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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 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.

Clinicians adopt it as the intervention of choice for chronic joint pain [Hurley et al 2009].

Patients describe first-hand, positive experiences 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.

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.

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.

Research papers

Download and read our published research papers.

Clinical Outcomes (Hurley et al 2007a)

Long Term Outcomes (Hurley et al 2012)


Patients Perspectives (Hurley et al 2010)

Economic Evaluation (Hurley et al 2007b)

Psychological Benefits (Hurley et al 2002)

Hip Feasibility Trial (Hurley et al 2011)

Long Term Benefits (Jessep et al 2009)

Community-based care and ESCAPE-pain

Effectiveness of a Web-Guided Self-Managed Telerehabilitation Program