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The ESCAPE-pain programme is an intervention for people with chronic joint pain, developed by Professor Mike Hurley. The flexibility of the ESCAPE-pain programme means it can be delivered in a variety of locations and by a range of professionals. ESCAPE-pain has been successfully delivered in hospital outpatient physiotherapy departments, leisure centres/ gyms, and in community settings such as church halls and community centres.

ESCAPE-pain offers two programmes:

  • ESCAPE-pain for knees and hips: designed to benefit people with chronic knee or hip pain.
  • ESCAPE-pain for backs: designed to benefit people with chronic low back pain.

The two programmes complement each other, however, they are two separate programmes, with their own evidence, participant eligibility criteria, session content and facilitator training requirements.

ESCAPE-pain for knees and hips

ESCAPE-pain delivers the NICE core recommendations of exercise and education for the management of osteoarthritis. The programme was referenced in the original National Institute for Health and Care Excellence (NICE) Guidelines for the Management of Osteoarthritis [2008], and adopted as a case study in NICE’s Quality, Innovation, Productivity and Prevention programme [2013]. The NICE guidelines for the care and management of osteoarthritis were revised in 2014 (CG17).

Robust evaluation shows that the programme is clinically and cost-effective.

The ESCAPE-pain programme for knees and hips has received the following support/ endorsements:

  • ESCAPE-pain is referenced in the new resources published in April 2020 by the Chartered Society of Physiotherapy (CSP) to support people self-managing their musculoskeletal conditions. These resources are supported by NHS England and NHS Improvement as part of the MSK leadership group which also includes the British Orthopaedic Association (BOA), the British Society for Rheumatology (BSR), the Chartered Society of Physiotherapy, Versus Arthritis and the Arthritis and Musculoskeletal Alliance (ARMA).
  • Highlighted in the updated NHS England clinical guidance (pages 15-18) on knee arthroscopy for patients with osteoarthritis in their Evidence-Based Interventions: Guidance for Clinical Commissioning Groups (CCGs) published in November 2018 and updated in January 2019. The guidance states that exercise programmes like ESCAPE-pain are more effective treatments for patients with osteoarthritis than arthroscopic knee washouts.
  • Mentioned in the NHS Long Term Plan launched on Monday 7th January 2019. Read our response here.
  • Referenced in the Public Health England published guidance on musculoskeletal health – ‘Musculoskeletal Health: applying All Our Health’.

The following resources have been designed to support Integrated care boards (ICBs) formerly, clinical commissioning groups who might want to consider integrating ESCAPE-pain for knees, hips or backs into their MSK contracts.

ESCAPE-pain for backs

ESCAPE-pain for backs implements the NICE clinical guidelines for the management of low back pain [NG59]. The programme builds upon the strong evidence base behind the original ESCAPE-pain programme for knees and hips, following the same model and structure to help participants self-manage non-specific low back pain.

The research, evidence, and endorsements for each programme can be found in the ‘about us’ section.

For further information please email: