Health

Pilates for back and neck pain: what does the research say?

By: Studio 4 PilatesPublished: 2 November 20264 min read

One of the things we hear most often at the studio is: "I work at a desk and my back and neck get stiff." If you're wondering whether pilates is a good option for this, the short answer is: for many people it's a sensible place to start, but it's not a miracle. In this article we explain what the research actually says, without exaggerating.

What does the research say about low back pain?

One of the most comprehensive studies on this topic is a Cochrane review published in 2015. The researchers pooled 10 controlled trials involving 478 adults with chronic low back pain. The results can be roughly summarised under two headings:

In the review, side effects were rare and mostly mild muscle soreness. Because none of the studies looked beyond 12 months, nothing definite can be said about very long-term effects.

The UK's national health guideline, NICE, also puts exercise at the centre of treatment for low back pain and recommends considering group exercise suited to the person's needs. The guideline does not rank any specific type of exercise above another; pilates can be considered one of these options.

The common message of the research: instead of staying inactive, do regular exercise suited to your level.

What about neck pain?

There are few studies on pilates for neck pain. A systematic review published in 2017 found only two eligible studies; in these, pain and limitation decreased from around the sixth session onwards. The result is positive, but the evidence base is small, so caution is needed.

In practice, many people with neck tension say they benefit from breath-supported movements that work the muscles around the upper back and shoulder blades. These experiences are valuable, but they are no substitute for scientific evidence.

Why might pilates help the back and neck?

Pilates has a few features that explain its possible benefit for these areas:

• It strengthens the core: The muscles around the abdomen, back and hips work like a belt that supports the spine.
• It is slow and controlled: Instead of sudden, jerky movements, you do slow, controlled ones and can progress by listening to your body.
• It builds postural awareness: You start to notice how you sit and hold your shoulders during the day.
• It works with the breath: Focusing on the breath may help reduce tension that builds up, especially in the neck and shoulders.
• It is adaptable: The reformer's springs can be set to support a movement as well as to make it harder, which makes moving easier during painful periods.

What to keep in mind before you start

• Share any diagnosis: If you have a lumbar or cervical disc herniation, scoliosis or have had surgery, be sure to tell your instructor. If necessary, bring your doctor's recommendations as well.
• Close supervision instead of a crowded class: For someone in pain, doing a movement correctly matters as much as the movement itself. That's why private or very small group classes are a safer start.
• Don't push through pain: Mild muscle fatigue is normal; if you feel sharp, stabbing pain or pain that spreads into your leg, stop the movement and tell your instructor.
• Be patient: The programmes in the studies usually consist of regular classes over several weeks. A single class isn't enough to expect a big change.

When should you see a doctor?

See a doctor before exercising if any of the following apply:

• Pain that started after a fall or accident
• Numbness, tingling or weakness in the legs or arms
• Changes in bladder or bowel control
• Fever, unexplained weight loss or pain at night that doesn't ease with rest
• Pain that doesn't go away within a few weeks or keeps getting worse

How we work at Studio 4 Pilates

With students who come to us with back or neck pain, we make the first class an introductory one: we talk about which movements you find difficult, how you sit during the day and your doctor's recommendations. Then we build the programme around you. Because our classes have no more than 3 people, our instructor can follow every movement closely. For someone in pain we usually recommend starting with private classes; once the movements feel natural you can move on to duo or trio classes.

Frequently asked

Sources

• Yamato TP et al. Pilates for low back pain. Cochrane Database of Systematic Reviews, 2015 (AAFP summary)
• NICE. Low back pain and sciatica in over 16s: assessment and management (NG59)
• Cemin NF, Schmit EFD, Candotti CT. Effects of the Pilates method on neck pain: a systematic review. Fisioterapia em Movimento, 2017