Lower back pain can interfere with every aspect of your life. Getting out of bed carefully, been afraid to pick up a dropped phone, taking a moment to brace as pain subsides during day-to-day tasks; surely it shouldn't be this bad?
If you’ve ever felt this way, you’re not alone. In fact, in 2020, the World Health Organisation (WHO) declared that lower back pain was the leading cause of disability worldwide, impacting over 619 million people worldwide.
It's easy to lose hope. But after more than 20 years of helping people with lower back pain, I have seen time and time again that recovery is possible.
From mothers of young children through to professional rugby players; a herniated disc doesn't discriminate. But I’ve seen people from all walks of life rediscover freedom and confidence, and—most importantly—they return to living their best life.
Step one: connect with your breath
Dan*, a professional athlete and father of young kids, came to me after months on painkillers. Every day movements, like picking up the kids and getting out of the car, felt like a struggle. Returning to international sport seemed out of reach. But after just a few sessions, his movements changed dramatically.
What shifted? He learned how to use his breath for support and safety, and quickly integrated it into his training and daily movement.
Maybe you’ve caught yourself doing it too. Making that sharp little gasp as you bend down, and the subconscious bracing when picking something up off the floor. Or perhaps it’s the way you instinctively grab the benchtop before turning around, just in case your back locks again.
These are clues that your nervous system is on high alert, literally bracing for pain. Your central nervous system needs to feel safe to allow the back muscles to finally let go and relax. Your breath is one of the easiest ways to do this.
Slow, relaxed exhales signal calm to your nervous system and tell the back muscles they can release. It also naturally enhances the coordination of the trunk muscles to support your back, improving mobility and control rather than creating stiffness.
A fundamental principle of Pilates is awareness of breath. Whenever a movement feels challenging or restricted, your instructor will guide your attention back to your breath, reminding you to move with more ease.
This focus on mindful movement, rather than pushing through with grit, is what creates lasting change in your nervous system and relief from low back pain.
Step two: focus on lengthening your spine
Amanda* had experienced severe episodes of lower back pain for years. About every six months, her back would “go”, often doing something as simple as putting on socks.
Treatment would ease the acute pain, and she’d go back to doing all the core exercises she’d been told to do. But the pain kept returning. Frustrated and losing hope, she walked into her first reformer Pilates session.
Unlike her previous physios, I didn’t cue her to “switch on her abs” or “flatten her back”. Instead, I asked her to focus on the feeling of length and support through her spine as she lay back on the moving carriage. Within minutes, her body released. Like so many clients I had seen before, Amanda stood up with a look of amazement on her face and said, “I feel taller and lighter.”
That sense of ease and lightness didn’t come from activating her core. It came from tuning into her body and learning how to move in a different way.
For decades, people with back pain have been told to strengthen their core. Yes, trunk muscles do play a key role in spinal support. However, what is often missing is an understanding of how to create coordinated support, rather than rigid tension.
There’s a big difference between bracing your abs versus allowing your diaphragm, pelvic floor, and abdominals to work together in a way that supports your spine naturally.
When you move on the supportive surface of the reformer and focus on finding length, something changes. The body finds alignment. The trunk muscles coordinate naturally. You feel taller and less compressed, and perhaps for the first time in a long time, your back moves without fear.
Step three: improve mobility throughout your entire body.
Chrissy* was a 52-year-old who came to me after struggling with ongoing lower back pain for over a year. She’d done everything the books and blogs suggested. Stretches, core work, strengthening. She even invested in a standing desk. But her back still ached by the end of each day, especially after long hours at work.
She described it as a deep, tight gripping in her lower back that wouldn’t release, no matter how much she stretched it. When we assessed her movement, the problem wasn’t just in her lower back. Her mid back barely moved, and her hips were stiff and restricted.
Once we started working on mid-back and hip mobility, she noticed a change. Within a few weeks, she could sit longer without aching, and even got back to walking the hills with her friends–something she hadn’t done in months.
She said to me, “I kept trying to stretch my back because that’s where the pain was. I had no idea the real problem was above and below it.”
When your lower back feels stiff or tight, it’s easy to assume that’s where the problem is and to try stretching it out. However, the lower back often compensates for a lack of movement elsewhere, particularly in the hips and mid-back.
That’s why reformer Pilates goes beyond just core work. It targets the mobility of your entire body, helping you distribute load more evenly, move more efficiently, and take pressure off your lower back.
Your own rehab space at home
Consistency is essential for long-term relief from lower back pain. Having a Pilates reformer at home is a massive advantage for anyone looking to recover for life, not for a few weeks.