In 2020, 619 million people lived with lower back pain worldwide, the leading cause of years lived with disability. Among the exercises proposed to relieve it, Pilates often tops comparisons: in the Cochrane review dedicated to it, it reduced pain by 14 points on a 100-point scale on average in the short term, compared to minimal intervention, in people suffering from chronic lower back pain.
This guide brings together what studies identified via PubMed show: the magnitude of the effect, the number of useful sessions, mat or equipment, exercises suited to the back, warning signs, then what provides relief as a complement and the role of medical treatments. An 8-week program concludes the article.
Pilates and Lower Back Pain : the Cochrane review finds a moderate effect on pain versus minimal intervention, based on low to moderate quality evidence, with no demonstrated superiority over other exercises. Network meta-analyses nonetheless rank it first for pain, with low-quality evidence in the analysis of 89 trials. Two sessions per week performed better than one in a trial of 296 patients.
As a Complement : heat provides some short-term relief, massage perhaps as well (low to very low quality evidence), and harpagophytum extracts dosed in harpagoside performed better than placebo in two trials, based on low-quality evidence. Acetaminophen does not relieve lower back pain, and after the episode, a walking program delayed recurrence in a trial of 701 people.
- Common Lower Back Pain: What Are We Talking About?
- Pilates and Back Pain: What the Cochrane Review Says
- Pilates Versus Other Exercises
- Why Pilates Relieves Back Pain
- How Many Sessions, and for How Long?
- On the Floor or on a Reformer, in Class or at Home
- Pilates Exercises for the Back
- Acute Episode: Move Without Straining, Identify Warning Signs
- Neck Pain, Sciatica, Scoliosis and Posture
- Heat, Massage, Harpagophytum: What Provides Additional Relief
- Medications, physical therapy, injections, surgery
- The 8-week Pilates program for back pain
- Frequently asked questions
Common low back pain: what are we talking about?
Low back pain is pain located between the bottom of the ribs and the gluteal fold, with or without pain in the leg; it becomes chronic beyond 12 weeks. According to the Global Burden of Disease study, it affected 619 million people in 2020, and could affect 843 million by 2050. In up to 90% of chronic low back pain cases, no specific cause is identified: it's called common, or non-specific, low back pain, the type studied in Pilates trials.
Imaging rarely helps to decide. A review of 33 studies (3,110 people without back pain) found disc degeneration in 37% of 20-year-olds and 96% of 80-year-olds: according to the authors, many of these findings likely represent normal aging. A synthesis of 15 guidelines reserves imaging for suspicions of serious causes.
The prognosis is often favorable. According to a meta-analysis of 33 cohorts (11,166 participants), pain from acute low back pain drops on average from 52 out of 100 to 23 in six weeks, then to 6 at one year. When it persists, improvement is slower: from 51 to 33 in six weeks, then 23 at one year. It is in this persistent low back pain that Pilates has been evaluated.
Pilates and back pain: what the Cochrane review says
Pilates is an exercise method based on principles such as centering, concentration, control, precision, fluidity, and breathing. It is performed on the floor or on equipment such as the reformer, and several trials use a version adapted for back pain, conducted by physical therapists.
The Cochrane review on Pilates included 10 randomized trials, totaling 510 participants suffering from chronic low back pain. These trials were small, ranging from 17 to 87 participants, with programs lasting 10 to 90 days and follow-up of at most six months.
Compared to minimal intervention, Pilates reduced pain by 14.05 points out of 100 in the short term, an effect considered moderate, based on low quality evidence, and by 10.54 points in the medium term, beyond three months (up to six months), based on moderate quality evidence. Compared to other exercises, no significant difference appeared in disability, and no conclusive evidence shows that Pilates is superior to other forms of exercise: the choice can be based on patient preferences and cost.
Yamato TP, Maher CG, Saragiotto BT, et al. Cochrane Database Syst Rev 2015;2015(7):CD010265. DOI: 10.1002/14651858.CD010265.pub2
The Cochrane review on exercise in general (249 trials) considers a reduction of 15 points out of 100 in pain to be clinically important: Pilates approaches this in the short term, without reaching it on average. It concludes that exercise probably reduces pain by 15.2 points compared to no treatment, usual care, or placebo (moderate certainty).
