Does Pilates Cause Or Treat Back Pain?

Barbara Hughes cutting a back flip with beach ball (black ballet fashion) - Saint Petersburg Beach, Florida
Photo: State Archives of Florida

Yes, Pilates can cause back pain. And yes, it can treat back pain.

Pilates and Core Strengthening
Pilates has many great benefits, including core strengthening. Core strengthening is beneficial, as it incorporates deep muscles of the abdominals and back that often are weak, especially among individuals with back pain. Having a strong core is one piece of preventing back pain, but other components include postures, body mechanics and proper treatment of present back pain.
Pilates vs. Physical Therapy
Pilates and core strengthening alone will likely not eliminate present back pain. It may play a role in preventing future episodes of back pain, but alone it is not the solution to low back or mid-back pain. If Pilates could treat back pain, I would not have a job as a Physical Therapist. Clearly, there is more to your back pain than weak core muscles, so proper treatment/prevention is urgent. If your back pain comes and goes, get it treated now, and you can learn why it happens and how to decrease the pain and prevent future episodes.  
Pilates Exercises to Avoid
There are some Pilates exercises that can actually produce or aggravate back problems, and these should generally be avoided. Any Pilates exercise that puts your back into a forward-bent (AKA flexed or rounded) position is not ideal for most individuals and can be harmful if you have back problems. Which forward-bending exercises are safe? Cat/camel (on your hands and knees and you arch your back up and down) and abdominal crunches are fairly safe for most people. 
Preferred Pilates Exercises
The Pilates exercises that bend your spine backwards (AKA extended, as in the photo above) are safe and highly recommended for most healthy people. This includes positions such as lying face-down and pressing up onto your hands or lying on your back and lifting your hips. Likely there are many extension exercises incorporated into your Pilates class, so these are generally beneficial and less likely to be harmful.
If either direction of spine movement aggravates your back pain, stop Pilates workouts, and get medical attention.

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I am a Physical Therapist and Ergonomics Consultant, based out of Columbia, SC. My passion is to write about and speak about pain/injury prevention. I started Pain Talks as a consulting business in 2018.

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