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Musculoskeletal-related pain has a major impact on individuals and society. In the United Kingdom, an estimated 9.3 million working days were lost to musculoskeletal (MSK) pain between 2008-2009 with back, neck, shoulder and knee pain being the most commonly reported MSK problems. MSK-related pain is the second most common reason for GP visits and accounts for approximately 20-30% of all GP consultations in the UK.

ESCAPE-pain stands for Enabling Self-management and Coping with Arthritic Pain using Exercise. It 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

1. ESCAPE-pain for knees and hips

Designed to benefit people with chronic knee or hip pain, otherwise known as osteoarthritis (OA). Chronic joint pain, joint stiffness and reduced physical function are the main symptoms associated with osteoarthritis, the most common form of arthritis. Osteoarthritis is associated with age and obesity and with an ever ageing and obese population in the West, the socio-economic burden of OA is expected to rise in the future. Osteoarthritis affects at least 8.75 million people in the UK. This figure is set to double by the year 2030, due to an ageing population and increase in weight. Visit the NHS Choices website for more information about osteoarthritis.

2. ESCAPE-pain for backs: designed to benefit people with chronic low back pain

Low back pain affects around a third of adults in the UK each year, and about 9.11 million (16.9%) of these people in England are experiencing severe back pain. Over 70% of the population will experience a significant episode of back pain during their lives and it is the most common reason why middle-aged people visit their GP. The prevalence of back pain is increasing with an ageing and growing population. Back pain has a dramatic impact on individuals and society in general. It is the top cause of years lived with disability in the UK and is the second most common cause of time off work (after minor illness, such as colds, flu and sickness). Visit the NHS Choices website for more information about back pain.

Aims of the programme

The ESCAPE-pain programme aims to increase physical function and improve quality of life.

The programme will not cure, nor eliminate pain completely. However, it aims to help people understand their condition better, and to realise that exercise is a safe and effective self-management strategy, that can be used to reduce pain, improve physical function, self-confidence, sense of being in control of problems, and the depression and frustration that is often felt with pain.

The programme focusses on promoting and progressing functional exercises that improve strength, balance, range and coordination, and get participants back to doing the physical activities they enjoy. It aims to show people that they can change their health beliefs and behaviours, in order to increase their levels of physical activity and control their symptoms and the course of their condition.

Structure of the programme

The ESCAPE-pain programme is delivered in hospital outpatient departments, gyms, leisure centres and community halls, and can be facilitated by both healthcare and exercise professionals.

The programme is delivered to small groups of people twice a week, for six weeks (total 12 classes). There are two components of the programme:

1) an education component where people learn about the problem, what might be causing it, why they experience pain, simple ways to cope and self-manage their problems;

2) an exercise regimen where people undertake a progressive exercise programme tailored to each individual’s needs and abilities.

Core Tenets of the programme

The following core tenets of the ESCAPE-pain programme must be adhered to by healthcare and exercise professionals who wish to deliver the programme:

The Programme, and the use of the training materials, can only be delivered by facilitators who have attended the ESCAPE-pain training.

Get in touch with us

Email us at to find out more about implementing ESCAPE-pain in your organisation.