Pilates for lower back pain: how it can help and when to seek advice

Pilates can ease pain and improve function in some people with chronic lower back pain. What it works on, whether to train in pain and when to stop.

Technical reviewAna Carina Silvaphysiotherapist and Clinical Pilates instructor

Lower back pain is very common and can show up in different ways, with different possible causes. In many cases, people become afraid to move or find certain activities difficult.1

Physical activity and exercise can be part of the approach, but the choice should take into account each person's symptoms, preferences and circumstances.1

How can Pilates help?

A well-adjusted practice can include exercises aimed at working on:

  • The strength and endurance of the trunk muscles;
  • Control of the pelvis and spine;
  • Trunk mobility;
  • Coordination between breathing and movement;
  • A gradual return to movements and activities;
  • A progressive return to physical activity.1

Should I do Pilates when I'm in pain?

It depends on the nature, intensity and course of the symptoms, as well as each person's abilities and circumstances.1

Pilates can help reduce pain and improve function in some people with chronic lower back pain.2,3 However, a general online class cannot assess symptoms, identify a possible cause or replace an individual assessment by a health professional.1 Seek professional advice when the pain:

  • Persists or isn't improving;
  • Significantly interferes with daily activities;
  • Leaves you unsure about which movements or exercises you can do.

At DUO

Our classes state the level and the areas worked to help you choose more mindfully.

If you have lower back pain, stop the exercise if the movements clearly worsen your symptoms and seek professional advice when needed.4

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Content written by DUO Clinical Pilates

References

  1. World Health Organization. WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings. Geneva: World Health Organization; 2023.
  2. Huang J, Park HY. Effect of Pilates training on pain and disability in patients with chronic low back pain: a systematic review and meta-analysis based on randomized controlled trials. Physical Activity and Nutrition. 2023;27(1):16–29. doi:10.20463/pan.2023.0003.
  3. Patti A, Thornton JS, Giustino V, Drid P, Paoli A, Schulz JM, Palma A, Bianco A. Effectiveness of Pilates exercise on low back pain: a systematic review with meta-analysis. Disability and Rehabilitation. 2024;46(16):3535–3548. doi:10.1080/09638288.2023.2251404.
  4. National Health Service. Back pain. NHS; page reviewed on 5 March 2026.
Reference 1

World Health Organization. WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings. Geneva: World Health Organization; 2023.

Reference 2

Huang J, Park HY. Effect of Pilates training on pain and disability in patients with chronic low back pain: a systematic review and meta-analysis based on randomized controlled trials. Physical Activity and Nutrition. 2023;27(1):16–29. doi:10.20463/pan.2023.0003.

Reference 3

Patti A, Thornton JS, Giustino V, Drid P, Paoli A, Schulz JM, Palma A, Bianco A. Effectiveness of Pilates exercise on low back pain: a systematic review with meta-analysis. Disability and Rehabilitation. 2024;46(16):3535–3548. doi:10.1080/09638288.2023.2251404.

Reference 4

National Health Service. Back pain. NHS; page reviewed on 5 March 2026.