So the irritation of the week is back pain. I have a slight spinal deformity and gosh does that thing flair up sometimes. I was looking around for some good papers to help address this issue, when I stumbled across this one that compared yoga, exercise, and a self care book. It’s called Comparing Yoga, Exercise, and a Self-Care Book for Chronic Low Back Pain A Randomized, Controlled Trial by Karen J. Sherman, PhD, MPH; Daniel C. Cherkin, PhD; Janet Erro, RN, MN, PNP; Diana L. Miglioretti, PhD; and Richard A. Deyo, MD, MPH. Here’s the sketchnote:
Some thoughts:
- It’s pretty unsurprisingly both exercise and yoga outperformed the book. Both were active interventions with some participation required. Interventions like that tend to do better.
- The design of this study had a lot of attention to detail. They were very careful to make the exercise as attractive as the yoga by having a physical therapist design a special program uniquely for the study. They wanted to make sure that both the yoga and the exercise were novel enough that people would be interested equally in both. I’ve seen other studies skip this step or have one clearly more interesting option, so I was happy to see they controlled for it.
- It’s interesting to think of the real world implications of point #2. It is likely much easier to find a yoga class than it is to find a custom back pain exercise class. OTOH, some people may like going to a physical therapist better than doing yoga, and that’s probably close to the same thing.
Ultimately, if it looks intriguing, that’s probably enough to help make a difference.
We’re comparing on two axes here: type of intervention (class versus self-directed) and content of intervention (physical therapy versus yoga versus… whatever was in the back pain book).
I wanna see a followup with a generic “back pain” book versus a book/DVD that presents physical therapy versus a yoga book/DVD.
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Or alternatively a class on back pain care that participants are required to go to, to make all 3 interventions “active”.
I actually think the most necessary follow up study may be about the potential injury risk for each of the interventions when practiced normally. The nice thing about PT and/or a book is they both will acknowledge risks. Showing up at any old yoga class could carry the risk that a new/inexperienced/full of hubris teacher will actually make things worse.
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