Pilates for Low Back Pain

Low back pain is a condition which affects almost all of us from time to time. It can range in severity from irritating to debilitating, and many untypeable ****ing’s in between! As physios, the phrases we often hear are ‘it just started out of the blue’, ‘I didn’t do anything’ or ‘it was lifting that chest of drawer/sweeping leaves/shovelling snow that did it’. Possibly the shovelling snow was the final straw in years of lack of movement, poor movement patterns and an imbalance in the repetitive loading of tissues.

The causes of back pain can be complicated and confusing, with everyone around you weighing in with their opinion. ‘ooh, that sounds exactly like when I slipped my disc and was flat on my back for three months’. Gosh that sounds terrifying, is that really what’s happening to me? Probably not.

The actual structures involved in causing back pain could be any one or any combination of muscles, joints, ligaments, connective tissue, nerves, discs. I am deliberately putting discs last, because there is a lot of mystery and confusion surrounding the intervertebral discs. The theory is that when pressure is put on one side of the disc for a prolonged period, there is a possibility that some of the jelly-like substance in the middle of the disc can protrude out the other side. The disc itself is very firmly attached to the vertebrae above and below it, and is not going to ‘slip out’. The other reason discs are last on the list is that disc protrusions account for approximately 5% of all back pains, and of those, only a tiny proportion will require surgery, most can be resolved over time by adapting the way you move and with targeted exercises..


The reasons for back pain occuring are as many and varied as the people experiencing the pain. It could arise from an imbalance in muscle function, deconditioning through our increasingly sedentary lifestyles,  the trauma of a fall from height or a number of conditions such as osteoporosis and osteoarthritis. Even people who have a these conditions can make drastic improvements to how they function and their pain levels by improving muscle function around the affected joints and improving joint alignment.

The worry when someone thinks they have hurt their back by doing an activity such as sweeping leaves or shovelling snow is they is they associate movement and exercise as the cause of the pain; therefore not moving and reducing exercises is seen as the solution. Unfortunately this can lead into a downward spiral of deconditioned muscles, poor posture and stiffening up resulting in more pain. This cycle can be broken by introducing gentle Pilates exercises gradually and building up stability, control and flexibility. So, first of all move, then improve functional movement and increase to higher performance Pilates.


Movement itself is known to reduce painful stimuli to the nerves and your physio or Pilates instructor can help you find the best ways to move and advise you on balancing movement and structured rest.

Pilates is great for back pain because it can be tailored to your level of ability and you can progress at your own rate. A balanced Pilates class will find and challenge areas you need to work on: The flexibility of joints and muscles, balance, body awareness and control. You will work on your posture and alignment of joints, improving your sense of how to hold yourself well when not moving. Your core stability,  the deep muscles in your torso which should work at a low level all the time, will improve to help you maintain an aligned posture. Recent research has shown that Pilates can improve bone health, therefore reducing your osteoporosis risk. For our older clients, your risk of falling is reduced through improved balance, but if you are unlucky enough to fall, you will have reduced your fracture risk by doing Pilates.


Our clients have long known the benefits of Pilates for their back pain. I wanted to share some feedback we received from clients recently:

I managed to do the Chicago marathon, which was a complete medical miracle as I literally couldn’t walk with the pain two weeks previously. The consultant can’t believe it either so I had another MRI Scan on Monday – with the results coming next week……

I have to say I was unsure about Pilates before as I always wanted to go to classes that got the ‘sweat on ‘! There are massive benefits for all ages groups – whether you are sporty or not.

“Having suffered lower back pain of varying degrees for many years my frustration with it increased in line with my interested in cycling.  I decided to seek a long term solution which came in the form of Pilates.  This increased my core strength providing more stability in my back and worked wonders on and off the bike including eliminating my pain.”

The best time to start Pilates is now. Whether you have never had low back pain or had it frequently, the sooner you get started, the sooner you can reduce the number of episodes of back pain and if you do get pain, you can reduce the duration and intensity of it. You may even manage to prevent it all together.


Take what you learn in your Pilates class and apply it in how you move every day. This will make a huge difference in how quickly you progress your practice and you will notice far more benefits than practicing for your one or two hours of Pilates a week.