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Medical evidence for lumbar support runs counter to claims made in U.S. News & World Report story

Rating

3 Star

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Can Lumbar Support Devices Relieve Lower Back Pain?

Our Review Summary

This U.S. News & World Report story looks at using back braces for lower back pain.

The story does some things well–it discusses the potential harms of back braces, for example, and provides information on how much they cost. But there’s a big problem overall with the story: It claims that a new study—a meta-analysis of 28 different studies that was published in the Annals of Physical Rehabilitation Medicine—shows back braces might provide some sufferers short-term pain relief.

But here’s what the study actually concludes: “To date, there is no proof to prescribe lumbar support in the management of low back pain general population.” What’s more, the story doesn’t explain the study is (at this point) only a brief abstract from a rehabilitative medicine meeting. Such meeting abstracts offer few details on study design, methodology, results, significance, or conclusions — they’re mainly discussion pieces for professionals who gather at meetings, and serve as previews for more fleshed-out research that’s in the works.

This makes the premise of the U.S. News story questionable, and its lack of any meaningful discussion of the study’s details or quality doesn’t help. In effect, the research abstract serves as a weak tool to discuss back pain, back braces, and how and when to seek treatment.

 

Why This Matters

Back pain is “one of the most common medical problems, affecting 8 out of 10 people at some point during their lives,” according to MedlinePlus, a patient information run by the National Institutes of Health. And according to The Lancet’s Global Burden of Disease Study, back pain is one of the leading causes of disability worldwide. If research reveals that wearing an inexpensive back brace stands to actually help alleviate pain and accelerate recovery compared to alternatives (e.g. drugs and surgery), it’s newsworthy.

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

We’re told over-the-counter lumbar support devices range in cost from $25 to $130, while prescription devices can cost up to $1,000.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The benefits aren’t quantified, and that’s probably because the meeting abstract the story is based on doesn’t provide any itself. However, if the reporter had contacted the abstract’s authors, getting such details ahead of a more fleshed-out research paper might have been possible. This may also have allowed the writer to share the preliminary study with outside experts and get their take.

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

The story describes a few possible harms of back brace use, including skin lesions, muscle wasting, and even gastrointestinal disorders, but notes their rarity. It also describes more common harms, such as irritated skin, and solutions to those problems.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

No real evidence is presented about the meta-analysis; all we’re told is that back braces “can provide short-term relief.” How many studies were examined? How many patients? How long was the follow-up? These are all questions that are left unanswered.

Does the story commit disease-mongering?

Satisfactory

The subject matter itself–lower back pain–is indeed a common problem, so we’ll rate the story satisfactory. The story’s intro–which describes some back pain as a “giant electrified claw […] tearing into each nerve” and a “torturous” feeling with sleight movements that can come with stiffness as bad as “hardened concrete”–was perhaps melodramatic.

But more importantly, it’s never made clear what the differences between acute, subacute, or chronic back pain are, and how the meta-analysis applies to each. It would have been helpful to readers to explain the differences. Also, the story implies that the patient can go get one of these devices at a store and try it on. But is that a good idea? Should a doctor be consulted? It’s not made clear.

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

A handful of medical experts were quoted in the story, but not in any way that assessed the quality or scope of the research. They mostly provided anecdotes and advice on back brace use. Also, the meeting abstract states that the “authors have not supplied their declaration of competing interest,” which the story should have noted in some way. (For example, if they are funded by a pharmaceutical company with a stake in questioning the efficacy of a cost-effective solution for back pain, as opposed to expensive medications, that’s a pertinent detail.)

Does the story compare the new approach with existing alternatives?

Satisfactory

Alternative treatments for back pain are discussed–though minimally. Still, there’s enough to rate satisfactory.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

We’re told back braces are available over-the-counter at drug stores, and that custom-made braces can be ordered, too.

Does the story establish the true novelty of the approach?

Not Satisfactory

The “new” thing here is not that a back support device might help alleviate pain, which is where the story focuses most of its word count. Back braces have been around for a long time and most studies have found them wanting when the evidence is reviewed.

What’s new is the meta-analysis: pooling similar but disparate data generally provides a more reliable assessment of an intervention. But again, those detailed results are not yet publicly available, but the main take-away in the summary was contrary to what the U.S. News & World Report story premised its story upon.

Does the story appear to rely solely or largely on a news release?

Satisfactory

We didn’t see any copy/pasted quotes or any evidence the story borrowed significantly from a news release.

Total Score: 6 of 10 Satisfactory

Comments (1)

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Joe Ellison

January 17, 2017 at 5:46 pm

FWIW, and I realize that anecdote =/= data, but I can assure you that “hardened concrete” and “tortuous” are accurate descriptors for the severe back spasm and pain that can accompany fibromyalgia. It is not at all melodramatic, but the best description available.