Is Yoga or Pilates Better for Back Pain?

Women doing yoga on the lake
bluecinema / Getty Images

Many people rave about Pilates, claiming that it saved their back or improved their posture in a major way. Others are practically married to yoga, saying nothing else comes close to giving them the pain relief they seek.

Which is it? Is one method better for your back than the other?

Yoga Joe

Believe it or not, Joe Pilates, the originator of the Pilates method, evolved his work from yoga (along with martial arts and a number of other rigorous physical disciplines).

Born in the late 1800s and living into the mid-20th century, Pilates started life as a sickly child, according to the Jillian Hessel Pilates website.

Joe took up bodybuilding, yoga, wrestling, gymnastics and martial arts as a way of overcoming his health issues. Throughout his childhood and beyond, Joe weaved these practices together, along with the study of anatomy, to forge his own individual healing pathway. 

But for Joe, these disciplines all lacked one important feature: A strong set of core muscles. So he set about to find and develop a way to incorporate the core into his work. His method, which was originally called "Contrology," resulted.

During World War I, he worked with prisoners of war—many of whom had been injured and were quite weak—to get them moving. He rigged bedsprings in a way that provided these "patients" with both support from and resistance to movement. Utilizing this setup, the prisoners got better.

This was how Pilates, as we know it today, got its start, especially that aspect of the work that is done in a studio with spring-driven machines.

The Elephant's Journey

An example of a yoga posture that may have been adapted for Pilates is the elephant. The elephant is done on the reformer, which is a specialized piece of spring-driven Pilates equipment. The elephant move looks a lot like the Downward Facing Dog yoga pose.

Although the elephant takes place in the same position as Down Dog, it can feel quite different while you are performing it. Because the movement of the lower extremity is involved, the elephant is great for releasing low back muscle tension, increasing awareness of hip joints as well as the shoulder girdle. And true to the Pilates mission, the elephant can get you to walk away with very sore abdominal muscles.

That is not to say yoga doesn't strengthen core posture muscles. But working the core is a key primary intention of Pilates, while in yoga it is one of a number of benefits. Both systems will likely increase flexibility, strength, balance, and coordination; both can be helpful in reducing or preventing back or neck pain. 

Pilates for Back Pain Research

As of 2015, few studies on the benefits of doing Pilates for back pain have been done. Those that were done don't have much to report. For example, a review of studies entitled "Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews," reported that the small number of studies, as well as poor quality of the studies that were found, precluded the authors from recommending Pilates for reducing pain and disability in people with chronic low back pain. But talk to the Pilates students themselves, and you may get a very different impression.

And a 2015 Cochrane Database Review could not find conclusive evidence that Pilates is superior to other forms of exercise for low back pain, even though, again, many students of the method would beg to differ.

Yoga for Back Pain Research

For yoga, the picture research paints is a little brighter. A 2015 review published in the International Journal of Yoga looked at 6 studies involving a total of 570 patients. The researchers found that in the short term, Iyengar may be effective for treating chronic spinal pain. The review did not find evidence for yoga as a back treatment in the long term, though.

Similarly (but not exactly the same,) a 2013 study published the Clinical Journal of Pain found strong evidence that yoga is effective in the short term. It also found moderate evidence for long term use. The researchers concluding remarks recommend yoga as an "additional therapy for low back pain." 

And finally, the Oklahoma Medical Association weighs in on yoga and meditation in their 2017 meta-analysis was published in their journal. The review found that for people with osteoarthritis, rheumatoid arthritis, and low back pain, yoga and meditation significantly helped decrease pain and dysfunction.

When it comes down to it, the choice between yoga and Pilates for reducing back pain may be personal preference. If you'd rather mix your physical healing with a spiritual experience, yoga may be for you. But if staying in the physical realm with your exercise routine sounds more palatable, consider Pilates. 


Was this page helpful?

Article Sources

  • Achilefu A., et. al. Yoga and other meditative movement therapies to reduce chronic pain. J Okla State Med Assoc. Jan. 2017.

  • Cramer, H, et. al. A systematic review and meta-analysis of yoga for low back pain. Clin J Pain. May 2013.

  • Crow, E.M., et. al. Effectiveness of Iyengar yoga in treating spinal (back and neck) pain: A systematic review. Int J Yoga. Jan. 2015.

  • Wells, C., et. al. Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews. BMC Med Res Methodol. Jan 2013.

  • Yamato, T.P., et. al. Pilates for low back pain. Cochrane Database Syst Rev. Jul 2015.