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Lower Back Pain Mistakes

5 Lower Back Pain Mistakes

Lower Back Pain management can be tricky due to contradicting information, the plethora of approaches available and the volatile nature of the symptoms and triggers. Whether in chronic pain or having acute symptoms here are the 5 lower back pain mistakes, you need to avoid.


Lower Back Pain Testimonial


1. Refrain from training

It is understandable that when the pain is acute movement options are limited. However refraining from all forms of exercise can be as debilitating on the long run as reinsuring yourself. Even if walking is the only thing you can do – turn walking into a workout. This may still mean no more than 20 mins of walks at a time. Do that daily.

2. Avoid exercises that involve the lower back

It may seem like an oxymoron but unless you exercise the muscles of your lower back they will not function properly again. A progressive approach is often necessary while it will help to understand the role of breathing and abdominal recruitment in the process.


3. Stretch your way out of pain

A lot of people when dealing with pain enjoy stretching as it provides some relief. Stretching, similar with massage, can be useful in LBP management but will not be sufficient to heal the injury. Use stretching as palliative medicine but not treatment.

plank to downward dog reformer pilates

4. Ignore the neurological aspect of pain

Whether the pain is experienced in the muscles, spine or in the fascia there will be a neurological component in your lower back pain. As a consequence there is a bilateral relationship between lower back pain and breathing which is why breathing exercises can be very useful.

Lower Back Pain Breathing
source: Kolář P et al. 2012

The lower back has a high concentration of sympathetic nerves [ref], which could potentially explain why some patients with lower back pain report increased intensity of pain under psychological stress [ref].


5. Practice the same rehabilitation program for ever

Whatever rehabilitation program you have been given they be updated after 4-10 weeks. Not doing so means you are wasting your time at best or risking the deterioration of the condition.



Whatever protocol you follow, if you don’t want to stay married to lower back pain for life, make sure you start exercising as soon as possible incorporating exercises that strengthen the lower back, address the neurological aspect of the pain and progressively make the protocol more challenging.




Chou, R., & Shekelle, P. (2010). Will this patient develop persistent disabling low back pain?. Jama, 303(13), 1295-1302.

Hirsch, C., Ingelmark, B. E., & Miller, M. (1963). The anatomical basis for low back pain: studies on the presence of sensory nerve endings in ligamentous, capsular and intervertebral disc structures in the human lumbar spine. Acta orthopaedica scandinavica33(1-4), 1-17.

Kolář, P., Šulc, J., Kynčl, M., Šanda, J., Čakrt, O., Andel, R., … & Kobesová, A. (2012). Postural function of the diaphragm in persons with and without chronic low back pain. journal of orthopaedic & sports physical therapy42(4), 352-362.

reformer pilates for lower back pain

Is Reformer Pilates good for lower back pain?

Epidemic as Lower Back Pain might be, it is in 90% treatable even it if the symptoms have lasted for years. Those using Reformer Pilates for Lower Back Pain not only recover faster but reduce their chances for a relapse.

In this article I am providing a reformer pilates roadmap for those suffering with Lower Back Pain (LBP), depending on the severity of the symptoms. Avoiding common mistakes in lower back pain rehab is equally important of course.


Severe Lower Back Pain

Those dealing with severe LBP are often restricted in performing many moves and experience intense pain, for prolonged periods of time, triggered by a variety of events (including long walks, lying down in the same position for more than 2 hours). The pain may wake them up in the middle of the night and pain killers often become part of their ‘diet’ so to speak.

There are 2 categories of severe LBP: sudden / acute and dull / chronic.

a. Acute LBP

Those experiencing acute LBP need to waste no time and consult a physician. A word of caution:

Be prepared to hear: ‘There is nothing wrong with you.’ Or ‘It’s in your head. Just get some rest and you will be fine.’ Which translate to: ‘With the means I have available and my current knowledge I cannot help you. Consult someone else.’

Please read the text above x2. What should you do if there is no explanation to your symptoms?

1 Continue to monitor the symptoms as this will help future physicians and therapists to advise you accordingly.

2 Proceed with the plan provided below.

b. Chronic LBP

Chronic intense lower back pain is common especially among the elder population and in particular women. It is not uncommon, when following the right protocol, for symptoms to reside substantially, lower:

If you have been living with the pain for years, you shouldn’t expect the recovery to be overnight. A recovery period of approximately 1-2 months, for every year you have lived with the symptoms is a reasonable expectation.

