The Effects of Physical Therapy Management and Pain Neuroscience Education for Patients With Musculoskeletal Pain Undergoing Rehabilitation for Substance Use Disorder: A Quality Improvement Project

OBJECTIVE: To determine the effectiveness of physical therapy (PT) management and pain neuroscience education (PNE) combined for patients with musculoskeletal pain while undergoing rehabilitation for substance use disorder (SUD). DESIGN: Quality improvement project using a quasi-experimental cohort design METHODS: Two female addiction recovery care (ARC) centers participated by completing 2 outcome measures: the Central Sensitization Inventory (CSI) and a novel questionnaire called the Recovery Exercise Program Index (REP Index). At ARC 1, participants received individualized and group PT and PNE interventions. ARC 2 participants received no additional interventions beyond the standard of care. Outcome measures were collected at baseline and 30 days later at both centers. A 2×2 repeated measure analysis of variance (ANOVA) model was used to compare group-by-time interactions to determine the effect the intervention had on each measure. RESULTS: The CSI ANOVA demonstrated a significant group-by-time interaction ( P<.001). The post hoc analysis at the follow-up assessment revealed improved and significantly lower scores at ARC 1 (31.0 ± 11.6) compared to ARC 2 (43.3 ± 13.6) ( P<.001). The REP Index ANOVA demonstrated a significant group-by-time interaction ( P = .002). The post hoc analysis at the follow-up assessment showed improved and significantly lower scores at ARC 1 (15.9 ± 6.4) compared to ARC 2 (31.1 ± 8.3) ( P<.001). CONCLUSION: Providing both individual PT management and PNE for 1 month to the unique patient population with chronic musculoskeletal pain undergoing SUD appears to have a positive effect during recovery by reducing CS. JOSPT Open 2025;3(3):354-361. Epub 24 April 2025. doi:10.2519/josptopen.2025.0111