Regarding tolerability, only two Pilates trials investigated adverse effects: none in one, minor effects in the other. For exercise in general, these are mainly muscle soreness: our guide on muscle soreness helps with better recovery.
Pilates compared to other exercises
A network meta-analysis combines direct and indirect comparisons to rank all exercises against each other, even when they have never been directly compared in the same trial. Three major analyses of this type rank Pilates first, or among the top, for pain.
| Analysis | Result for Pilates | Key takeaways |
|---|---|---|
| Cochrane Review, 10 trials | −14 points of pain reduction on a 100-point scale compared to minimal intervention | No demonstrated superiority over other exercises |
| Network, 89 trials, 5,578 patients | First for pain, effect size of 1.86 | Low quality of evidence |
| Network, 217 trials, 20,969 participants | −15 to −19 points on a 100-point scale compared to minimal treatment, range common to the three top-ranked exercises | Alongside McKenzie method and functional restoration |
| Network, 118 trials, 9,710 participants | Best ranking: 93% for pain, 98% for disability | Ahead of mind-body approaches, strengthening, and trunk exercises |
In the analysis of 89 trials, strengthening and stabilization ranked first for physical function, but only 7 out of 89 trials presented low risk of bias. Rankings also diverge: the McKenzie method, among the most effective in 217 trials, shows no distinction from no intervention in 89 trials. The authors of the 217-trial analysis therefore recommend practicing the exercise you enjoy, to maintain it over time.
An effect size relates the difference between two groups to the dispersion of measurements: by convention, 0.2 corresponds to a small effect, 0.5 to a medium effect, and 0.8 to a large effect. Pilates values above 1 are therefore large, but derived from often small trials at risk of bias.
What about yoga? Its Cochrane review (21 trials, 2,223 participants) found compared to no exercise a pain reduction of 4.5 points on a 100-point scale at three months, too small to be clinically important, and probably no difference with other back exercises on function. Its authors suggest choosing based on preferences, availability, and cost.
Why Pilates relieves back pain
Pilates engages the deep trunk muscles, such as the transverse abdominis. In a trial of 98 patients, 12 weeks of mat or equipment-based Pilates improved activation of this muscle, measured by ultrasound, as well as pain, disability, and fear of movement, with faster progress on equipment.
The benefit also works through the mind. In a Brazilian trial comparing one, two, or three weekly Pilates sessions to an advice booklet, mediation analysis (255 patients) shows that, depending on the mediator and criterion, 21% to 55% of Pilates' effect on pain and function was mediated by the reduction in kinesiophobia, the fear that movement will damage the back, or catastrophizing, the tendency to imagine the worst. According to the trial authors, part of the effect could also be attributed to the attention received and expectation of benefit.
How many sessions, and for how long?
This trial, conducted in São Paulo, divided 296 patients into four groups: an advice booklet alone, or the same advice plus one, two, or three Pilates sessions per week for 6 weeks. All frequencies outperformed the booklet, but two sessions performed significantly better than one, and three did not outperform two on pain and disability.
Compared to the booklet alone, pain decreased by 1.2 points with one Pilates session per week, 2.3 points with two sessions, and 2.1 points with three, on a 0-10 scale; disability decreased by 1.9, 4.7, and 3.3 points. Two sessions performed significantly better than one, and three sessions were the preferred option based on cost-utility analysis.
Miyamoto GC, Franco KFM, van Dongen JM, et al. Br J Sports Med 2018;52(13):859-868. DOI: 10.1136/bjsports-2017-098825
Duration also matters. In another Brazilian trial, 12 sessions over 6 weeks reduced pain by 2.2 points and disability by 2.7 points more than the booklet alone at the end of the program, a difference that was no longer significant six months after enrollment; however, the Cochrane review found a medium-term effect, up to six months, in two trials. It is therefore better to maintain the practice.
