EFFECTIVENESS OF PILATES IN THE MANAGEMENT OF CHRONIC NON-SPECIFIC LOW BACK PAIN: A NARRATIVE LITERATURE REVIEW
DOI:
https://doi.org/10.31435/ijitss.4(52).2026.6599Keywords:
Pilates, Chronic Non-specific Low Back Pain, Exercise Therapy, Rehabilitation, Pain, Functional DisabilityAbstract
This narrative review aimed to evaluate the effectiveness of Pilates in reducing pain and functional disability in adults with chronic non-specific low back pain, with additional consideration of quality of life, psychological outcomes, comparisons with other exercise modalities, and factors influencing treatment effectiveness. A literature search was conducted between May and June 2026 using PubMed, Scopus, and Embase, and reference lists of relevant systematic reviews and meta-analyses were also screened. Randomized controlled trials, prospective clinical studies, systematic reviews, meta-analyses, network meta-analyses, clinical practice guidelines, and state-of-the-art reviews were considered, with 24 publications included in the final narrative synthesis. Current evidence indicates that Pilates reduces pain intensity and functional disability and may improve health-related quality of life and selected psychological outcomes, including fear of movement and sleep-related measures. Pilates generally provides greater benefits than no intervention, minimal intervention, or non-specific exercise; however, its superiority over other structured exercise programmes is not consistently demonstrated. Treatment outcomes appear to be influenced by exercise dose, supervision, individualization, programme quality, and adherence, while heterogeneity in intervention protocols, participant characteristics, outcome measures, and follow-up duration limits direct comparisons across studies. Overall, Pilates represents an effective evidence-based exercise option for chronic non-specific low back pain and may be incorporated into individualized rehabilitation according to patients’ functional limitations, preferences, and therapeutic goals. Further high-quality randomized controlled trials with standardized protocols and longer follow-up periods are needed.
References
GBD 2021 Low Back Pain Collaborators (2023). Global, regional, and national burden of low back pain, 1990-2020, its attributable risk factors, and projections to 2050: A systematic analysis of the Global Burden of Disease Study 2021. The Lancet. Rheumatology, 5(6), e316–e329. https://doi.org/10.1016/S2665-9913(23)00098-X
Briggs, A. M., Sumi, Y., & Banerjee, A. (2025). The World Health Organization guideline for non-surgical management of chronic primary low back pain in adults: Implications for equitable care and strengthening health systems globally. Global Health Research and Policy, 10(1), 26. https://doi.org/10.1186/s41256-025-00426-w
Wells, C., Kolt, G. S., & Bialocerkowski, A. (2012). Defining Pilates exercise: A systematic review. Complementary Therapies in Medicine, 20(4), 253–262. https://doi.org/10.1016/j.ctim.2012.02.005
Tian, Q., Li, D., Xiong, H., Zhu, T., Li, X., & Huang, W. (2026). Comparative efficacy of different mind-body exercise modalities in low back pain: Systematic review and network meta-analysis. Complementary Therapies in Medicine, 96, 103309. https://doi.org/10.1016/j.ctim.2025.103309
Liang, Z., Tian, S., Wang, C., Zhang, M., Guo, H., Yu, Y., & Wang, X. (2024). The best exercise modality and dose for reducing pain in adults with low back pain: A systematic review with model-based Bayesian network meta-analysis. The Journal of Orthopaedic and Sports Physical Therapy, 54(5), 315–327. https://doi.org/10.2519/jospt.2024.12153
Gilliam, J. R., George, S. Z., Norman, K. S., Hendren, S., Sahu, P. K., & Silfies, S. P. (2023). Mind-body exercise performed by physical therapists for reducing pain and disability in low back pain: A systematic review with meta-analysis. Archives of Physical Medicine and Rehabilitation, 104(5), 776–789. https://doi.org/10.1016/j.apmr.2022.10.004
Patti, A., Thornton, J. S., Giustino, V., Drid, P., Paoli, A., Schulz, J. M., Palma, A., & Bianco, A. (2024). Effectiveness of Pilates exercise on low back pain: A systematic review with meta-analysis. Disability and Rehabilitation, 46(16), 3535–3548. https://doi.org/10.1080/09638288.2023.2251404
Wong, C. M., Rugg, B., & Geere, J. A. (2023). 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, 21(1), 78–96. https://doi.org/10.1002/msc.1667
Owen, P. J., Miller, C. T., Mundell, N. L., Verswijveren, S. J. J. M., Tagliaferri, S. D., Brisby, H., Bowe, S. J., & Belavy, D. L. (2020). Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis. British Journal of Sports Medicine, 54(21), 1279–1287. https://doi.org/10.1136/bjsports-2019-100886
Tottoli, C. R., Ben, Â. J., da Silva, E. N., Bosmans, J. E., van Tulder, M., & Carregaro, R. L. (2024). Effectiveness of Pilates compared with home-based exercises in individuals with chronic non-specific low back pain: Randomised controlled trial. Clinical Rehabilitation, 38(11), 1495–1505. https://doi.org/10.1177/02692155241277041
