This story begins with a young girl who finds relief from her crippling scoliosis-related back pain through yoga. Without warning or explanation, it morphs into a discussion of yoga for chronic low back pain in general. This shift is confusing and troubling, because while there is some evidence that yoga can be an effective approach for relief of chronic low back pain, there’s no such supporting evidence for yoga as an alternative to surgery for people with severe scoliosis. To suggest, based on one anecdote, that readers with severe scoliosis might look to yoga as an alternative to surgery is misleading and irresponsible.
Back pain is a huge issue in the United States. According to the CDC, more than 28 percent of adults it polled for a national health survey in 2009 had suffered from lower back pain within the previous three months. Estimates of the economic impact of back pain in the U.S. vary widely, with some reaching well into the tens of billions of dollars per year. Further, treatments for chronic back pain can include surgery — which comes with high costs and health risks of its own. There is a large market for non-invasive measures to improve back pain, and it’s important for stories discussing such measures to offer detailed information on the pros and cons associated with those options.
The story doesn’t mention cost. A quick internet search found that the cost of yoga classes ranged from $8 to $25 per class. If a beginner is expected to take classes on a regular basis, this could quickly become expensive. Then again, it could be a bargain compared with the cost of surgery, which also isn’t discussed.
The story focuses far too much on the experience of one woman who attributes her seemingly miraculous recovery from severe scoliosis to yoga. No matter how effective yoga might be, it’s not going to allow most people with low back pain to perform “handstands and acrobatic arm balances” or attract 1.6 million fans on instagram.
When it does turn to evidence from studies, the story describes benefits in vague terms. In one study, “back pain patients who learned yoga had better back function and were better able to manage their pain” — but it’s not clear how often the individuals practiced yoga, how much better their back function was or what is meant by better pain management. The second study, the story says, found “yoga improved disability from chronic back pain more than exercise or self-care instructions.” But we aren’t told what the benefits of exercise or self-care are, or how yoga performed better than those options.
The story cites a medical professor as recommending that those with back pain should get medical clearance before beginning yoga, and “taking it slow and easy to start.” But the story doesn’t say why. Yoga is a physical discipline, and can result in a wide range of injuries — particularly for beginners or those who are already suffering from back pain. Moreover, there is no evidence that yoga is safe for patients with severe scoliosis who are considering surgery.
The story describes one study as a randomized, controlled trial. However, that’s essentially all of the information the story provides about either of the two studies mentioned. It’s impossible to learn more about the studies, since the story doesn’t tell us who authored the studies, what organizations they were affiliated with, or when the studies were published. While the story is correct in noting that there is a “lack of conclusive research,” we’d need more than that blanket statement to award a satisfactory rating here.
This story doesn’t describe scoliosis or chronic low back pain in any meaningful way. As such, we question whether there’s enough information to even warrant a satisfactory or unsatisfactory grade or whether this should be ruled Not Applicable. Comments from Dr. Richard Besser at least hint at the diversity of issues that can cause back pain — enough for a borderline satisfactory.
This is satisfactory. We think. The story quotes two medical professionals who likely are not associated with either of the studies mentioned in the piece. However, that’s impossible to confirm, since the story doesn’t tell us who authored the studies. Similarly, it’s impossible to tell if the authors of the studies had any conflicts of interest.
The story does discuss back surgery as a treatment option for back pain and scoliosis. However, the story does not clearly distinguish between back pain resulting from scoliosis vs. other causes. The story also does not discuss non-surgical options for scoliosis — which include braces and therapeutic exercises for children or medications to address osteoporosis or osteoarthritis in adults. The story does compare yoga to “exercise and self-care instructions” in addressing chronic back pain, but it’s fairly vague. The story does not address other treatment options for chronic back pain, such as pain relievers, physical therapy, or cortisone injections.
While the story doesn’t explicitly say that yoga classes are taught around the country, it does note that there are 22 million practitioners in the U.S. — and the woman who appears in the headline is a yoga instructor. However, it’s worth noting that many communities may not have access to yoga classes where beginners can learn how to practice yoga safely.
The story could have done more to establish context. A search on Google Scholar turned up at least half a dozen studies on yoga and scoliosis, and quite a few more on yoga and lower back pain. The story doesn’t explain how the two studies it cites are different from any of the previous studies. That being said, the story doesn’t try to oversell the novelty of yoga for back pain; it establishes a trend toward growing popularity and seems content to document the trend. We’ll call this good enough for a satisfactory rating.
The story includes quotes obtained from at least three interviews. There does not appear to be any related news release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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