The network meta-analysis of 118 trials confirms these benchmarks: the most favorable programs included at least one to two sessions per week of Pilates or strengthening, and lasted 3 to 9 weeks for Pilates and core exercises.
On the mat or on a reformer, in a class or at home
Pilates on equipment, with the reformer leading the way, uses springs that either assist or resist movement. In a Brazilian trial of 86 patients, 12 sessions over 6 weeks on the mat or on equipment produced similar results at the end of the program; at six months, the equipment group had lower disability and less movement fear, with no difference in pain. A network meta-analysis of 45 trials, published in 2026, ranks Pilates on equipment first for disability with moderate confidence, and mat Pilates among favorable approaches with very weak confidence, without definitive hierarchy.
Compared to home exercises, Pilates at a center did not create a lasting gap in pain and disability: in a trial of 145 adults, two sessions per week of mat Pilates at a rehabilitation center performed slightly better at the end of the program, a difference deemed not clinically relevant and disappeared at six months, with only quality of life remaining better. A few supervised sessions allow you to learn proper form, then practice can continue at home on a non-slip mat like our NP Pilates Mat.
| Trial | Program | Result |
|---|---|---|
| Miyamoto, 2013, 86 patients | 12 sessions over 6 weeks, in addition to a booklet | Better than the booklet at the end of the program, difference not significant at 6 months |
| Miyamoto, 2018, 296 patients | 1, 2, or 3 sessions per week, 6 weeks | Two sessions better than one; three with no additional benefit |
| da Luz, 2014, 86 patients | 12 sessions over 6 weeks, on mat or equipment | Equipment better at 6 months for disability, not for pain |
| Cruz-Díaz, 2017, 98 patients | 12 weeks, on the ground or with equipment | Progress in both groups, faster with equipment |
| Tottoli, 2024, 145 patients | 2 sessions per week, 6 weeks, versus home exercises | Slight advantage on pain and disability, disappeared at 6 months; better quality of life |
Pilates exercises for the back
Here are basic floor Pilates movements, adapted for the back: practical advice inspired by rehabilitation programs, not study results. Move slowly, breathe, maintain control of your pelvis and stop any movement that triggers sharp pain.
| Exercise | How to do it | Target |
|---|---|---|
| Lateral breathing | On your back, knees bent, hands on your ribs: inhale as you expand them, exhale as you gently draw in your lower abdomen. | 5 to 10 breaths, neck relaxed |
| Pelvic tilt | Same position: on exhalation, gently roll your pelvis toward the ground, then return to neutral position. | 8 to 10 times, small range of motion |
| Mobilization on all fours | Hands under shoulders, knees under hips: round your back on exhalation, then extend it without arching beyond what feels comfortable. | 6 to 8 times, slow and fluid |
| Bridge | On your back, knees bent: lift your buttocks vertebra by vertebra until shoulders, hips and knees are aligned, then lower back down by rolling your spine. | 6 to 8 times, squeezing the glutes without arching |
| Alternating arm and leg extension | On all fours, extend one arm and the opposite leg without tilting your pelvis, hold for 3 to 5 seconds, switch sides. | 5 to 8 times per side, leg only to start |
| Simplified dead bug | On your back, knees bent at right angles above your hips: place one foot on the ground then the other, keeping your lower back stable. | 6 to 8 times per side, reduced range of motion if your back arches |
| Hip opening on the side | On your side, hips and knees bent, heels together: open the top knee without rolling your pelvis, then close it. | 10 to 12 times per side |
These exercises are performed on a non-slip surface: our NUTRITION•PRO Pilates Mat combines a microsuede covering, soft even during long sessions, with a non-slip rubber base that anchors each posture to the ground. Allow about thirty minutes to start, then gradually extend your session.
As a precaution, as long as pain is sharp, avoid full spinal rolls like the roll up, rolling on your back, forced stretching with legs straight, twisting movements with load, and any movement that sends pain down the leg. These are common-sense precautions, not restrictions from clinical trials; breathing and walking should resume as soon as possible.
