The Benefits of Pilates For People with Back Pain

This low-impact exercise is high on muscle strengthening and posture alignment.

Nearly 90 percent of American adults will experience at least one episode of back pain at some point in their lives, and the incidence of those episodes is on the rise. That rise is attributable to many factors, including a more sedentary lifestyle brought on by increasing dependence on technology, as well as a global pandemic that forced more people to work, learn, and stay at home than ever before.

Unfortunately, such lifestyle factors can manifest the occasional bout with back pain into a chronically debilitating condition. While most people turn to medication and rest for constant back pain, decades’ worth of evidence suggests that one way off the back pain merry-go-round is through exercise. If that makes you groan, take heart. There are plenty of low-impact exercises that don’t require a gym membership, complicated equipment, or professional knowledge of fitness that can help. In fact, for many people who’ve battled chronic back pain, a regular Pilates regimen has been a game-changer.

Developed by and named after Joseph Pilates, the concepts involved in the practice of Pilates have a storied history. Mr. Pilates, the son of a gymnast father and naturopath mother, says he developed the exercise practice (which he originally named Contrology), while being held in an internment camp during World War I. While there for four years he designed and honed the methods involved in the practice of Pilates and tested them on his fellow internees. The principals of his original Pilates design are still in practice today.

Many people dismiss Pilates as a complicated exercise practice best performed by a contortionist, but nothing could be further from the truth. Pilates is an exercise method that contains low-impact movement patterns and focuses intensely on improving flexibility, balance, and muscle strength. Flexibility, muscle strength, and balance are essential for everyone to maintain a healthy lifestyle, but they are especially crucial for individuals trying to improve episodic back pain. 

In general, people who suffer from chronic back pain due to spinal disc degeneration or those whose pain is made worse by constantly performing spine torquing movements may best benefit from introducing Pilates into their exercise routine. Pilates helps a person erase movements that can put unnecessary stress on the spine and replace them with those that improve strength, flexibility, and muscle health. A regular Pilates practice can improve asymmetries in a person’s posture while reducing wear and tear on the spinal discs that result from uneven stress on the spine.

Pilates and Core Strength – One of the most critical factors in helping people reduce their chronic back pain episodes focuses on strengthening the abdominal muscles. The core is comprised of muscles that provide protection and support for the spine. As is often the case with back pain, it puts unnecessary stress on other parts of the body, including the neck, shoulders, and hips. A strong core helps the body develop total alignment so that each muscle and joint is doing its job and is not compensating or doing more than it should. 

Pilates and Posture Correction – When body alignment is off, more stress is placed on the spine, and back pain is usually the result. The practice of Pilates pays particular attention to how each body part aligns to create good posture. Once those core muscles are stronger and doing the job they were designed to do, the body’s entire frame is adequately supported, and posture improves. Correct posture helps elongate the spine so that the joints and vertebrae are not compressed and are appropriately nourished. 

Pilates and Spinal Alignment – The health of the spine has a domino effect on the rest of the body. When one area of the spine isn’t functioning correctly, it has a cascading and adverse impact on other areas. But through the core strengthening and posture correcting practice of Pilates, the spine can achieve perfect alignment – a necessary tenet for significantly reducing and, in many cases, eliminating back pain.

Pilates and Flexibility – As previously mentioned, when one part of the body is improperly aligned, it often harms the spine. For example, when a person has decreased hip flexibility, the spine can overcompensate for the issue and carry the extra burden that the hips were designed to carry. But when Pilates is practiced regularly, it has total body benefits that include increased flexibility. Each area designed to maintain a specific stress load carries only the load that it was intended to take. 

As you can see, Pilates’ practice can be a significant benefit to the back pain sufferer. Remember, fancy equipment and a studio membership are not required. Talk to your doctor about whether starting a Pilates practice is right for you. Then, give an at-home practice with just a mat and instructional video a try for at least 4-6 weeks. You will likely see some extremely positive benefits, including reducing back pain, that can last a lifetime if you keep it up. 


Neel Anand MD