Pilates – Can it help with back pain?

Pilates is a form of exercise that has become more and more popular over the past 10 years. You can now pick from mat classes, reformer classes, Pilates HIIT classes, Pilates barre classes, paddleboard Pilates classes -you name it, you can do it with Pilates! If you suffer from back pain, and 70-85% of people will suffer from low back pain at some point in their life2, then you are likely to stumble across a Pilates class in your pursuit of conquering your back pain. But can Pilates help?

What does the research say?

A recent systematic review of the research surrounding Pilates concluded that Pilates significantly improved back pain in those suffering from chronic low back pain1.  This is great news and something a lot of Pilates instructors and physiotherapists already knew was happening, but it is great to have the scientific backing through evidence-based research. So the evidence is starting to build to paint a picture that Pilates definitely does help. The interesting thing with the results of this systematic review though, was that although it showed Pilates showed a significant reduction in back pain for the participants, it also showed that those with chronic low back pain who participated in other forms of treatment (including general exercise) also showed a significant improvement in their back pain. So what does this mean? This basically means, that although Pilates can definitely help reduce back pain, so can other forms of treatment and exercise. So Pilates is not superior to other forms of treatment or exercises. But this doesn’t take anything away from Pilates as a form of exercise to help with your back pain. It is just that it isn’t significantly better than other forms of exercise. But that’s ok, and if you’ve tried Pilates and maybe it isn’t your thing then that’s good news for you, as there are other forms of treatment or exercise that can help with your back pain too. So the evidence is out there to support Pilates, so how do you pick the best type of class for you? Here are a few things to think about before joining a Pilates class to help you make that decision;

How to pick your class;

Do you have neck, back or joint pain?

Pilates can be great for back, neck and joint pains as it focuses on controlled movements whilst engaging your core muscles (your deep abdominals and your pelvic floor). However, some Pilates exercises can strain your neck and other joints if not done correctly. For those with back, neck or joint issues, I would strongly suggest going to a physio-led Pilates class as they will be able to assess and adapt your exercises to ensure you don’t flare up any neck pain that you have.

Mat or reformer class?

Pilates mat classes are great for getting to grips with the basics of the exercises and learning how to engage your core (deep abdominals and pelvic floor) and help you focus on doing the correct movements with control. Mat classes are a must for beginners and those new to Pilates as this allows you to really understand what you are supposed to be doing with the exercises. Reformer classes are great too and can be lots of fun (even if they look a bit scary when you first see the machines!). But I would recommend if you are new to Pilates or have been experiencing back or joint pains, that you start with a mat class to get to grips with the basics before delving into the world of the reformer.

Reformers are great for more advanced exercises and starting to work you harder and a lot of fun can be had on these moving Pilates machines.

Your instructor

As Pilates has become more popular over the past few years there are more and more Pilates classes and Pilates instructors popping up everywhere. There is no standardised training for Pilates so anyone can call themselves a Pilates instructor and open a Pilates studio. It is worth checking out the background of your instructor (most instructors will have undergone some formal Pilates training) but be careful and do your own research as I have seen gyms advertising Pilates classes run by instructors who have no Pilates training. So do some basic research on your instructor first, most studios will have this information on their website as they will want to promote their instructors and the experience they have. And most studios and instructors will be more than happy for you to give them a call and ask any questions you have about them and the classes they run.

Teaching Style

Having great Pilates training is essential, but the instructor and their style of teaching also have to fit with you. Everyone is different and likes different things, some people like upbeat music during their workout, others prefer relaxing music or no music at all. Some people like to be left alone and not touched during their workout whereas others prefer for the teacher to come round and correct them so they know they are doing the exercises correctly. We’re all different and we all need different things.  A great teacher will be able to adapt to different peoples learning styles, but not all instructors will be the right fit for you. If you’re not enjoying a particular Pilates class or the way the instructor teaches, that’s fine you may still enjoy and benefit from Pilates but may need to find a different instructor or studio to do your Pilates – remember one size does not fit all!  


Research is showing that Pilates can help to reduce chronic low back pain and improve people’s function1. In my own experience, as a physiotherapist and a Pilates instructor, I would second this, as I have seen hundreds of clients improve their quality of life and reduce their pain through investing time in attending Pilates classes. Not all Pilates classes are the same, do some research and find a class that fits with you and then go out and enjoy the benefits of Pilates!  


1Lin, H. T., Hung, W. C., Hung, J. L., Wu, P-S, Liaw, L-J, Chang, J-H (2016). ‘Effects of Pilates on patients with chronic non-specific low back pain: a systematic revie2’,  J. Phys. Ther. Sci. 28: 2961-2969.

2 Andersson, GB (1999). ‘Epidemiological features of chronic low back pain’, Lancet. 354; 581-585.

Lisa Rushton

Hi, I’m Lisa, a physiotherapist with over 15 years of clinical experience in a variety of health and medical settings. I have a real passion for all things women’s health and love writing and sharing knowledge. With these passions, I have put together my blog, Pelvic-Flaws, to try and share all things women’s health-related and empower women with evidence-based information about their health and well-being.