Acute crisis: move without straining, identify warning signs
Cochrane review trials on Pilates all focused on chronic lower back pain: the method has not been evaluated during an acute crisis. In acute lower back pain, the Cochrane review on rest shows that the advice to stay active performs slightly better than bed rest for pain and function (two trials, 401 patients, effect sizes of 0.22 and 0.29); in the case of sciatica, no clear difference emerges.
The American College of Physicians then recommends superficial heat (moderate quality evidence), massage, acupuncture or spinal manipulation (low quality), and if needed an anti-inflammatory or muscle relaxant, while noting that most patients improve over time, regardless of treatment.
Serious causes are rare: in an Australian cohort of 1,172 patients seen in primary care for acute lower back pain, 11, or 0.9%, had one, most often a vertebral fracture, whereas 80.4% had at least one warning sign. A review of 14 studies identified the most informative warning signs.
Cauda equina : loss of sensation in the perineum and inner thighs, difficulty urinating, loss of urine or stool. These signs are more specific than sensitive, and their presence warrants prompt examination. Fracture : advanced age, prolonged corticosteroid use, significant trauma, back contusion or abrasion; the probability of fracture reached 90% when several of these signs were present. Cancer : a history of cancer is the most informative warning sign, with a probability of spinal cancer of 33%. As a precaution, also consult if you have fever, progressive weakness in one leg, or nighttime pain that does not resolve.
Neck pain, sciatica, scoliosis and posture
Neck pain. A meta-analysis of 8 studies (439 patients) found Pilates superior to control groups for chronic neck pain: approximately 1.5 points less pain at the end of treatment (very low certainty) and 2.5 points at follow-up (moderate certainty). Compared to other exercises, these performed slightly better just after treatment, by half a point (low certainty).
Sciatica and disc herniation. Evidence is limited: in a trial of 54 patients with lumbar disc herniation, 6 weeks of clinical Pilates, three times per week, reduced pain and disability more than in the control group. This is a preliminary signal: exercises are then performed with a physical therapist, stopping any movement that increases leg pain.
Scoliosis and posture. In children and adolescents, a meta-analysis of 18 studies found, with moderate certainty, better thoracic and lumbar alignment with Pilates than with no activity; for scoliosis, the Schroth method performed better than Pilates (very low certainty), and scoliosis should be monitored by a physician. In adults, evidence on alignment is very low to low certainty: varying your positions remains common sense advice.
Heat, massage, devil's claw: what provides additional relief
Heat. In the Cochrane review on heat and cold (9 trials, 1,117 participants), a heating belt reduced pain after 5 days compared to oral placebo in patients with acute or subacute crisis (two trials, 258 participants), and a heating pad reduced it by 32 points on a 100-point scale just after application (one trial, 90 participants). The authors conclude there is a weak and short-duration effect, and insufficient data for cold.
These trials tested heat applied by a belt or heating pad; a warming gel is another approach, not evaluated in these studies. Our Joint Gel, for external use, combines camphor and devil's claw, with a warming effect; it is not recommended for pregnant or nursing women.
Massage. Its Cochrane review (25 trials, 3,096 participants) found it superior to inactive controls in the short term for subacute or chronic lower back pain, with an effect size of 0.75 on pain, but not long-term, on low to very low quality evidence. In the meta-analysis of 89 trials, exercise performed better on pain than passive treatments delivered by a therapist, including massage.
Devil's claw. The Cochrane review on phytotherapy for lower back pain (14 trials, 2,050 participants) ranks devil's claw among plants that appear to reduce pain more than placebo: in two trials totaling 315 patients, standardized extracts providing 50 or 100 mg of harpagoside per day performed better than placebo in the short term, on low quality evidence.
In 197 patients experiencing a flare-up of chronic low back pain, 4 weeks of devil's claw extract providing 50 or 100 mg of harpagoside per day allowed 6 and 10 patients respectively to be pain-free and free of rescue analgesics for at least 5 days during the final week, compared to 3 under placebo, representing a minority of patients in each group. The only possible adverse effects were mild and infrequent digestive disorders.
