Abstract
In a 2018 survey led by the CDC, 28.0% of men and 31.6% of women aged ≥18 years had lower back pain in the past 3 months. The percentage of women who had lower back pain increased as age increased. Among men, the percentage increased with age through age 74 years and then decreased. Women in the age groups 18–44, 45–64, and ≥75 years were more likely to have lower back pain in the past 3 months than were men in the same age groups, but percentages were similar between men and women in the age group 65–74 years (CDC, 2020).
Low back pain (LBP) can be categorized as either acute (less than 4 weeks), subacute (4 to 12 weeks), or chronic (more than 12 weeks) (Center for Disease Control and Prevention, 2020). Experiencing lower back pain often hinders a person's ability to participate in meaningful occupations like work, education, and ADLs. In 2012, more than 52.3 million patients visited a physician resulting in an estimated annual direct medical cost for all back-related conditions to $253 billion. (Andersson, 2014). In addition to the surplus spending, the CDC reports that opioids continue to be prescribed for LBP (CDC, 2020). In 2017 alone, 68% of the 70,237 drug overdose deaths in the United States involved an opioid (Wilson, 2020). The opioid epidemic has continued to rise with synthetic opioids accounting for two-thirds of opioid-involved deaths in 2018. (U.S. Department Health and Human Service, 2019). Therefore, by addressing low back pain relief with physical agent modalities and mechanical methods, an occupational therapist can help decrease low back pain that limits the ability of individuals to participate in their meaningful roles, habits, and routines, which are essential to occupational engagement. Furthermore, these interventions may reduce the financial burden on the U.S. healthcare system and opioid prescription epidemic. This CAT focuses on mechanical modalities: massage, yoga, Pilates and motor control exercise, and the physical agent modality ultrasound.