By Jana Zuidema (Bsc Physio)

At least 85% of us will experience lower back pain at some point in our lives. Lower back pain is not only painful, but it can cost us money, time and energy we don’t have to waste.

So what can one do to prevent being just another statistic?

We can BE PROACTIVE. Do something that has been proven to help prevent and treat lower back pain: EXERCISE. Exercise is well researched to aid in recovery from lower back pain and can prevent lower back pain.

So the best exercise approach would be to strengthen our core muscle. Pilates exercises are great for strengthening our core. Research has shown that Pilates-based exercises are very effective in treating chronic, unresolved lower back pain (3) In a study in 2014 Wells et al concluded that: Pilates strengthening exercise offers greater improvements in pain for people suffering from chronic lower back pain and functional ability compared to usual care and physical activity in the short term (1)

So here are 5 easy core exercises to reduce lower back pain:

Abdominal setting with Pelvic tilts - to strengthen the pelvic floor and transversus abdominis muscles

  • Lie on your back with the knees bent and the feet flat on the floor.
  • Engage your lower abdominals (transverses abdominis) by engaging your pelvic floor muscles. To engage your pelvic floor muscles, pull up your pelvic floor muscles. i.e. don’t pass wind and water. You should feel your lower tummy drawing downwards towards your spine as you do this. You have now engaged your deep core muscles.
  • Breathe normally and DO NOT hold your breath.
  • Hold for 10 seconds and repeat 10 times.

This is called ‘setting’ and is encouraged in most Pilates exercises.

  • Now add a pelvic tilt, i.e. flatten your lower back into the ground whilst you are setting your deep core muscles, then release and return to a neutral spine (i.e. a slight hollow in the lower back). Repeat 10 times.

Bridging- to strengthen the multifidi and gluteal muscles

  • Lie on your back, with the knees bent and the feet flat on the floor.
  • Set the lower abdominals as explained above.
  • Tilt your pelvis so that your lower back is on the floor, tighten your buttock muscles and set your lower abdominals by not passing wind or water.
  • Then lift your hips off the floor.  
  • Keep your pelvis still. If your hamstrings cramp then you need to tilt your pelvis a bit more or start with your heels closer towards your buttocks.
  • Repeat 10 times.

Now that you are taking the bull by the horn, (or the pelvic floor by its harness) it’s time to add to your program. Remember that exercise is the key to preventing and managing lower back pain. The next 3 exercises focus on your gluteal (buttock) muscles, your deep core muscles and your balance. These are vitally important to stabilize your lower back, particularly in walking and standing. Our gluteal muscles are often very weak as most of us sit for the majority of the day. Your gluteal muscles are then doing nothing expect adding to the padding of your sitting bones! So – make them work and do these exercises:


  • Lie on one side, hips and knees bent to 450, pretend you are lying against an imaginary wall with your head, back, buttocks and feet touching the wall.
  • Lengthen out your top and bottom waist by creating a gap under your bottom waist. Pretend a ripe peach is under your bottom waist and you don’t want to squash it. This ensures that your spine is in neutral.
  • Now, set your lower abdominals and tighten your glutes and then slowly lift the top knee off the bottom one keeping your ankles together. The work should be done by the buttock muscles and not the muscle on the side of your hip. If this happens tuck in your pelvis a bit.
  • Repeat 10 times and then on the other side.

Hip twist

  • Lie on your back with the knees bent and the feet flat on the floor.
  • Set the lower abdominals, maintain a small arch in your lower back.
  • Slowly allow one leg to fall out to the side whilst keeping the pelvis level and the spine in neutral. i.e. don’t let the opposite leg follow.
  • Put pressure down into the foot of the leg not moving to maintain stability.
  • As you move the leg, keep the lower abdominals tight and the pelvis still.
  • Slowly bring the leg back to the original position.
  • Repeat 5 times with each leg.

4 Point kneeling

  • Start on your hands and knees. The hands should be under your shoulders and your knees under your hips.
  • Keep the back straight, head level, chin tucked in and lower abdominals tight, by pulling the abdominals up towards your spine. Watch out not to hunch your shoulders into your ears.
  • Lift the right arm and left leg into the air.
  • Do NOT arch the back.
  • If possible, use a mirror to see that your body line is straight.
  • Alternate with the left arm and right leg. Repeat 5 times each side

If at any time you feel discomfort you should discontinue the exercise. It is always advisable to seek medical advice prior to starting any new exercise program. Now, go and conquer the world of exercises for lower back pain!

Please always seek medical advice before starting a new exercise regime.


  1. The effectiveness of pilates exercise in people with chronic low back pain: a systematic review. Wells etal, PLoS One. 2014 Jul 1;9(7):e100402.
  2. Inefficient Muscular Stabilization of the Lumbar Spine Associated With Low Back Pain: A Motor Control Evaluation of Transversus Abdominis
    Hodges and Richardson, Spine:15 November 1996 - Volume 21 - Issue 22 - p 2640–2650
  3. Pilates-Based Therapeutic Exercise: Effect on Subjects With Nonspecific Chronic Low Back Pain and Functional Disability: A Randomized Controlled Trial
    Rydeard et al, J Orthop Sports Phys Ther 2006;36(7):472–484.