Chrubasik S, Junck H, Breitschwerdt H, et al. Eur J Anaesthesiol 1999;16(2):118-129. DOI: 10.1046/j.1365-2346.1999.00435.x
These results concern standardized extracts. Our Organic Harpagophytum is a different preparation: organic root powder of Namibian origin, with four capsules providing 1,200 mg per day, in courses lasting one to three months. Since its harpagoside content is not indicated, its dosage cannot be compared to that of clinical trials. It is not recommended in cases of stomach or duodenal ulcers or gallstones. A review of 28 trials conducted with various harpagophytum preparations in osteoarthritis and low back pain reports minor adverse effects, mainly digestive, in approximately 3% of patients, never more frequent than placebo in double-blind trials; its authors call for more long-term data.
| Option | What studies show | Level of evidence |
|---|---|---|
| Heat, belt or blanket | Less pain in the short term during acute or subacute crisis | Moderate, few trials |
| Massage | Better than inactive control in the short term, not in the long term | Weak to very weak |
| Devil's claw, extracts at 50 or 100 mg of harpagoside | Better than placebo for pain in the short term | Weak |
| White willow, extracts at 120 or 240 mg of salicin | Probably better than placebo in the short term | Moderate |
| Chili pepper, cream or plaster | Probably better than placebo in chronic low back pain | Moderate |
Medications, physical therapy, injections, surgery
In chronic low back pain, the American College of Physicians recommends first non-pharmacological treatments: exercise, multidisciplinary rehabilitation, acupuncture and mindfulness (moderate-quality evidence), as well as tai chi, yoga, motor control exercises, cognitive-behavioral therapy or spinal manipulation (low quality). Medications come next: anti-inflammatory drugs, then tramadol or duloxetine, and opioids only after failure of other options. A synthesis of 15 recommendations advises referral to a specialist if no improvement after 4 weeks.
Medications. In a meta-analysis of placebo-controlled trials, the three trials conducted in low back pain (1,825 patients) show, based on high-quality evidence, that acetaminophen neither reduces pain nor disability in the short term, with a difference of 0.5 points on a 100-point scale in the largest trial. Anti-inflammatory drugs perform slightly better than placebo, by 3.3 points on 100 according to the Cochrane review, a weak effect based on low-quality evidence, and their long-term safety remains poorly established.
Physical therapy. Supervised exercise is its core component. A more recent approach, called cognitive functional therapy, works on both movement and the thoughts, emotions and behaviors that perpetuate pain.
In 492 adults with disabling chronic lower back pain, up to seven sessions of functional cognitive therapy over 12 weeks, with a booster session at 26 weeks, reduced activity limitation by 4.6 points out of 24 compared to usual care at 13 weeks, an effect maintained at 52 weeks, at a lower overall cost to society.
Kent P, Haines T, O'Sullivan P, et al. Lancet 2023;401(10391):1866-1877. DOI: 10.1016/S0140-6736(23)00441-5
Injections. In sciatica, the Cochrane review on epidural corticosteroid injections (25 trials, 2,470 participants) found a reduction in leg pain of 4.9 points out of 100 in the short term compared to placebo injection, a weak effect that may not be considered meaningful by patients and clinicians.
Surgery. It is discussed mainly for sciatica caused by persistent disc herniation. In a trial of 283 patients with severe sciatica lasting 6 to 12 weeks, early surgery relieved leg symptoms faster than prolonged conservative treatment, after which 39% underwent surgery; however, disability did not differ significantly at one year, and the probability of feeling recovered during the first year reached 95% in both groups.
The 8-week Pilates program for the back
This program follows the parameters of the trials: two sessions per week over 8 weeks, within the range of the most favorable Pilates programs. It is designed for common lower back pain without warning signs, ideally after medical or physical therapy consultation; durations and repetitions are practical guidelines.
After the episode, the goal becomes preventing recurrence, and walking has encouraging evidence here; our guide details how many steps to aim for each day.
