Can I Do Pilates If I Have Back Pain?
Whether I am leading Pilates classes or teacher trainings, the most common injury my students and clients deal with is low back pain. Low back pain refers to discomfort anywhere between the ribcage and the pelvis. It can feel sharp, achy, or stiff and may last for a few days or become a chronic issue.
According to the National Center for Biotechnology Information (NCBI), about 26% of adults in the United States experience low back pain at any given time.
Some people develop back pain from spinal conditions such as degenerative disc disease, herniated discs, spinal stenosis, or osteoarthritis. Others experience it during pregnancy, with menstrual cramps, from muscle strain or tight muscles, emotional stress, poor posture or sitting too much.
How Pilates Can Help with Low Back Pain
Since Pilates focuses on core strength, posture, and controlled movement, it strengthens your deep stabilizing muscles, creating balanced alignment, and releasing tension without high impact exercises, making it a great option for those with low back pain.
When the core (your abdomen, hips, and back muscles) gets stronger, pressure is naturally relieved from your low back and it will feel more supported. Pilates also improves posture, keeping your spine in a healthy position, which helps prevent pain, and it increases flexibility through stretching and gentle movements that can loosen tight muscles pulling on the spine.
Over time, Pilates movements can reduce discomfort, improve mobility, and give you more confidence in daily movement like walking, sitting, or bending. Practicing Pilates regularly will teach you how to move safely and make you more aware of how your body feels.
Simple Tips for Getting Started
When working with low back pain, the goal is to move safely and consistently rather than push for big results right away. I always tell my clients to:
Check with a healthcare provider before starting any exercise routine to rule out red flags and receive clearance.
Move mindfully and stay within a comfortable range of motion.
Communicate with your instructor so exercises can be modified to fit your needs.
Progress gradually by focusing on stability before adding more challenging movements.
When communicating with a Pilates instructor about your back pain, keep in mind that they want to understand your unique situation before you begin movement. A few questions I always ask those who are dealing with low back pain are:
When did the pain begin, and what makes it better or worse?
Is the discomfort sharp, dull, or constant?
Have you noticed if certain positions (like sitting or standing) change how it feels?
Are you currently working with a healthcare provider or Physical Therapist?
How does your back feel after rest or gentle movement?
These questions help me design a session that meets clients where they are—focusing on safe, supportive movement rather than one-size-fits-all exercises.
Movements to Try at Home
While it’s important to maintain safe movement when dealing with any sort of pain, there are four simple Pilates exercises that you can do in the comfort of your own home to help support your spine! Check out my step-by-step instructions for each and try them out today:
1. Pelvic Tilts
Lie on your back with your knees bent and feet flat on the floor, arms by your side.
Inhale to press through the arms.
As you exhale, gently tilt your pelvis toward your nose and feel your lower back pressing lightly into the mat. Inhale through the center and exhale tilting your pelvis toward your ankles.
Inhale to return to neutral.
Repeat 8–10 times, focusing on smooth, controlled movement.
2. Cat-Cow Stretch
Start on your hands and knees with your hands under your shoulders and knees underneath your hips.
Inhale to press through your palms, arching your back and opening your chest (Cow).
Exhale to round your spine and gently draw your belly in (Cat).
Move slowly between the two shapes, matching movement to breath for 5–10 rounds.
*If spinal flexion is contraindicated, skip the Cat portion and focus on gentle spinal extension, lengthening through the spine and opening the chest.
3. Seated Spine Twist
Sit tall on the floor with your legs extended hip distance apart. (You can also sit in a chair for this one!)
Open your arms out to the sides in a “T” position.
Inhale to lengthen your spine.
Exhale as you gently rotate your torso to one side, keeping your hips steady.
Inhale back to center, then exhale to twist the other way.
Repeat 3–4 times each direction.
4. Bird Dog
Begin on your hands and knees with hands under your shoulders and knees underneath your hips.
Inhale and extend your right arm forward and left leg back, keeping your hips and shoulders square.
Exhale to lower and switch sides.
Repeat 5–8 times each side to strengthen your deep core and back stabilizers.
These gentle movements can help relieve tension, improve mobility, and reconnect you to your core—the foundation of a healthy back! I even include some of these same exercises in my FREE guide: 4 Feel-Good Postnatal Moves, because they’re safe, restorative, and effective for rebuilding strength from the inside out (even if you’re not postnatal!).
How Often Should You Do Pilates for Low Back Pain?
Consistency matters more than intensity. For most of my clients, practicing Pilates two to three times per week is enough for them to start noticing less stiffness, better posture, and improved core strength.
Don’t feel pressured to dedicate a full 50 minutes each time you practice—even shorter sessions of 20–30 minutes can be beneficial when done regularly! And on days when you’re short on time (because we all have those days), just five minutes can make a difference.
When all you have is a few minutes to squeeze in some movement, try a few of the exercises I shared earlier to gently wake up your core and release tension through your back. The goal is about building awareness and strength over time so your body feels more supported in daily movement.
When to Pause Pilates
While Pilates is adaptable for many back issues, there are times when it’s better to pause your practice. Take a break from Pilates if pain is acute or worsening, if you’ve recently had surgery and haven’t received medical clearance yet, or if your healthcare provider has advised against exercise. Taking time to heal first ensures you can return to movement safely and with confidence.
The Bottom Line
Pilates is a gentle and effective way to strengthen your body and support your spine. With regular practice, many people find that their back pain decreases, their posture improves, and they move through life feeling stronger and more balanced.
If you’re ready to start moving with less pain and more confidence, explore a private movement session with me! Together, we’ll create a plan that supports your body and helps you feel your best.
With love,
Lia