This story described a new study as showing it proved yoga was basically as good as physical therapy. That’s somewhat correct, but a key detail to this is defining what “good” means in numerical terms, which the story didn’t do. As it turns out, the results weren’t overwhelming: The people who were assigned to yoga or PT didn’t have much better outcomes than the control group on pain and function measurements. (The control group received educational materials.)
Another detail many stories missed: This research is unique because it enrolled low-income patients. Since the magnitude of benefit was lower in this study, it suggests that these treatment options may not be as effective as seen in previous studies that included mainly middle and higher income individuals.
Yoga very likely does help reduce pain–and at a relatively low risk profile compared to pain medications. Still, it shouldn’t be promoted as more effective than it really is, because that’s misleading to readers.
When it comes to chronic back pain, “any single treatment approach is unlikely to prove helpful to all or even most patients,” as this editorial accompanying the study explained. This includes yoga.
The story does not discuss the costs of a set of yoga classes for a patient with chronic back pain. It would also be helpful to talk about whether insurers would reimburse patients for yoga in the same way they reimburse for prescription pain medications. Out of pocket costs may be greater for yoga than for PT, which may be more likely to be covered by the insurer.
The story does not quantify how much “better” patients felt who received yoga classes compared to patients who received only education, or who received only physical therapy.
Here is the statement by the researcher. Italics by editor.
“Yoga was as effective as physical therapy for reducing pain intensity,” Saper said. “Perhaps most importantly reducing pain medication use.”
There should have been numbers for “as effective as” showing us the comparison of some measurement.
What this news story and many others missed: The study’s primary outcomes were pain and functional status. It found that neither yoga nor physical therapy were statistically better than education (the control group). And due to the lack of numbers in this story, it’s not clear how effective any of them are.
The story could have included some statement of potential harms from yoga. While it may seem that yoga is innocuous, that’s not exactly the case: In a 2017 Cochrane review of 12 different research studies on yoga and chronic back pain, they included potential harms, including the risk of “increased back pain.”
This story does tell us a few details about the study. For example, that “320 adults with moderate to severe back pain received one of three approaches over 12 weeks:
But the story would have been stronger if it had pointed out this was a randomized study–meaning participants weren’t allowed to pick the treatment they wanted, which helps avoid bias. It also should have discussed that there was a high drop-out rate (not everyone completed the study) among the PT and yoga groups, reducing the actual patient size substantially.
There was no disease mongering. But we thought the story tried too hard to raise the specter of opioid addiction, which was not the focus of the research itself. If you’re going to go there, then at least go deeper into the topic of pain and addiction–rather than just raising that scary reality and not explaining it better.
No independent sources were quoted.
The story was about three alternative therapies for chronic low back pain–physical therapy, education, and yoga. While a lot more could have been said on the effectiveness of these treatments, it was at least clear that there are options beyond yoga.
Yoga is widely available, although it may be harder to find for rural and low-income neighborhoods. Ironically, the story does not tell us that the 320 patients in this research study were primarily low-income. The study publication itself does say that.
Yoga and back pain has been studied a lot, yet this story didn’t place this new study in context with past research.
An editorial that accompanied the study highlights what is novel about this study: It was made up of low-income patients and there was a longer evaluation period than most studies (1 year).
If the story had mentioned these differences, then it would be Satisfactory on this criterion.
We did not find a news release for this study, so we’ll rate this N/A.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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