In 701 adults who had just recovered from lower back pain, an individualized and progressive walking program, combined with education during six sessions with a physical therapist over six months, reduced the risk of activity-limiting recurrence, with a hazard ratio of 0.72; the median time to recurrence was 208 days, compared to 112 without the program. Adverse effects affecting the lower limbs were more frequent in the walking group.
Pocovi NC, Lin CC, French SD, et al. Lancet 2024;404(10448):134-144. DOI: 10.1016/S0140-6736(24)00755-4
Pilates : stop any exercise that triggers sharp pain or radiates down the leg, and seek professional advice in case of herniated disc, sciatica, osteoporosis, or recent back surgery. Harpagophytum : not recommended in case of stomach or duodenal ulcers and gallstones; consult your doctor or pharmacist if you are taking other treatments. Joint Gel : external use only, not recommended for pregnant or nursing women. Anti-inflammatory medications : under medical supervision, especially for long-term use.
Harpagophytum root, devil's claw, from organic farming and Namibian origin, in vegetable capsules. Four capsules per day provide 1,200 mg of root, and one bottle lasts one month, for treatments lasting one to three months.
View Organic HarpagophytumTo practice at home, discover our NP Pilates Mat, in microsuede on a non-slip rubber base.
Frequently Asked Questions
Is Pilates good for back pain?
For chronic lower back pain, yes: in the Cochrane review, it reduced pain by 14 points on a 100-point scale on average in the short term compared to minimal intervention, based on low to moderate quality evidence. Network meta-analyses rank it among the most effective exercises for pain, without clear superiority over other exercises.
Which Pilates exercises are good for the back?
To start: lateral breathing, pelvic tilt, four-point mobilization, bridge, alternating arm-leg extension, simplified dead bug, and side hip opening. These are practical tips: slowly, without sharp pain, ideally after a few guided sessions.
How many Pilates sessions per week to relieve back pain?
Two sessions per week is a good benchmark: in a trial of 296 patients, two sessions performed better than one on pain and disability, and three did not perform better than two. A network meta-analysis of 118 trials associated the most favorable programs with at least one to two sessions per week.
How long does it take for Pilates to relieve back pain?
The Cochrane review programs lasted 10 to 90 days, and several trials measured benefit after 6 weeks; a network meta-analysis places the most favorable ones between 3 and 9 weeks. In one trial, the advantage was no longer significant six months after enrollment: it's better to continue.
Pilates or yoga for the back?
Both can help. The Cochrane review on yoga found small effects compared to no exercise, and probably no difference from other back exercises on function. Network meta-analyses rank Pilates higher for pain, with low quality evidence in the analysis of 89 trials: choose whichever you will practice regularly.
Can you do Pilates with a herniated disc or sciatica?
It's possible, under professional guidance. In a trial of 54 patients with lumbar herniated disc, 6 weeks of clinical Pilates, three times per week, reduced pain and disability more than in the control group. Stop any exercise that increases leg pain, and seek urgent care in case of urinary problems.
Mat Pilates or reformer for the back?
Both are suitable. In a trial of 86 patients, Pilates on equipment showed lower disability and movement fear at six months compared to mat Pilates, with no difference in pain; a network meta-analysis of 45 trials ranks it first for disability. Mat Pilates remains the simplest option at home.
Which exercises to avoid when you have back pain?
During an acute flare-up, as a precaution: full trunk curls, rolling on the back, forced stretches with straight legs, rotations with load, and any movement that causes pain to radiate down the leg. Pilates has not been evaluated in the acute phase, but staying active performs slightly better than bed rest.
Does Harpagophytum relieve back pain?
In two trials totaling 315 patients, standardized extracts providing 50 or 100 mg of harpagoside per day performed better than placebo on short-term pain, based on low quality evidence according to the Cochrane review. A root powder with no specified harpagoside content is a different preparation. Not recommended in case of digestive ulcers or gallstones.
When to consult for back pain?
