# Pilates as a valuable tool in the physiotherapeutic management of low back pain in adults > One of the studied methods for treating lower back pain is Pilates training, as it strengthens the muscles of the core, improves posture, and increases mobility. ## Introduction Physiotherapy aims to find methods that are meaningful to the client. Pilates is a gentle form of exercise that has found its place as an exercise that calms both the body and the mind. One of the studied methods for treating lower back pain is Pilates training, as it strengthens the muscles of the core, improves posture, and increases mobility (Finnish Pilates Association 2022). Lower back pain is a very common musculoskeletal disorder, and in most cases the pain is non-specific. Although the prognosis for lower back pain is usually good, patients often need guidance from a physiotherapist on how to stay active despite the pain (Low back pain: Current care guidelines, 2025). ## Background This article is part of a series produced within the course of Professional in Physiotherapy, which is included in the physiotherapy degree program at Savonia University of Applied Sciences. The article was created as part of the evidence-based physiotherapy section of the course. In small groups, students practice elements of a systematic literature review, including systematic information retrieval, critical appraisal using the PEDro Scale tool, and writing up the results in the form of a scientific article. The aim of this article is to describe the importance of Pilates training in physiotherapy as one method among others. The aim is to specifically examine how Pilates is suitable for the rehabilitation of adults suffering from lower back problems and what role it could play in the client’s rehabilitation process. ## Methodology The article is based on a small literature review conducted by third-year physiotherapy students, which selected four randomized controlled trials (RCTs) that are less than a year old. The methodological quality of the studies was assessed using the PEDro scale, which consists of 11 criteria, of which 10 evaluate internal validity and statistical reporting. A higher PEDro score indicates better methodological quality. The studies reviewed include: * *Preventing chronic low back pain: investigating the role of Pilates in subacute management* * *High-intensity and low-intensity Pilates have similar effects on pain and disability in people with chronic non-specific low back pain* * *Effects of reformer Pilates on pain, psychological factors, and sleep in chronic musculoskeletal pain* * *Effectiveness of Pilates compared with home-based exercises in individuals with chronic non-specific low back pain* ## Findings Pilates-based interventions have shown promising results in adult patients with both chronic and subacute low back pain: * **Şahan et al. (2025):** Found that reformer Pilates significantly improved pain, psychological well-being, and sleep quality. (PEDro score 7/10). * **Asik & Sahbaz (2025):** Demonstrated that Pilates was more effective than home exercise in preventing chronic low back pain during the subacute phase. (PEDro score 7/10). * **Tottoli et al. (2024):** Concluded that Pilates led to statistically better outcomes than home-based exercises in pain and disability. (PEDro score 7/10). * **Coelho et al. (2025):** Found that both high- and low-intensity Pilates similarly reduced pain and disability. Low-intensity Pilates was associated with fewer adverse effects. (PEDro score 8/10). ## Conclusion Pilates can be effectively integrated into physiotherapy sessions. However, education and training in Pilates-based techniques are needed to ensure safety and optimal training sessions. New research topics could reveal whether Pilates training alone has an effect on pain or whether other complementary exercises performed in addition to Pilates also have a similar effect. ## Authors * **Tuuli Honkonen**, Bachelor’s degree student, Physiotherapy degree programme, Savonia University of Applied Sciences * **Riitta Huotari**, Nurse, Bachelor’s degree student, Physiotherapy degree programme, Savonia University of Applied Sciences * **Maria Suomela**, Bachelor’s degree student, Physiotherapy degree programme, Savonia University of Applied Sciences * **Tero Tikkanen**, Engineer (Master’s level), Bachelor’s degree student, Physiotherapy degree programme, Savonia University of Applied Sciences * **Marja Äijö**, TtT, ft, Senior Lecturer in Gerontology and Rehabilitation, Savonia University of Applied Sciences ## References * 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 (1971-)*, 1-8. https://doi.org/10.1007/s11845-025-03939-y. Accessed 26.9.2025. * Coelho, A. C. S., Dourado, J. F., & de Paula Lima, P. O. (2025). High-intensity and low-intensity Pilates have similar effects on pain and disability in people with chronic non-specific low back pain: A randomized controlled trial. *Journal of Physiotherapy*, 71(2), 123–130. https://doi.org/10.1016/j.jphys.2025.03.002. Accessed 27.9.2025. * Finnish Pilates Association 2022. What is Pilates? Online publication. https://suomenpilatesyhdistys.fi/mita-on-pilates/. Accessed 1.10.2025. * Low back pain. Current care guidelines. Working group appointed by the Finnish Medical Society Duodecim and the Finnish Physiatry Association. Helsinki: Finnish Medical Society Duodecim, 2025. https://www.kaypahoito.fi/hoi20001. Accessed 1.10.2025. * Pilates picture. Microsoft Corporation. (n.d.). Stock image of a business meeting. Microsoft 365. Accessed 1.10.2025 * Physiotherapy Evidence Database 2020. PEDro scale. Online publication. Updated 1.9.2025. https://pedro.org.au/english/resources/pedro-scale/. Accessed 26.9.2025. * 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/10.1177/02692155241277041. Accessed 25.9.2025. * 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. Accessed 2.10.2025.