I found Pilates as a result of having back surgery (a discectomy) in 2001 after years of sciatica. The sciatica had progressed to a point that I could not stand, walk, sit or lay down without pain and I was out of options. Physical therapy and cortisone shots did not help at all. Years of doing step aerobics at a crazy pace without strong enough abs and three c-Sections had taken their toll. I was fortunate that my surgery went very well and I recovered easily.

I worried about getting to that point again and I knew I had to find something that would help my back, not harm it. I started taking mat Pilates classes at my gym and realized quickly I had nearly no flexibility or ab strength. I kept at it because I was improving quickly and nothing hurt after class or the next day. Soon I began working in a Pilates studio, and found that I loved Pilates on equipment so much that I went on to do the instructor training and started teaching.
Everything we do in Pilates is focused on the core. Every exercise is an ab strengthener in some form. That is critical to healing back issues and preventing them. And everything we do can be modified which is why Pilates is for almost every body.
Back care is taught from day one in Pilates Instructor training. In general for people with osteoporosis, osteopenia, disc issues, scoliosis, sciatica and a few other common problems, articulation (rounding) is not recommended). Although our goal is to work in neutral spine (the natural curve in your low back) it is not recommended or sometimes not even possible for people with back concerns. There is so much abdominal strengthening that can be done supine (lying on your back) and that is a great way to be able to imprint (flatten) your spine to maintain spinal stability. It also helps people feel stability in their pelvis which is critical for back strength. Because Pilates is slow and controlled movement people are generally able to progress steadily. I find the first thing people who are new to Pilates notice is that their posture improves right away. I believe that is due to the body awareness you gain doing Pilates. People who start with good body awareness can progress very quickly. Part of good posture is keeping the abdominals engaged to protect your back so the strengthening starts immediately also.

As an instructor I cue for back position constantly because of my history of back problems. But many clients learn that naturally because when you modify for your needs you feel a difference that allows you to do more safely. Another way to focus on caring for your back during Pilates (or any exercise) is to focus on the breath. In general we exhale on exertion which allows your ab muscles to engage more as you create space.
Clients need to let their instructor know about any health issue, but especially back concerns since our focus is abdominal work. When you join a studio, even if you have the same instructor be sure to let her/him know at the beginning of every class for the first few times to be safe. Notify any instructor who is new to you know and most of all never do anything that hurts.
When you are doing an exercise that feels hard, it is important to determine if it is hard because it is painful or hard because you aren’t used to it and need to build strength. Hard is ok, painful is not.
I like to remember these two quotes from Joseph Pilates, the father of Pilates: