Minor benefits of pilates for chronic low back pain
One article on PainSci cites Miyamoto 2013: The Complete Guide to Low Back Pain
PainSci commentary on Miyamoto 2013: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.
In this test of Pilates for back pain, patients who did Pilates had “small benefits” compared to those who did not, and six months later even those small benefits were gone. The test had a serious flaw: it neglected to compare Pilates to any other kind of activity, shamefully sloppy design, fairly junky science. These results only add to the pile of evidence that exercise and therapeutic attention of any kind are probably good for low back pain. It’s only worth reporting these results insofar as they damn Pilates with the faintest possible praise — evidence that Pilates has no special power over back pain.
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
BACKGROUND: The Pilates method has been used to improve function and reduce pain in patients with chronic nonspecific low back pain, although there is little scientific evidence that describes its efficacy.
OBJECTIVE: The purpose of this study was to investigate the effectiveness of the addition of modified Pilates exercises to minimal intervention in patients with chronic low back pain.
DESIGN: A randomized controlled trial was conducted.
SETTING: The study was done in an outpatient physical therapy department in Brazil.
PATIENTS: Eighty-six patients with chronic nonspecific low back pain participated in the study.
INTERVENTION: All participants received an education booklet containing information about low back pain and were randomly allocated to receive 12 sessions, over 6 weeks, of exercises based upon Pilates principles (n=43) or of education alone (n=43).
MEASUREMENTS: Primary outcomes were pain intensity and disability measured at 6 weeks and 6 months. Secondary outcomes were patient-specific functional disability, global impression of recovery, and kinesiophobia measured at 6 weeks and 6 months. All outcomes were measured by a blinded assessor in all time points.
RESULTS: There was no loss to follow-up at any of the time points. Improvements were observed in pain (mean difference=2.2 points, 95% confidence interval [CI]=1.1 to 3.2), disability (mean difference=2.7 points, 95% CI=1.0 to 4.4), and global impression of recovery (mean difference=-1.5 points, 95% CI=-2.6 to -0.4) in favor of the Pilates group after intervention, but these differences were no longer statistically significant at 6 months.
LIMITATIONS: Treatment provider and participants could not be blinded to the interventions.
CONCLUSIONS: The addition of modified Pilates exercises to an educational booklet provides small benefits compared with education alone in patients with chronic nonspecific low back pain; however, these effects were not sustained over time.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Cannabidiol (CBD) products for pain: ineffective, expensive, and with potential harms. Moore 2023 J Pain.
- Inciting events associated with lumbar disc herniation. Suri 2010 Spine J.
- Prediction of an extruded fragment in lumbar disc patients from clinical presentations. Pople 1994 Spine (Phila Pa 1976).
- Characteristics of patients with low back and leg pain seeking treatment in primary care: baseline results from the ATLAS cohort study. Konstantinou 2015 BMC Musculoskelet Disord.
- Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial. Kuyken 2022 Evid Based Ment Health.