Without delay in case of loss of perineal sensation, urinary problems, loss of bowel control, fever, leg weakness, after a fall or impact, especially in elderly persons or those on corticosteroids, or with a history of cancer; and if pain has not improved after 4 weeks. Serious causes remain rare, 0.9% of cases in one cohort.
Sources
The studies cited below were identified via PubMed.
- GBD 2021 Low Back Pain Collaborators. Global burden of low back pain from 1990 to 2020, attributable risk factors and projections to 2050: Global Burden of Disease 2021 study. The Lancet Rheumatology, 2023;5(6):e316-e329. DOI
- Owen PJ, Miller CT, Mundell NL, et al. Which training modalities are most effective for treating low back pain? Network meta-analysis. British Journal of Sports Medicine, 2020;54(21):1279-1287. DOI
- Brinjikji W, Luetmer PH, Comstock B, et al. Systematic review of imaging signs of spinal degeneration in asymptomatic populations. American Journal of Neuroradiology, 2015;36(4):811-816. DOI
- Oliveira CB, Maher CG, Pinto RZ, et al. Clinical practice recommendations for non-specific low back pain in primary care: updated synthesis. European Spine Journal, 2018;27(11):2791-2803. DOI
- da C Menezes Costa L, Maher CG, Hancock MJ, et al. The prognosis of acute and persistent low back pain: a meta-analysis. Canadian Medical Association Journal, 2012;184(11):E613-E624. DOI
- Yamato TP, Maher CG, Saragiotto BT, et al. Pilates for low back pain. Cochrane Database of Systematic Reviews, 2015;2015(7):CD010265. DOI
- Hayden JA, Ellis J, Ogilvie R, et al. Therapeutic exercise for chronic low back pain. Cochrane Database of Systematic Reviews, 2021;9(9):CD009790. DOI
- Hayden JA, Ellis J, Ogilvie R, et al. Certain types of exercise are more effective than others for chronic low back pain: network meta-analysis. Journal of Physiotherapy, 2021;67(4):252-262. DOI
- Fernández-Rodríguez R, Álvarez-Bueno C, Cavero-Redondo I, et al. Best exercise options for pain and disability in chronic low back pain (Pilates, strengthening, core, mind-body): network meta-analysis. Journal of Orthopaedic and Sports Physical Therapy, 2022;52(8):505-521. DOI
- Wieland LS, Skoetz N, Pilkington K, et al. Yoga for non-specific chronic low back pain. Cochrane Database of Systematic Reviews, 2022;11(11):CD010671. DOI
- Cruz-Díaz D, Bergamin M, Gobbo S, et al. Effects of 12 weeks of Pilates on apparatus or mat on pain, function and transverse activation in chronic low back pain: a randomized trial. Complementary Therapies in Medicine, 2017;33:72-77. DOI
- Wood L, Bejarano G, Csiernik B, et al. Catastrophizing and kinesiophobia partially explain the progress achieved with Pilates in chronic low back pain: mediation analysis of a randomized trial. Journal of Physiotherapy, 2023;69(3):168-174. DOI
- Miyamoto GC, Franco KFM, van Dongen JM, et al. Different doses of Pilates in chronic low back pain: a randomized trial with economic evaluation. British Journal of Sports Medicine, 2018;52(13):859-868. DOI
- Miyamoto GC, Costa LO, Galvanin T, Cabral CM. Addition of modified Pilates exercises to minimal intervention in chronic low back pain: a randomized trial. Physical Therapy, 2013;93(3):310-320. DOI
- da Luz MA, Costa LO, Fuhro FF, et al. Mat or apparatus Pilates in nonspecific chronic low back pain: a randomized trial. Physical Therapy, 2014;94(5):623-631. DOI
- Robles-García M, González JLS, Sánchez-Sánchez JL, et al. Comparative effects of therapeutic exercise and manual therapy on disability in nonspecific chronic low back pain: a network meta-analysis. Journal of Clinical Medicine, 2026;15(12):4809. DOI
