Impact of Core Stabilization Exercises Versus Pilates on Pain Intensity, Lumbar Range of Motion, and Daily Activity Performance in Patients with Lumbar Disc Herniation: A Randomized Controlled Trial

Background: Lumbar disc herniation (LDH) is a common source of pain and disability, often impairing mobility and daily function. While core stabilization exercises and Pilates are widely used in rehabilitation for LDH, comparative evidence of their effectiveness remains limited. Objective: To compare the effects of core stabilization exercises and Pilates on pain intensity, lumbar range of motion (ROM), and daily activity performance in patients with lumbar disc herniation. Methods: In this single-center randomized controlled trial, 60 patients aged 30 to 55 years with MRI-confirmed LDH and moderate to severe pain (VAS ≥4) were randomly assigned to core stabilization (n = 30) or Pilates (n = 30) groups. Both groups received 12 supervised sessions over six weeks. Pain intensity (Visual Analog Scale), lumbar ROM (flexible goniometer), and functional disability (Roland-Morris Disability Questionnaire) were measured at baseline and post-intervention by blinded assessors. Data were analyzed using paired and independent t-tests, with effect sizes and confidence intervals reported. Results: Both interventions significantly reduced pain and disability and increased lumbar ROM (all p < 0.001). Core stabilization yielded greater improvements in VAS (mean change: -3.1 vs. -1.7), ROM (+14.7° vs. +9.8°), and RMDQ (-7.7 vs. -4.4) compared to Pilates, with significant between-group differences favoring core stabilization for all outcomes (VAS p = 0.02, ROM p = 0.01, RMDQ p = 0.03). Conclusion: Core stabilization exercises are more effective than Pilates in reducing pain and disability and enhancing lumbar mobility in patients with LDH. These findings support prioritizing core stabilization protocols in conservative LDH management.