How Mat Pilates Reduces Stress, Inflammation, and Chronic Pain

Cortisol is a steroid hormone made in your adrenal glands, and it plays a big role in managing stress. It’s controlled by something called the HPA-axis — a communication network in the brain that affects stress response, immune health, mood, digestion, and even how you store and use energy.

Your body constantly keeps an eye on cortisol to make sure everything stays balanced. At healthy levels, cortisol helps control blood sugar, break down fats and proteins for energy, manage water levels in your body, support your immune system, and even affect growth and reproduction. Most importantly of all, cortisol shapes how your body responds to stress. (That’s why it’s often called “the stress hormone”.)

Cortisol follows your body’s 24-hour internal clock (your circadian rhythm), which keeps you in sync with day and night. Usually, cortisol levels are lowest around midnight, rise early in the morning, and peak just after you wake up. Then they slowly drop throughout the day. This daily cycle helps regulate your energy, mood, and metabolism.

But when stress becomes chronic and cortisol stays too high for too long, your circadian rhythm gets disrupted. You might start experiencing sleep issues, fatigue, mood swings, or other health problems. That’s why keeping cortisol balanced is key to maintaining overall health.

It turns out Pilates isn’t only great for strength and posture — it has also been linked to lower stress hormones like cortisol. Regular physical activity has been shown repeatedly to help manage cortisol, and Pilates specifically has some pretty impressive effects.

Several studies back this up. For example, one study looked specifically at sedentary women who started an 8-week Pilates program, doing 60-minute sessions three times a week. At the end of those eight weeks, the women’s cortisol levels dropped significantly, especially compared to women who didn’t participate. Since chronically elevated cortisol (caused by ongoing stress and an overactive stress-response system) can lead to mental health struggles, this study suggests Pilates might work as a protective buffer, helping your body handle stress more effectively.

Similar research looked specifically at women dealing with premenstrual syndrome (PMS). After an 8-week Pilates program focused on controlled breathing, precise body positioning, and core exercises like single-leg stretches, chest lifts with rotation, and ball bridges, participants had higher serotonin levels. Since serotonin plays a key role in mood regulation, these women reported feeling less depressed, more resilient to stress, and better able to cope emotionally during PMS.

Pilates doesn’t only have a positive effect on specific hormones like cortisol — it has also been found to ease inflammation. A 12-week Mat Pilates program significantly improved blood pressure and inflammation markers in older adults. Participants showed lower systolic and diastolic blood pressure and had improved circulation (meaning better oxygen delivery to muscles). Pilates also reduced oxidative stress (which contributes to inflammation) and boosted nitric oxide (which helps your blood vessels function properly).

Another interesting finding involves how you practice Pilates. Research comparing face-to-face Pilates classes with online sessions found both formats beneficial, but face-to-face classes offered an extra boost. In-person sessions provided immediate instructor feedback, deeper breathing exercises, and more personal encouragement, which are all helpful for reducing stress, anxiety, and inflammation.

All these findings point to the same conclusion. Pilates — especially Mat Pilates with its focus on controlled breathing and targeted movements — is a simple and effective way to manage stress, lower inflammation, and boost overall well-being.

As we’ve seen so far, Mat Pilates is great for managing stress and inflammation, but it’s also especially helpful if you deal with chronic pain like lower back pain. Weak or uncoordinated core muscles often play a role in back pain, and Mat Pilates directly targets these muscles to improve strength, stability, and balance.

In fact, one study directly compared Mat Pilates to apparatus-based Pilates for women struggling with chronic low back pain. After eight weeks (three sessions per week), the group practicing Mat Pilates had bigger improvements in both pain reduction and balance than the apparatus group. Researchers believe Mat Pilates might have worked better for these participants because it focuses on strengthening core muscles using body weight (without relying on heavier or more complicated equipment).