Does yoga or pilates help with pain and ageing?

Yoga and pilates both help with chronic low back pain. A large meta-analysis of 75 controlled studies involving more than 5,000 participants shows that yoga has a moderate to large effect on both pain reduction and physical functioning, compared with conventional rehabilitation¹. Pilates also reduces pain clearly, but scores somewhat lower than yoga or tai chi. In the same analysis, pilates did not score significantly better on physical functioning. The numerical difference between yoga and pilates is small, and direct comparisons between the two are scarce.

In people aged 50 and over with joint pain, such as osteoarthritis or neck pain, there is moderate evidence that yoga helps. Of the eight studies that measured pain, six found a significant effect. That is comparable to other forms of exercise. Yoga is therefore not a miracle cure for joint pain, but simply a useful option alongside other forms of movement. Quality of life did not improve clearly in the short term.

There is also an important safety signal. A large controlled study from 2025 involving 700 community-dwelling adults aged 60 and over showed that a 12-month Iyengar yoga programme actually increased the number of fall incidents: 0.87 versus 0.64 falls per person per year². The researchers explicitly advise against this programme for fall prevention. Notably, that same programme did improve balance confidence and weekly activity time. How someone feels and how safe something is do not always go hand in hand.

For other applications the evidence is thinner. A broad review on ageing sees positive effects of yoga on balance, bone density and Parkinson's disease, but in that review yoga did not consistently outperform other forms of exercise. For menopausal complaints such as hot flushes, anxiety and sleep problems, yoga is mentioned in a 2024 review overview as an option with some supporting evidence, but without hard figures. For migraine there is limited positive evidence. For cancer pain, a joint guideline from two major oncology organisations concludes that there is insufficient evidence for a recommendation.

No single form of exercise convincingly outperforms all others for chronic low back pain. Tai chi, yoga and pilates perform comparably to or better than conventional rehabilitation, but differ little from one another. Simply choose the form that suits your own preferences and abilities.