As I have written before, back pain is extremely common (>80% of population). Not only that, but it is known to return. Upwards of 90% of people who experience back pain will have at least 1 future episode. (I am included in this statistic). That said, there are ways we can be proactive in avoiding future back pain. One of these ways to avoid back pain is pilates. Pilates for back pain is not new, but rather a topic that is showing more benefit in the last 5 years. (Full disclosure- my wife owns 5 pilates studios).
It is becoming a regular occurrence to view a professional article writing on the benefits of pilates for back pain. Admittedly, at first, I was a bit skeptical as well. How can pilates compare to physical therapy? What training do they really have? But, as I thought more about it 2 questions came to mind- – What is the purpose or goal of pilates? and How is this achieved?
As I took a step back (and watched a class or hundred) as well as trying it myself, I came to realize that there is a great parallel between what I instruct my patients in as a physical therapist and what pilates enthusiasts are instructed in as well. There is no need to be confrontational or closed minded here. There is a place and purpose for both in the overall health and wellness of the patient or client.
The goals of pilates are to lengthen, strengthen, improve flexibility and tone (WITH CONTROL). This is exactly what I am often instructing my patients with back pain in as well. Everything is to be done with a purpose regardless of discipline. The unique differences of each patient/client must be respected and adapted to in certain instances. Also, how either discipline approaches exercise for a 25 y.o vs. 75y.o will be slightly different. But that does not mean both age groups cannot benefit nonetheless from pilates.
With all that said, just what are the benefits of pilates for back pain? As I just ran a search of professional publications looking at this topic…no less than 75 reputable sources and unique articles were found. The evidence overwhelmingly shows (after weeding out the BS) that BEST benefit for pilates and back pain is for individuals with persistent or chronic back pain. In folks with chronic back pain (generally defined as pain > 3 mo), at least 6 weeks of regular pilates (equipment over mat) was shown to reduce pain/disability and improve function in those long suffering with back pain. What this means is that this is hope for a life with less pain and better function with taking regular pilates (2x/wk).
If you are dealing with an active or acute bout of back pain…there is not the evidence to support pilates for this. The majority of research has looked at pilates effectiveness for chronic back pain only. So for those with an “acute” episode of back pain, physical therapy should really be your 1st stop.
What I must tell you is that in most of these studies (that I scanned), the pilates instructors had an advanced background in anatomy/biomechanics of the body (many were physical therapists as well). This does bias the findings a bit and may make the findings less generalizable to other instructors without advanced training (most will not offer their training or background) making this more difficult to decipher. This means just any pilates instructor is not likely to create the same benefit for a client of theirs without specific training.
A good option is to find a PT who is well versed in pilates (and you/your issue) to help begin the transition into a pilates routine. You may be someone who will benefit from a program specifically tailored to you (that the PT can create). As part of my regular treatment sessions for patients with back pain, I am integrating pilates exercises on the reformer. Thus, by the time they finish PT, they are ready to take the next step with their pilates program. I can then provide their instructor detailed information on the best items to include or exercises to avoid based on the given presentation. And it works both ways…countless times, I work with pilates enthusiasts who are having some issue. I am able to assess and troubleshoot their difficulties to get them back to their regular program more quickly.
Knowing this, if you are suffering with chronic back pain and interested in pilates, do your homework. Find a PT or pilates instructor with the right experience for you. OR at least an instructor who has direct access to a medical professional to consult. I am regularly called upon to consult about various clients with back pain for my wife’s studios.
For more information on all that pilates can do for you….click HERE