Introduction
Chronic low back pain (CLBP) is a disabling condition and a
major health problem, with 70—85% of people suffering low
back pain (LBP) at some time in their lives,1,2 and nonspecific
low back pain cited as the fifth most common reason for
healthcare provider visits in the United States.3 Chronic low
back pain is defined as a chronic condition of lower back
pain lasting for at least three months or longer.2,4 In the
USA, approximately 36% of community-dwelling older people
experience a period of back pain every year5 and 21% of
those report frequent moderate to severe pain.1 Similarly,
the incidence of LBP among older people in Eastern countries
such as Thailand is high, with a reported 70% of older Thai
people experiencing muscle and back pain.6 CLBP impairs
quality of life, restricts physical activity, reduces psychosocial
well-being, and is therefore costly for society.7,8 CLBP
costs are estimated to be more than 36 billion dollars per
annum in the United States from lost work time and as
a result of disability.9 Non-pharmacologic interventions for
CLBP are recommended when patients do not show improvement
with standard treatment.10