Kwok, B. C., Lim, J. X. L., Wong, J. K. H., Tan, J. J. R., Kumar, K., Smith, H. E., & Kong, P. W. (2026). DMA Clinical PilatesTM exercises improved clinical and biomechanical outcomes for adults with nonspecific chronic low back pain: A randomized controlled trial. Disability and Rehabilitation, 48(5), 1436–1449. https://doi.org/10.1080/09638288.2025.2563762
Yu, Z., Yin, Y., Wang, J., Zhang, X., Cai, H., & Peng, F. (2023). Efficacy of Pilates on pain, functional disorders and quality of life in patients with chronic low back pain: A systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 20(4), 2850. https://doi.org/10.3390/ijerph20042850
Ha, D., Jung, J., & Lee, S. (2026). Improving muscle function and quality of life in women with chronic low back pain through combined self-myofascial release and Pilates: A randomized clinical trial (CONSORT). Medicine, 105(2), e46971. https://doi.org/10.1097/MD.0000000000046971
Şahan, N., Uluğ, N., & Özeren, A. (2025). Effects of reformer Pilates on pain, psychological factors, and sleep in chronic musculoskeletal pain: A randomized controlled trial. BMC Psychology, 13(1), 836. https://doi.org/10.1186/s40359-025-03207-9
Cruz-Díaz, D., Romeu, M., Velasco-González, C., Martínez-Amat, A., & Hita-Contreras, F. (2018). The effectiveness of 12 weeks of Pilates intervention on disability, pain and kinesiophobia in patients with chronic low back pain: A randomized controlled trial. Clinical Rehabilitation, 32(9), 1249–1257. https://doi.org/10.1177/0269215518768393
Eliks, M., Zgorzalewicz-Stachowiak, M., & Zeńczak-Praga, K. (2019). Application of Pilates-based exercises in the treatment of chronic non-specific low back pain: State of the art. Postgraduate Medical Journal, 95(1119), 41–45. https://doi.org/10.1136/postgradmedj-2018-135920
George, S. Z., Fritz, J. M., Silfies, S. P., Schneider, M. J., Beneciuk, J. M., Lentz, T. A., Gilliam, J. R., Hendren, S., & Norman, K. S. (2021). Interventions for the management of acute and chronic low back pain: Revision 2021. The Journal of orthopaedic and sports physical therapy, 51(11), CPG1–CPG60. https://doi.org/10.2519/jospt.2021.0304
Miyamoto, G. C., Franco, K. F. M., van Dongen, J. M., Franco, Y. R. D. S., de Oliveira, N. T. B., Amaral, D. D. V., Branco, A. N. C., da Silva, M. L., van Tulder, M. W., & Cabral, C. M. N. (2018). Different doses of Pilates-based exercise therapy for chronic low back pain: A randomised controlled trial with economic evaluation. British Journal of Sports Medicine, 52(13), 859–868. https://doi.org/10.1136/bjsports-2017-098825
Lunkes, L. C., Dias Neto, M. A., Barra, L. F., de Castro, L. R., de Sá Ferreira, A., & Meziat-Filho, N. (2026). Keeping the abdomen relaxed versus contracted during Pilates improves disability slightly and may improve other outcomes in chronic non-specific low back pain: A randomised trial. Journal of Physiotherapy, 72(2), 116–121. https://doi.org/10.1016/j.jphys.2026.03.007
Zygouna, L., Lytras, D., Kasimis, K., Chatziprodromidou, I. P., Apostolou, T., & Iakovidis, P. (2025). Comparison of the effectiveness of home-based video-supported McKenzie versus Pilates exercise programs in patients with chronic non-specific low back pain: A randomized controlled trial. Journal of Bodywork and Movement Therapies, 45, 598–605. https://doi.org/10.1016/j.jbmt.2025.09.044
Asik, H. K., & Sahbaz, T. (2025). Preventing chronic low back pain: Investigating the role of Pilates in subacute management-a randomized controlled trial. Irish Journal of Medical Science, 194(3), 949–956. https://doi.org/10.1007/s11845-025-03939-y
Coelho, A. C. S., Dourado, J. F., & Lima, P. O. P. (2025). High-intensity and low-intensity Pilates have similar effects on pain and disability in people with chronic non-specific low back pain: A randomised trial. Journal of Physiotherapy, 71(2), 100–107. https://doi.org/10.1016/j.jphys.2025.03.002
Ulusoy, M., & Iyigun, G. (2025). Comparison of proprioceptive neuromuscular facilitation and Pilates exercises in patients with chronic low back pain: A randomized study. Journal of Bodywork and Movement Therapies, 42, 463–470. https://doi.org/10.1016/j.jbmt.2025.01.018
Amaral, D. D. V., Miyamoto, G. C., Franco, K. F. M., Dos Santos Franco, Y. R., Bastos De Oliveira, N. T., Hancock, M. J., Van Tulder, M. W., & Nunes Cabral, C. M. (2020). Examination of a subgroup of patients with chronic low back pain likely to benefit more from Pilates-based exercises compared to an educational booklet. The Journal of Orthopaedic and Sports Physical Therapy, 50(4), 189–197. https://doi.org/10.2519/jospt.2019.8839
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Marta Żółtowska, Paulina Jasak, Aleksandra Wesołowska, Hanna Mruzek, Barbara Głowacka, Sandra Owczarek, Aleksandra Sobótka
This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.
