The benefits of Pilates for lower back pain

What is lower back pain (LBP)?

Lower back pain is extremely common, affecting at least 80% of people at some point in their lifetime. Of these cases, non-specific lower back pain accounts for around 90% - this means that the cause of the back pain is nothing serious but does not have one exact cause. The majority of cases will resolve within six weeks, but for some people, symptoms can linger or re-occur and negatively impact daily activities.

Whilst there are physical factors that can lead to lower back pain, such as muscle strain or aggravation from repetitive movements, there is also a connection between stress and lower back pain, particularly when predicting how long it will take for someone’s lower back pain to improve. It is therefore important to address all possible factors you feel may be contributing. Pilates can be a very useful tool for this as it has been shown to not only improve physical strength and pain but also support overall wellbeing.

What is Pilates?

Pilates is a form of exercise that was originally developed by Mr Joseph Pilates in the early 1900s to help people that were bed bound in hospital. He realised that those who did the exercises seemed to have a much quicker recovery. It has since developed into a popular form of exercise that looks at improving movement control and muscle strength. Pilates is now recommended by the NHS as a treatment approach for lower back pain and there is growing research on the benefits for improving back pain even compared to other forms of exercise.

There are lots of variations of Pilates exercises to make them more or less challenging. Whilst the exercise might feel like an effort, it shouldn’t cause significant pain - it is important to always work at a level that is right for you. Over time, you will find exercises becoming easier and be able to work through a variety of levels as you progress.

Pilates or yoga?

Both are great forms of movement and complement each other well, so there is no need to choose one or the other. Joseph Pilates actually took inspiration for his work from yoga, martial arts and other traditional forms of exercise so they share many similarities.

Pilates can be a useful starting point for learning core engagement and movement control that will support both activities, but yoga is also beneficial for improving these areas as long as the practice you are doing feels comfortable for you. Research has shown that yoga and Pilates support people to build a healthier lifestyle, having both physical and psychological benefits. Both activities are suitable for anyone at any age or level and it is never too late to start.

Getting started

If you are interested in starting Pilates, it is always best to start with in-person classes, either as a group or one-to-one, so that the instructor can support you with technique and give different options if an exercise feels uncomfortable. However, if a class wouldn’t fit into your routine or the thought is a bit overwhelming, there are loads of great online classes – live or pre-recorded – that make it a very accessible form of exercise.

You can incorporate equipment into your practice, but it is certainly not essential, meaning you can also do it from anywhere. Lower back pain that has been present for six months or longer is seen to improve over around three months of doing Pilates for one hour twice a week. However, you do not have to initially commit to an hour-long session, even taking 10-15 minutes a few times a week can begin to make a difference and the time can be built up gradually.

Exercises to try:

If you have lower back pain and have been considering Pilates, then these exercises will be a good introduction and hopefully the beginning of your Pilates journey.

Arm openings

Begin lying on one side with your knees bent and your arms out straight in front of your face.
Lift the top arm in a rainbow shape up and overhead and take it as far behind you as you can comfortably reach, allowing your chest and upper body to rotate with the arm so you feel a stretch.
Hold this position for around 10 seconds before returning the arm back to the start position.
Repeat 2-4 times on each side.

One leg stretch

Begin lying on your back with your knees bent so your feet are flat on the ground.
Exhale and slowly slide your right foot away until your right leg is straight on the ground and at the same time take your arms overhead.
Ensure your core remains active so that your back doesn’t arch as you do this – you should remain still through your body.
With control, inhale and slide the right foot back into the starting position whilst circling the arms around and back to your sides.
Repeat 8-10 times on each side.

Hundreds

Begin lying on your back with your head on a small pillow, arms by your side, and your knees bent so your feet are flat on the ground.
Engage your core muscles so that your ribs are flat on the ground and there is a slight natural curve at your lower back.
Maintain this body position as you float your arms off the ground a few inches and pulse them in this hovered position.
Inhale for five pulses, then exhale for five pulses.
The aim is to do 100 reps but start with as many as you can and build it up with practice.

Hip twist

Begin lying on your back with your knees bent so your feet are flat on the ground, arms by your side.
As you exhale, let your right knee rotate towards the ground.
Pause with the knee out as you inhale, then exhale again to bring the knee back to the middle.
Feel your core muscles engage as you do this – your body should aim to stay still whilst the leg rotates.
Repeat 8-10 times and then switch to the other side.

Bridge

Begin lying on your back with your knees bent so your feet are flat on the ground, arms by your side.
Exhale to tilt your hips back and flatten your lower back into the ground.
Then slowly lift your hips off the floor by squeezing your buttocks, then continue to lift your whole back off the floor working from hips to shoulders.
You are aiming to create a straight line from your shoulder to your knee but lift as high as feels comfortable to start with. Inhale and lower back down with control, from shoulders to hips.
Repeat 8-10 times.