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Does Pilates help back pain? Reviews say it eases pain, but not clearly more than other exercise

Several reviews of randomised trials find Pilates eases chronic low back pain more than little or no treatment. It has not clearly beaten other exercise.

Published October 2026

Short answer

Pilates eases chronic low back pain more than minimal care. It has not clearly beaten other exercise, and the evidence is low to moderate quality. Evidence grade B (Moderate). Several meta-analyses and a network meta-analysis of randomised trials; downgraded for risk of bias, since the Cochrane review found no high-quality evidence.

Key takeaways

  • Across 10 trials with 510 people, Pilates reduced back pain more than minimal treatment [1].
  • In a network meta-analysis of 217 trials, Pilates was among the exercises with moderate to clinically important pain relief compared with minimal treatment [2].
  • Compared with other exercise, the reviews find no clear winner, so the best choice is often the one you will keep doing [1][3][2].
  • Limited evidence suggests Pilates may also ease back pain in pregnancy [4].

The short version

Yes, for chronic low back pain. Pilates eases pain more than little or no treatment, according to several reviews of randomised trials [1][2]. It has not clearly beaten other types of exercise, and the reviews rate much of the evidence as low to moderate quality [1][3].

What the studies show

A Cochrane review of 10 trials with 510 people found Pilates reduced pain more than minimal care. In the short term, pain scores were about 14 points lower on a 0 to 100 scale [1]. A larger network meta-analysis of 217 trials, with about 21,000 people, placed Pilates among the exercise types with moderate to clinically important pain relief compared with minimal treatment [2]. A 2024 meta-analysis of 36 studies also reported less back pain with Pilates than with no exercise [5].

Compared with other exercise, the picture is less clear. The Cochrane review found no significant difference in disability between Pilates and other exercise [1]. A 2023 review found Pilates better than general exercise for pain, though with low certainty of evidence, and no strong evidence to prefer one type of exercise over another [3]. A 2022 network meta-analysis ranked Pilates highest for pain and disability, while noting that most types of exercise helped [6].

For back pain in pregnancy, two small trials with 65 women found Pilates reduced pain more than no exercise [4].

The nuances

The trials vary in how Pilates was taught and how long it lasted. The 2022 network meta-analysis suggested programmes of 3 to 9 weeks with one or two sessions a week [6]. Programmes also differ in whether a certified instructor supervises them, a factor one review examined [7].

Few trials recorded side effects. In the Cochrane review, two trials reported on this: one found none and another reported minor events [1]. The pregnancy trials reported no adverse effects, but they were small [4]. The abstracts we read do not cover medicine interactions; the Pilates topic page explains what is and is not known.

For older adults, the evidence on falls is mixed. A 2021 meta-analysis of 39 trials linked Pilates to a large reduction in falls risk, with moderate certainty [7]. A 2024 review of 39 studies with 1,770 people found better balance but no clear reduction in the number of falls or fear of falling [8].

What this means for you

If you have chronic low back pain, Pilates is one of several exercise options with reasonable evidence behind it. The reviews do not show that it is clearly better than other kinds of exercise, so the 2021 network meta-analysis authors suggest choosing a programme you will keep doing [2]. Talk with a doctor or physiotherapist first if your pain is new, severe or linked to a spinal condition.

Go deeper

  • Pilates — Pilates eases chronic low back pain more than minimal treatment, according to several reviews of randomised trials.

References

  1. Pilates for low back pain.. Cochrane Database Syst Rev, 2015.
  2. Some types of exercise are more effective than others in people with chronic low back pain: a network meta-analysis.. J Physiother, 2021.
  3. The effects of Pilates exercise in comparison to other forms of exercise on pain and disability in individuals with chronic non-specific low back pain: A systematic review with meta-analysis.. Musculoskeletal Care, 2023.
  4. Effect of the pilates method on pain and quality of life in pregnancy: A systematic review and meta-analysis.. J Bodyw Mov Ther, 2023.
  5. Effectiveness of Pilates exercise on low back pain: a systematic review with meta-analysis.. Disabil Rehabil, 2024.
  6. Best Exercise Options for Reducing Pain and Disability in Adults With Chronic Low Back Pain: Pilates, Strength, Core-Based, and Mind-Body. A Network Meta-analysis.. J Orthop Sports Phys Ther, 2022.
  7. Pilates improves physical performance and decreases risk of falls in older adults: a systematic review and meta-analysis.. Physiotherapy, 2021.
  8. Effects of Pilates exercises on postural balance and reduced risk of falls in older adults: A systematic review and meta-analysis.. Complement Ther Clin Pract, 2024.