Back pain patients across the globe are always on the lookout for ways to both prevent and treat recurring pain. As more people look to exercise to keep their backs healthy, the discussion centers around which exercises are most effective. Recently there has been a trend towards yoga for back pain, but another contender in the exercise world has come to the forefront – Pilates. But does Pilates for back pain work?

Pilates for back pain

Pilates is a series of exercises that can be completed using bodyweight, a special apparatus, or a variety of props. Joseph Pilates developed this method of exercise to focus on the area of the body he calls “the powerhouse.” The powerhouse includes the abdomen, including the obliques, plus the inner and outer thighs and muscles of the rear end. The goal of Pilates is to build and balance strength, flexibility, endurance, coordination of muscles, and good posture.

Pilates emphasizes proper form in completing the exercises over pushing for more repetitions. Because of this, Pilates for back pain offers less chance of injury than many other forms of exercise for back pain.

Exercise in real life

A key feature of Pilates for back pain is that the exercises aren’t confined to the gym. Each exercise requires attention to how each muscle is moving, both by itself and in relation to other muscles.

Pilates teachers ask that each person pay attention to the movements and try to replicate that in their daily lives. This way of thinking can be very helpful when preventing back pain. It asks participants to use each muscle consciously to move their bodies both in and out of the gym.

Research on Pilates for back pain

There is copious research on the effectiveness of exercise for relief and prevention of back pain, but less focuse specifically on Pilates for back pain. One small study from Queen’s University in Kingston, Ontario looked at 39 men and women ages 20 to 55 who suffered from back pain. They found that those patients who used Pilates for back pain had significantly less pain and debilitation than a control group who underwent standard protocols for lower back pain treatment. These individuals were also able to maintain these results at a one-year follow-up.

A recent systematic review of 14 randomized controlled trials of Pilates for back pain found that Pilates was a superior treatment to traditional treatments for chronic lower back pain. In the short term, Pilates was more effective than other traditional treatments. Pilates was about as effective in the short term as massage or other forms of exercise. The results were mixed for long-term results. Reviewers did indicate that some people may find more benefit than others and recommended follow-up studies to confirm those results.

Equipment used for Pilates for back pain

While many Pilates exercises can be completed with just a mat, there are other pieces of equipment that can be helpful and are often used in a gym.

  • Magic circle: This piece of equipment was invented by Joseph Pilates. Essentially a large, flexible ring with two pads opposite each other to hold, the magic ring is intended to provide additional resistance. This resistance helps identify which muscles are being used.
  • Large apparatus: The ladder barrel and Pilates chair are two larger pieces of Pilates equipment. The ladder barrel helps work with flexion and extension in the lower back, while the Pilates chair builds strength.
  • Pilates reformer: This apparatus is a classic piece of Pilates equipment that is what many people envision when they think about Pilates for back pain. The Pilates reformer is a versatile machine that is usually only found in Pilates studios.
  • Pilates tower and Pilates Cadillac: Both of these large apparatus add gravity to the workout and are expensive pieces of equipment that require a trained teacher’s help to use correctly. These resemble traditional workout equipment, minus the added weights (you use your bodyweight instead).
  • Small Pilates equipment: These pieces of equipment include various balls and bands designed to add resistance and challenge to each workout. The magic band could be placed in this category.

Pilates for low back pain at home

Even though the Pilates machines and a personalized session with a trained instructor can be helpful, there are workouts you can do at home without equipment. If you are experiencing back pain in its acute phase, it is best to begin with some fundamentals of Pilates. These are small movements that teach the basic principles. If your back is hurting and feeling delicate, these exercises are gentle and easy. They serve as the basis for more complex movements.

Once the acute phase of pain begins to end, more involved Pilates exercises for back pain can be initiated. Many of these are very similar to yoga. They have similar guidelines for execution, including:

  • Breathe: Breath helps keep the muscles of the body relaxed and open.
  • Move slowly: Don’t rush through each exercise. The emphasis here is on feeling each movement in each specific muscle.
  • Mind your form: Only complete as many exercises as you can execute with proper form. Pilates for back pain is not about pushing for quantity. It’s about quality of movement.
  • Be gentle with yourself: If something hurts, back off and stop for the day, at least that exercise. This is meant to be healing exercise.
  • Imagine the box: Think about your shoulders and hips as four corners of a box and strive to keep them level and even.
  • Lengthen the neck: Keep your neck extended and shoulders relaxed away from the ears as you do Pilates for back pain.

If you don’t have access to an instructor, watching a video of basic Pilates exercises for back pain can be very helpful, too.

Exercise is one of the first-line recommendations for preventing and healing back pain. Have you ever tried Pilates for back pain?


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