Davis: A different kind of reformer


The current U.S. health care system relies on people being sick and injured in order for it to remain financially solvent. Efforts are being made to keep people healthy, save money and maintain some degree of vibrancy as we try to deconstruct the worst elements of the current non-system. If we are ever going to enact lasting and effective health care reform we need to think outside the box

It makes sense to go after the low hanging fruit first. One of the most common problems people suffer from is back pain. Millions of dollars are spent on drugs and treatment and the results are not very good. Why not look for a better way to treat back pain?

In a Sept. 29 article published on the Medscape website a study by a Boston researcher sheds light on an alternative approach to treating back pain. "Our study showed that yoga was non-inferior to physical therapy for a diverse group of low-income patients," said Robert B. Saper, MD, director of integrative medicine, Boston Medical Center, Massachusetts. "Its effectiveness was most obvious in the most adherent patients."

The article goes on to note that Dr Saper presented his study at the American Academy of Pain Management 2016 Annual Meeting. It is worth sharing the details of the research because they offer a real life example of how yoga can be just as effective as physical therapy for the treatment of back pain.

"For this new study, researchers enrolled 320 adult patients from Boston-area community health centers who had chronic back pain with no obvious anatomic cause, such as spinal stenosis. The patients were predominantly nonwhite and low income, with a relatively low education level."

Their findings indicate that, "As for the percentage of participants who had at least a 30 percent reduction (in pain), it's 48 percent for yoga, 37 percent for PT, and 23 percent for education," said Dr Saper. "What that means is that for every two patients who go to yoga, about 50 percent of them are going to have a clinical response."

"Looking at odds ratios for function, comparing the various interventions, "yoga is actually superior" to PT and is "quite a bit" superior to education, said Dr Saper. At baseline, about 70 percent of participants were using medication. At 12 weeks, such use was down by about 20 percent in both the yoga and PT groups, and hadn't changed in the education group.

A similar number of yoga and PT subjects reported being "very improved" and "very satisfied," said Dr Saper."

These numbers are quite impressive. Considering the fact that yoga is generally less expensive than physical therapy, it makes sense for those who pay the bills to figure out a way to legitimize yoga treatment so that health care professionals can order yoga treatment in a way that provides payment to yoga teachers.

That would mean that a state such as Vermont would have to pass a law licensing and regulating therapeutic yoga practitioners. It could be done, and now that mainstream studies are providing evidence-based affirmation of positive outcomes, legislators and insurers should be able to embrace a new and more cost-effective mode of treatment for back pain, as well as a host of other bodily ailments.

I suspect there might be an outcry from the physical therapy community saying that yoga teachers don't have enough training to treat the problems that physical therapists treat. But yoga is a different modality and it has been around a lot longer than physical therapy.

If yoga practitioners were to be certified I would expect them to have to receive national recognition by passing a sanctioned course. These courses run from 500-800 hours. In addition, a law could require yoga practitioners to have at least five years of experience before being certified in Vermont.

This kind of reform could offer the kind of health care vision we need as we try to create a sensible, affordable and outcome-driven health care system.

Richard Davis is a registered nurse. He writes from Guilford and welcomes comments at rbdav@comcast.net. The opinions expressed by columnists do not necessarily reflect the views of the Brattleboro Reformer.


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