Breakthrough research to self-manage and cope with pain through exercise

Physiotherapy students

Mike HurleyMike Hurley, Professor of Rehabilitation Sciences, has devised a rehabilitation programme for patients with chronic knee pain caused by osteoarthritis. Small groups of six to eight patients are taught physiotherapy exercises and coping strategies in the ESCAPE-pain (Enabling Self-management and Coping for Arthritic pain through Exercise) programme.

After receiving training in the programme, clinicians at Sevenoaks District General Hospital in Kent ran ten sessions over five weeks, each consisting of physical exercises with themed discussions on topics such as setting goals and controlling pain. Participants received tailored exercises to do at home, and their progress was reviewed in the sessions.

The evidence shows that participation in the programme improves pain management, reduces consultations, investigations and ineffective treatments, reduces medications and helps avoid surgery. The programme is also more cost effective than the usual individual outpatient physiotherapy.

Osteoarthritis is a major cause of suffering, physical disability, distress, and direct and indirect healthcare and socioeconomic costs. Chronic pain leads to lower levels of physical activity which can have knock-on effects such as greater likelihood of developing diabetes or cardiovascular conditions. While NICE recommends that exercise should be a core treatment for people with osteoarthritis, many people with Joint pain are managed in primary care with painkillers, despite the risks of side effects associated with long-term use.

ESCAPE-pain has now been promoted by NICE as an intervention that commissioners and providers should deliver and the programme has been introduced at other hospitals across the UK. As news of the programme’s benefits spreads throughout the professional community, more and more people living with chronic Joint pain will be able to live happier and productive lives.