Pilates for Back Pain Pilates really hits your core muscle, which Joseph Pilates once referred to as our ‘powerhouse’. We strengthen from the core which supports the lower back, abdomen, hip and pelvic muscles. Not only is a strong core essential for exercises but for everyday tasks such as carry heavy items and picking up your shopping. A strong core will help reduce back pain and reduce the chances of injury. And as a bonus it will give you a nice flat tummy!