OT & PT in Clinical Treatment Guidelines

Condition

Treatment Recommendations that include OT and/or PT

OT Potential Clinical Decision Support Page

Low back pain

Current treatment guidelines, including those from the American College of Physicians, strongly recommend nonpharmacologic interventions as first-line therapy for both acute and chronic low back pain and support the inclusion of occupational therapy and physical therapy as part of a multidisciplinary, biopsychosocial approach, particularly for patients with work-related issues or persistent pain and disability.

Alzheimer’s disease and other dementias

AOTA guidelines and supporting systematic reviews and randomized controlled trials recommend occupational therapy as a core nonpharmacologic intervention for Alzheimer’s disease and other dementias. Strong evidence demonstrates improvements in activities of daily living, behavioral and psychological symptoms, and quality of life for both patients and caregivers.

Osteoarthritis

Occupational and physical therapy are defined as essential services in the management of osteoarthritis according to the 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. The AOTA practice guidelines also recommend occupational therapy in the management of osteoarthritis and rheumatoid arthritis.

Cancer

Occupational and physical therapists are explicitly highlighted as first-line providers for the management of lymphedema in the American Cancer Society/­American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline. Systematic reviews and meta-analyses demonstrate that occupational therapy interventions improve quality of life, physical health, social health, cognitive function, fatigue, and role function in breast cancer patients. The AOTA cancer practice guidelines recommend evidence-based OT interventions for adults with and beyond cancer.

Cancer Rehab: Adults and Older Adults
Cancer Rehab: Adolescents and Young Adults

Stroke

Current U.S. practice guidelines from the American Heart Association/American Stroke Association (AHA/ASA) and the U.S. Department of Veterans Affairs and Department of Defense guidelines (VA/DoD) recommend both occupational and physical therapy as core components of stroke rehabilitation to maximize functional recovery and independence. The AOTA stroke practice guidelines promote evidence-based OT interventions across all stages of stroke recovery.

Stroke / Cerebrovascular Accident (CVA)

Falls

Guideline recommendations from the U.S. Preventive Services Task Force, the American Geriatrics Society/British Geriatrics Society, the CDC STEADI initiative, and the American Physical Therapy Association all consistently support the integration of PT and OT into fall prevention strategies for older adults.

Mental health conditions

Occupational therapy is a mandatory part of Medicare’s partial hospitalization programs, and is generally considered a crucial part of the treatment team in psychiatric hospitals. Systematic reviews and meta-analyses highlight the role of occupational therapy in preventive mental health care in schools and communities, promoting wellness and early detection of behavioral health challenges.

Postpartum Anxiety

Hypertension

Current hypertension treatment guidelines from the American College of Cardiology and American Heart Association (ACC/AHA) and the American Diabetes Association (ADA) both include lifestyle interventions as foundational therapy for elevated blood pressure and hypertension. Current literature provides robust evidence for the effectiveness of OT interventions focused on medication adherence and lifestyle modification, particularly when interventions are individualized and integrated into chronic disease management.

Chronic obstructive pulmonary disease

Multiple chronic obstructive pulmonary disease (COPD) treatment guidelines, including those from The American Thoracic Society and Global Initiative for Chronic Obstructive Lung Disease (GOLD), explicitly mention physical therapy as a core component of pulmonary rehabilitation. Two practice guidelines endorse occupational therapy in pulmonary rehabilitation programs, with tasks such as teaching energy conservation, addressing activities of daily living, and providing breathlessness management, all contributing to improved outcomes in COPD.

Neck pain

Physical therapy is consistently recommended in the management of neck pain, with robust evidence supporting exercise-based interventions in treatment guidelines. Across guidelines, multidisciplinary approaches within the scope of occupational therapy, including education, self-management strategies, and psychological support, are recognized as important, especially for chronic pain and disability.

Multiple sclerosis

The American Academy of Neurology guidelines explicitly mention physical therapy and multidisciplinary rehabilitation (which includes occupational therapy) as effective interventions for improving functional outcomes in multiple sclerosis. Additional systematic reviews and consensus statements also consistently support the use of OT and PT as part of comprehensive MS care, particularly for activity, participation, and quality of life improvements. The AOTA MS practice guidelines promote evidence-based OT interventions for adults with MS.

