Los Altos, CA
A reader recently reached out with a question I hear often: “I’ve been dealing with chronic back pain for years, and I’m desperate to get back in shape. Physical therapy helps, but I want to do more on my own. The problem is, I’m nervous about which exercises are actually safe.”
If this sounds familiar, you’re not alone. Back pain affects roughly 31 million Americans at any given time. And while the instinct to rest and avoid movement makes sense, staying inactive can actually make things worse.
Why Movement Matters When Your Back Hurts
Many people with chronic back pain develop weak back muscles precisely because they’ve stopped being active. Modern life doesn’t help either. Sitting at a desk all day, then sitting on the couch at night, puts constant pressure on your spine. Our bodies simply weren’t designed for this kind of sedentary lifestyle.
Physical therapy is an excellent starting point, but it works best when combined with your own efforts outside of treatment. The goal is to strengthen the muscles that support your spine so your back can handle daily activities without flaring up.
Pilates: A Smart Starting Point
For anyone easing back into exercise after dealing with persistent back pain, Pilates offers an ideal entry point. The controlled movements focus on building core strength, improving flexibility, and developing better posture—all without jarring impact on your spine.
Pilates targets the deep stabilizing muscles around your midsection that act like a natural support belt for your back. As these muscles get stronger, you’ll likely notice less discomfort during everyday activities.
Building Up Over Time
Once you’ve established a foundation of core strength, you can gradually add other forms of exercise. Swimming, walking, and cycling are all excellent options that improve cardiovascular health while remaining gentle on your back. The key is progression—starting where you are and building up slowly rather than diving into intense workouts.
Give yourself at least three months of consistent Pilates practice before expecting significant changes. This timeline allows your muscles to strengthen and your body to adapt without rushing the process.
The Bottom Line for Chronic Back Pain
Yes, you absolutely can get fit and stay active even with chronic back pain. It requires patience, consistency, and choosing the right exercises for where you are right now. Start with movements that strengthen your core, listen to your body, and work alongside your healthcare providers rather than trying to push through on your own.
Your chronic back pain doesn’t have to mean giving up on fitness—it just means taking a smarter approach to getting there.
ABOUT THE AUTHOR
Kim Gladfelter, MPT, OCS, FAAOMPT
Women's Health Physical Therapy Specialist at PhysioFit Physical Therapy & Wellness
Kim Gladfelter is a physical therapist, Pilates instructor, educator, author, and co-founder of PhysioFit Physical Therapy & Wellness. She is known as a keen, well-rounded expert of healing through movement and women’s health specialist in the Silicon Valley area.
Kim has helped men and women of all ages to stay active and feel their best. She also writes about managing pain in her health columns, blogs and the local Los Altos Town Crier newspaper as well as reaches out to the local community, support groups, schools, libraries, and sports centers to advise and educate on body awareness and therapeutic exercise.