New Study Highlights Key Exercise Factors for Managing Chronic Low Back Pain

Resistance band exercise

Chronic low back pain (LBP) is a widespread issue affecting millions worldwide, often leading to discomfort, reduced mobility, and a lower quality of life.  Exercise is a well-established strategy for managing LBP, with research highlighting that certain types—such as resistance training, Pilates, and motor control exercises—are particularly effective in reducing pain intensity and disability.

A recent study published in BMJ Open Sport & Exercise Medicine sheds light on the role of specific training parameters in pain reduction.  While the type of exercise is important, the study emphasises that how one exercises—specifically the intensity, volume, and session duration—may have an even greater impact on pain relief than frequency alone.

Key Findings from the Research

This research is a secondary analysis of a randomised controlled trial involving adults with chronic LBP who participated in a strength and conditioning program.  The analysis found that lower pain intensity was associated with:

• Higher Training Intensity – Participants who engaged in exercises with a higher rating of perceived exertion (RPE) experienced greater reductions in pain.

• Greater Training Volume – Increased time under tension (the duration a muscle is engaged during an exercise) correlated with decreased pain intensity.

• Shorter Session Duration – Shorter exercise sessions were linked to lower pain levels, suggesting that quality and intensity matter more than session length.

• Training Frequency Was Less Significant – Unlike intensity and volume, how often participants exercised did not show a strong link to pain reduction.

Applying These Findings to Pilates

Pilates is already recognised as an effective approach for managing LBP due to its focus on core strength, flexibility, and movement control.  However, integrating these research-backed training principles can further enhance its benefits:

• Increase Exercise Intensity – Engage more deeply in each movement, reaching a higher RPE while maintaining proper form.

• Enhance Volume Through Time Under Tension – Slow, controlled movements that increase the duration muscles remain active can improve outcomes.

• Optimise Session Durations – Shorter, high-quality sessions may be more effective than longer, lower-intensity workouts.

The Bigger Picture: Any Exercise Can Help

While Pilates is a fantastic option, this research reinforces the idea that exercise in general is beneficial for chronic LBP.  Whether it’s resistance training, yoga, walking, or a structured Pilates program, what matters most is engaging in progressive, well-structured movement that prioritises intensity and volume over sheer frequency.  So find something you enjoy and will practice consistently.

Final Thoughts

For those managing chronic LBP, the key takeaway is that exercise works—but how you exercise matters just as much as what you do.  Incorporating Pilates with appropriately adjusted training parameters, or applying these principles to any exercise program, can help reduce pain and improve overall function. A s always, individuals should consult a qualified instructor or healthcare professional to ensure a safe and effective approach tailored to their needs.

REFERENCES: Christopher Neason, Clint T Miller, Scott D Tagliaferri, Daniel L Belavy, Luana C Main, Jon J Ford, Andrew J Hahne, Steven J Bowe, Patrick J Owen - Exercise prescription variables predict reductions in pain intensity in adults with chronic low back pain: secondary analysis of a randomised controlled trial: BMJ Open Sport & Exercise Medicine 2024;10:e001744.