Rheumatoid arthritis

The American College of Rheumatology recommends comprehensive occupational therapy and physical therapy as integral components of RA management, with early and individualized referral to these services. OT and PT are shown to improve pain and physical function, preserve independence, and support work participation in this population. The AOTA practice guidelines also recommend occupational therapy in the management of osteoarthritis and rheumatoid arthritis.

Headache disorders

Several consensus statements, systematic reviews, and expert recommendations in the medical literature consistently recommend physical therapy as part of a multimodal approach for tension-type headache, cervicogenic headache, and migraine. Occupational therapy is included as part of a recommended multidisciplinary approach to address environmental and functional triggers, as well as to support behavioral modification and coping strategies.

Other musculoskeletal conditions

The American College of Rheumatology conditionally recommends PT and OT for all juvenile idiopathic arthritis (JIA) patients, regardless of pharmacologic therapy. AJOT provides evidence supporting expanding the role of OT for adults with musculoskeletal conditions. Treatment for carpal tunnel syndrome, lateral epicodylitis, rotator cuff tendinopathy, and trigger finger are squarely in the scope of physical and occupational therapy, according to American Family Physician.

Rotator Cuff Strain
Distal Radius Wrist Fracture
Golfer’s Elbow (Medial Epicondylitis)
Carpal Tunnel Syndrome
Tennis Elbow (Lateral Epicondylitis)

Sleep conditions

Current clinical treatment guidelines and recommendations for sleep conditions, including multiple systematic reviews, support occupational therapy and physical therapy as first-line treatment for sleep disorders such as insomnia. The use of CBT-I and sleep hygiene education is considered the gold-standard treatment for older adults and veterans with sleep conditions, with physical therapists and occupational therapists shown to safely and effectively deliver these interventions following advanced training.

Sleep Difficulties

Autism

Occupational therapy is specifically recommended as part of the clinical management of autism spectrum disorder (ASD in children) across current U.S. guidelines, including the American Academy of Pediatrics, the U.S. Preventive Services Task Force, and the American Occupational Therapy Association. Most children with ASD require school-based assistance through an individualized education program, which often includes occupational therapy.

Low vision

Clinical treatment guidelines and recommendations for adults with low vision consistently mention occupational therapy and, when mobility or balance issues are present, physical therapy as integral components of multidisciplinary low vision rehabilitation. The American Occupational Therapy Association practice guidelines provide strong evidence supporting the role of OT for older adults with low vision, particularly for ADL and IADL impairments.

Functional Neurological Disorder (FND)

Occupational therapy and physical therapy are recommended as core components of multidisciplinary treatment for Functional Neurological Disorder (FND), especially for patients with motor symptoms. OT and PT are considered first-line treatment for functional motor symptoms in FND.

Functional Neurological Disorder

Postural Orthostatic Tachycardia Syndrome (POTS)

Guideline recommendations from the Heart Rhythm Society and expert reviews emphasize the importance of a multidisciplinary approach to POTS management, explicitly recommending the involvement of physical therapists and occupational therapists as part of collaborative care teams. While scientific literature on POTS is still relatively new, strong evidence including systematic reviews and expert consensus statements support the involvement of both OT and PT in the multidisciplinary approach to FND treatment.

POTS (Postural Orthostatic Tachycardia Syndrome)

Ehlers-Danlos Syndrome (EDS)

The GeneReviews guidelines for classic and hypermobile EDS, published by the University of Washington, specifically states that tailored physical therapy is central for improving muscle strength, proprioception, and joint stability, and that occupational therapy is important for recommending assistive devices, optimizing ergonomics, and supporting activities of daily living. Systematic reviews provide strong evidence for the effectiveness of PT in improving pain, proprioception, and functional capacity in hEDS and generalized hypermobility spectrum disorder.

Hypermobile Ehlers-Danlos Syndrome (hEDS) and Hypermobility Spectrum Disorders (HSD)