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Pilates and Chronic Low Back Pain – Part I

Low back pain is very common.  The National Institute of Health (NIH) estimates that 80% of people will be affected with low back pain during their lifetime.  Approximately 20% of people with acute low back pain develop chronic low back pain, where the symptoms persist one year or longer.  Most low back pain is “mechanical” in nature.  In other words, the pain is related to posture and movement.  Our posture and the way we move is controlled by our muscles, so it stands to reason that exercise can reduce low back pain. 

However, some exercise may make our pain worse while other exercise may make our pain better.

How does Pilates help?

  • Pilates improves muscle strength and endurance.  But perhaps more important than pure muscle strength and endurance, is its focus on “neuromuscular control”.  This is the ability of our muscles to provide both spinal stability and coordinated movement in our spine and extremities. 

  • Pilates focuses on posture, alignment and symmetry between sides.  Our muscles are more efficient when they work from a position of good posture.

  • Pilates improves flexibility.  Lack of flexibility in muscles that attach to the spine or pelvis can create stress on the low back.

  • Pilates improves your body awareness through feedback from both the instructor and the Pilates equipment.   The frame of the equipment and the quality of the movement of the carriage and springs helps you learn proper alignment and movement of your body.

Pilates and Chronic Low Back Pain Part II will focus more on the specifics of the Pilates exercises.



1.        National Institute of Health website

2.     Rydeard R, Leger A, Smith D. Pilates-based therapeutic exercise: effect on subjects with nonspecific chronic low back pain and functional disability: a randomized controlled trial. The Journal Of Orthopaedic And Sports Physical Therapy [serial online]. July 2006;36(7):472-484.

3.     Smith C, Nyland J, Caudill P, Brosky J, Caborn D. Dynamic trunk stabilization: a conceptual back injury prevention program for volleyball athletes. The Journal Of Orthopaedic And Sports Physical Therapy [serial online]. November 2008;38(11):703-720.

Matt Seltzer