- Tottoli CR, Ben AJ, da Silva EN, et al. Pilates or home exercises in nonspecific chronic low back pain: a randomized trial. Clinical Rehabilitation, 2024;38(11):1495-1505. DOI
- Dahm KT, Brurberg KG, Jamtvedt G, Hagen KB. Advice for bed rest or advice to stay active in acute low back pain and sciatica. Cochrane Database of Systematic Reviews, 2010;2010(6):CD007612. DOI
- Qaseem A, Wilt TJ, McLean RM, et al. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 2017;166(7):514-530. DOI
- Henschke N, Maher CG, Refshauge KM, et al. Prevalence and screening for serious spinal pathology in acute low back pain seen in primary care. Arthritis and Rheumatism, 2009;60(10):3072-3080. DOI
- Downie A, Williams CM, Henschke N, et al. Red flags for detecting cancer or fracture in low back pain: a systematic review. BMJ, 2013;347:f7095. DOI
- Dionne N, Adefolarin A, Kunzelman D, et al. Diagnostic accuracy of cauda equina syndrome red flags against MRI: a systematic review. Musculoskeletal Science and Practice, 2019;42:125-133. DOI
- Lazoura E, Savva C, Ploutarchou G, et al. Efficacy of Pilates in chronic cervical pain: a systematic review and meta-analysis. BMC Musculoskeletal Disorders, 2025;26(1):629. DOI
- Taşpınar G, Angın E, Oksüz S. Effects of Pilates on lumbar disc herniation: pain, function, quality of life, flexibility and endurance. Journal of Comparative Effectiveness Research, 2023;12(1):e220144. DOI
- Roque GC, de Oliveira RG, Sorzi MV, de Oliveira LC. Do Pilates exercises improve postural alignment defects? A systematic review and meta-analysis. Musculoskeletal Care, 2024;22(4):e70009. DOI
- French SD, Cameron M, Walker BF, et al. Superficial heat or cold for low back pain. Cochrane Database of Systematic Reviews, 2006;2006(1):CD004750. DOI
- Furlan AD, Giraldo M, Baskwill A, et al. Massage for low back pain. Cochrane Database of Systematic Reviews, 2015;2015(9):CD001929. DOI
- Oltean H, Robbins C, van Tulder MW, et al. Herbal medicine for low back pain. Cochrane Database of Systematic Reviews, 2014;2014(12):CD004504. DOI
- Chrubasik S, Junck H, Breitschwerdt H, et al. Harpagophytum extract WS 1531 in acute low back pain flares: a randomized, double-blind, placebo-controlled study. European Journal of Anaesthesiology, 1999;16(2):118-129. DOI
- Vlachojannis J, Roufogalis BD, Chrubasik S. Systematic review of the safety of Harpagophytum preparations in osteoarthritic pain and low back pain. Phytotherapy Research, 2008;22(2):149-152. DOI
- Machado GC, Maher CG, Ferreira PH, et al. Efficacy and safety of paracetamol for spinal pain and osteoarthritis: meta-analysis of randomized placebo-controlled trials. BMJ, 2015;350:h1225. DOI
- Enthoven WT, Roelofs PD, Deyo RA, et al. Non-steroidal anti-inflammatory drugs for chronic lower back pain. Cochrane Database of Systematic Reviews, 2016;2(2):CD012087. DOI
- Kent P, Haines T, O'Sullivan P, et al. Cognitive functional therapy with or without biofeedback versus usual care for disabling chronic low back pain (RESTORE): phase 3 trial. The Lancet, 2023;401(10391):1866-1877. DOI
- Oliveira CB, Maher CG, Ferreira ML, et al. Epidural corticosteroid injections for lumbosacral radicular pain. Cochrane Database of Systematic Reviews, 2020;4(4):CD013577. DOI
- Peul WC, van Houwelingen HC, van den Hout WB, et al. Surgery or prolonged conservative treatment for sciatica. The New England Journal of Medicine, 2007;356(22):2245-2256. DOI
- Pocovi NC, Lin CC, French SD, et al. Individualized and progressive walking and education program to prevent low back pain recurrence (WalkBack): randomized trial. The Lancet, 2024;404(10448):134-144. DOI
