphasizes stretch the muscles in the lower back, thereby easing lower back tightness. Plus, the controlled breathing taught by Pilates instructors helps with body control and activates the deep muscles in the pelvis.
Other Benefits of Pilates
Beyond a strong core, Pilates improves body alignment and posture. One of the causes of back and neck pain is poor posture and alignment. Pilates enhances body control and functionality through full-body exercises with an emphasis on the core. Unlike strength training, the goal isn’t to develop muscle size but to enhance flexibility, and improve total body control, coordination, and muscle endurance.
Other Ways to Build Core and Back Strength
Pilates isn’t the only strategy for building a strong core and back. Planks and their many variations are some of the best exercises for strengthening your core and back muscles. When you do a plank, you activate the muscles that stabilize your spine, and that gives your spine more support and resistance to injury.
One study found that people who did spine-stabilizing exercises, like planks, for 6 weeks experienced greater improvements in lower back pain than those who took part in supervised physical therapy. Other research shows planks improve balance and proprioception and reduce disability in people with lower back pain.
Another study found that core stabilization exercises were more effective than a general exercise program for easing lower back pain symptoms and improving functionality. So, the benefits of Pilates for back pain may come from its core strengthening benefits rather than specific to the Pilates approach.
Know What’s Causing Your Back Pain
Back pain has many causes. One of the most common is a muscle strain from poor posture or from straining a muscle through a sudden movement. But many spinal conditions cause back pain, including spinal stenosis (a narrowing of the spinal canal), a ruptured disc, inflammation or compression of a spinal nerve, disc degeneration, and more. If you have numbness or tingling, weakness, or bowel/bladder issues, get your back pain assessed by a healthcare professional. Don’t try to self-diagnose or treat.
The Bottom Line
Pilates is an effective form of exercise for lower back pain if you do it consistently. By strengthening your core muscles, it also lowers the risk of back pain by improving body alignment, body control, and posture. Movement is better than bed rest for lower back pain due to muscle strains. Plus, the stretch you get when you do Pilates movements will provide instant relief for an achy back.
However, there’s no evidence that Pilates is better than core-stabilization exercises, like planks, and other exercises that strengthen the back muscles and the muscles that support your spine. Planks are an easy exercise to master, require no equipment, and offer multiple fitness benefits.
References:
- Fitness Prescription. February 2011. page 26.
- Patti A, Bianco A, Paoli A, Messina G, Montalto MA, Bellafiore M, Battaglia G, Iovane A, Palma A. Effects of Pilates exercise programs in people with chronic low back pain: a systematic review. Medicine (Baltimore). 2015 Jan;94(4):e383. doi: 10.1097/MD.0000000000000383. PMID: 25634166; PMCID: PMC4602949.
- “Core Exercises for Back Pain: 6 Moves for Seniors – SilverSneakers.” 12 Mar. 2019, https://www.silversneakers.com/blog/core-exercises-ease-back-pain/.
- Wells C, Kolt GS, Marshall P, Hill B, Bialocerkowski A. The effectiveness of Pilates exercise in people with chronic low back pain: a systematic review. PLoS One. 2014 Jul 1;9(7):e100402. doi: 10.1371/journal.pone.0100402. PMID: 24984069; PMCID: PMC4077575.
- Graves, S., et al. 2005. Influence of Pilates-based mat exercise on chronic lower back pain. Medicine & Science in Sports & Exercise, 37 (5, Suppl.), S27.
- Hlaing SS, Puntumetakul R, Khine EE, Boucaut R. Effects of core stabilization exercise and strengthening exercise on proprioception, balance, muscle thickness and pain related outcomes in patients with subacute nonspecific low back pain: a randomized controlled trial. BMC Musculoskelet Disord. 2021 Nov 30;22(1):998. doi: 10.1186/s12891-021-04858-6. PMID: 34847915; PMCID: PMC8630919.
- Coulombe BJ, Games KE, Neil ER, Eberman LE. Core Stability Exercise Versus General Exercise for Chronic Low Back Pain. J Athl Train. 2017 Jan;52(1):71-72. doi: 10.4085/1062-6050-51.11.16. Epub 2016 Nov 16. PMID: 27849389; PMCID: PMC5293521.
- “The Real Costs of Back Pain – Treatment & Prevention – Money Crashers.” 07 Jun. 2022, https://www.moneycrashers.com/costs-back-pain-treatment-prevention/.
References:
- “Posture and back health – Harvard Health.” 09 Mar. 2014, https://www.health.harvard.edu/pain/posture-and-back-health.
- Augeard N, Carroll SP. Core stability and low-back pain: a causal fallacy. J Exerc Rehabil. 2019 Jun 30;15(3):493-495. doi: 10.12965/jer.1938198.099. PMID: 31316947; PMCID: PMC6614774.
- “Avoid back pain and improve balance by strengthening core ….” 01 May. 2013, https://www.health.harvard.edu/newsletter_article/avoid-back-pain-and-improve-balance-by-strengthening-core-muscles.
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