During this phase the goals ⚽️ are to:

1 Recover and perform regularly all physical movements that do not trigger the lower back

2 Improve strength in all muscles that work synergistically with the lower back and abdomen

3 Start challenge the mid-section progressively and only when appropriate. This often involves exercises that are not typically classified as core exercises (ie. Carries).

calf stretches reformer pilates

Hamstring & ankle stretches gentle

easy cat cow reformer pilates

Articulate upper back

leg scissoring

Dissociate hips & abdominals

100s reformer pilates

Rectus abdominis


Moderate LBP

Pain will be triggered in individuals suffering from moderate LBP, when performing specific activities. In men these activities are: seating for long periods of time (ie. when driving or during flights), after doing manual work of moderate intensity. Women’s lower back might be triggered before their period, when standing for long periods (ie. when cooking or visiting galleries).

Both men and women in this category are less likely to experience LBP while walking.

During this phase the goals ⚽️ are to:

1 Strengthen the muscles that work synergistically with the lower back.

2 Improve spine stability with abdominal inner unit work

3 Perform low intensity plyometric training (both bilateral and unilateral)

hip extensions reformer pilates

Strengthen glutes

Strengthen the inner unit

superman planks reformer pilates

Intermediate rectus abdominal exercises

intro oblique reformer pilates

Introductory oblique

floor splits reformer pilates
Hamstring work


Occasional LBP

Occasional discomfort in the lower back is unfortunately not rare. It is often attributed to age, over or under training, the weather, the planets, … but whatever the reason lower back sensitivity is an amber flag and if ignored it can escalate or cause issues in the knees or ankles. Lower back sensitivity is likely to cause involuntary adaptations in how many movements are performed, including squatting, walking, running and a few lifts.

During this phase the goals ⚽️ are to perform:

1 Compound movements

2 Supersets of lower back and ab exercises

3 Plyometric training


Compound movements:

high splits reformer pilates

  • Leg flexibility & core

intro to camel reformer pilates

  • Shoulders & core (Not just muscle isolation)

plank sideplank sequence pilates reformer

Intermediate oblique

Long Spine long sequence Reformer Pilates

Supersets of abdominal work including isometric holds, spine flexion

pull the sword reformer pilates

Upper back stability work



How do you stretch your lower back with Pilates Reformer?

You can stretch your lower back by bringing your spine into flexion. These exercises can provide temporarily relief from lower back pain but should be treated as palliative work and not treatment.

plank to downward dog reformer pilates


Is Reformer Pilates good for herniated disc?

The reformer pilates is a low impact form of resistance training and thus can help those suffering from herniated disc to maintain muscle tone without loading their joints to the point of discomfort.

Herniated disc can cause different degrees of pain, from severe to just an occasional discomfort. The protocols above can be used but the exercise selection has to be personalised to the individual’s limitations.


What causes lower back pain in females?

Women with low levels of oestrogen [ref], progesterone or testosterone [ref] are more prone to experience pain. In one study the peak of progesterone during the 2nd phase of the menstrual cycle was associated with a 25.6% reduction in pain severity [ref].

Those suspecting hormonal imbalances can perform a hormonal test such as the Dutch one, to confirm if the problem exists.


Which exercises to avoid with lower back pain?

As a rule of thumb you should refrain from the exercises that intensify the pain you experienced prior, as well as those that you feel you have no control in their execution.

Depending on the level of severity and the nature of the pain (ie. neurological, muscular, fascial) two individuals with lower back pain may have to avoid different exercises.



For those that have access to a reformer machine and suffer from lower back pain, practicing on the reformer x2-5 times per week is a non-brainer. Make sure the challenge of the class matches your current needs and over time you increase the difficulty as you progressively get stronger.




Chen, Q., Zhang, W., Sadana, N., & Chen, X. (2021). Estrogen receptors in pain modulation: cellular signaling. Biology of sex Differences12, 1-10.

Schertzinger, M., Wesson-Sides, K., Parkitny, L., & Younger, J. (2018). Daily fluctuations of progesterone and testosterone are associated with fibromyalgia pain severity. The journal of pain19(4), 410-417.

Vincent, K., & Tracey, I. (2008). Hormones and their interaction with the pain experience. Reviews in pain2(2), 20-24.