Enabling Self-management
and Coping with Arthritic Pain
using Exercise
Research
ESCAPE-pain stands for Enabling Self-management and Coping with Arthritic Pain using Exercise.
ESCAPE-pain is an evidence-based, cost effective, group rehabilitation programme for people with chronic joint pain, that integrates educational self-management and coping strategies with an exercise regimen individualised for each participant. The programme was developed by Professor Mike Hurley and was originally devised for people with knee osteoarthritis.
ESCAPE-pain offers two programmes:
- ESCAPE-pain for knees and hips: designed to benefit people with chronic knee or hip pain, otherwise known as osteoarthritis.
- ESCAPE-pain for backs: designed to benefit people with chronic low back pain.
ESCAPE-pain for backs
ESCAPE-pain for backs implements the NICE clinical guidelines for the management of low back pain [NG59]. The programme was piloted in 2019 to assess whether the model and principles behind the original ESCAPE-pain programme, for knees and hips, are effective in the self-management of non-specific low back pain. The evaluation of the 2019 pilot showed that ESCAPE-pain for backs delivers effective care, managed in line with NICE guidelines, that significantly improves participant outcomes.
ESCAPE-pain for knees and hips
ESCAPE-pain for knees and hips implements the NICE clinical guidelines for the management of osteoarthritis [CG177]. Rigorous evaluation and independent review shows that the ESCAPE-pain programme for knees and hip is:
- safe and produces better clinical outcomes [Hurley et al 2007a, Hurley et al 2012]
- reduces pain;
- improves physical function, general well-being and quality of life;
- reduces depression.
- has lower healthcare utilisation and cost savings
- compared with usual outpatient physiotherapy;
- lower overall healthcare costs through reduced use of A&E services, medical consultations, referrals, investigations (i.e. X-rays and MRI scans);
- reduced use of analgesia and gastro-protective agents, side effects of medication.
- is more cost-effective than usual care [Hurley et al 2007b, Hurley et al 2009]
- may help delay or avoid surgery
- promotes physical activity, reducing the risk of acquiring or exacerbating comorbidities such as diabetes and cardiovascular conditions
- patients describe how first-hand, positive experience of the programme [Hurley et al 2010]
- alters beliefs about the importance of exercise in managing their knee pain;
- allays fears that exercise might exacerbate joint pain and damage;
- helps them appreciate the benefits of exercise;
- become more confident in their ability to use exercise as a self-management strategy;
- are less reliant on other people.
- clinicians adopt it as the intervention of choice for chronic joint pain [Hurley et al 2009]
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Research papers
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Clinical Outcomes (Hurley et al 2007a)
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Long Term Outcomes (Hurley et al 2012)
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NICE QIPP Report
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Patients Perspectives (Hurley et al 2010)
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Economic Evaluation (Hurley et al 2007b)
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Exercise - Psychological Benefits (Hurley et al 2002)
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Hip Feasbility Trial (Hurley et al 2011)
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Long Term Benefits (Jessep et al 2009)
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