ESCAPE Pain Programme
ESCAPE-pain is a rehabilitation programme for people with chronic joint pain of the knees and/or hips. It links self-management and coping strategies with exercise specific for each person. It helps people understand their condition, teaches them simple things they can help themselves with, and takes them through a progressive exercise programme so they can cope with pain better.
Robust evaluation shows that ESCAPE-pain:
- Reduces pain
- Improves physical function
- Improves the psychosocial consequences of pain
- Reduces healthcare and utilisation costs
The programme will help you learn to cope with your knee and/or hip pain better. ESCAPE-pain is delivered as 2 classes per week for 6 weeks (12 classes in total). Class size is usually 8-10 people but can be increased if there is more than one facilitator.
Each class usually starts with a brief group discussion around a topic relating to joint pain. This helps participants to share their experiences with others, to encourage shared learning. This is followed by about 40 minutes of a simple circuit-type exercise programme. A Physiotherapist will supervise and tailor exercises to suit your needs.
During the first and last session, you’ll be asked to complete some questionnaires about your pain and management. More information on this can be found below.
All exercise equipment will be provided. It’s recommended that you:
- Wear loose-fitting clothing
- Wear comfortable, flat shoes (e.g. trainers)
- Bring a water bottle
- Bring reading glasses, if needed.
ESCAPE-pain stands for Enabling Self-management and Coping with Arthritic (knee) Pain using Exercise. It is a programme for people with chronic joint pain – often labelled osteoarthritis – that integrates education and exercise.
ESCAPE-pain aims to reduce pain, improve physical function and self-confidence. It also improves people’s sense of being in control, and the depression and frustration that people with chronic pain feel. However, ESCAPE-pain does not cure arthritis or eliminate pain completely.
ESCAPE-pain was referenced in the original National Institute for Health and Care Excellence (NICE) Guidelines for the Management of Osteoarthritis (2008). NICE guidance is used by the NHS, local authorities, employers, voluntary groups and others involved in delivering care or promoting well-being.
It successfully delivers the NICE core recommendations of exercise and education for the management of osteoarthritis and was used as a case study in the NICE Quality, Innovation, Productivity and Prevention (QIPP) programme (2013).
ESCAPE-pain is referenced in the Public Health England (PHE) published guidance on musculoskeletal health. – “Musculoskeletal Health: applying All Our Health”.
ESCAPE-pain is designed to benefit people with chronic knee or hip pain and with a confirmed or likely diagnosis of osteoarthritis.
If you live in Bedfordshire or Greenwich and are registered with a local GP, they can refer you to the MSK service and ask for you to be seen in a class, local to you.
Some people think that being more active will increase their pain, but after 1-2 sessions you will learn that exercise isn’t painful, and start to feel the benefits.You will be better able to do the exercises, feel more confident and more in control.
No. To prolong the life of a joint you need to be physically active. Strong, well-coordinated muscles are a necessity, not a luxury. They protect your joint and can delay, even prevent, pain and disability.
You do not need strenuous exercise to make your muscles stronger. Doing some physical activity regularly is better than doing nothing regularly. Blood, sweat and tears are NOT essential.
You will attend two classes a week for 6 weeks, for a total of 12 classes. Each class starts with a brief discussion around a set theme. (I.e. pain; what it is, simple ways to reduce it using heat, ice or rest-activity cycling). This is then followed by 40 minutes of a circuit type exercise programme.
It is important to commit to attending all 12 of the sessions in order to gain the benefits of the programme.
The Physiotherapist will work with you encouraging you to try to do as many exercises as you can, taking rest in between. They will work with you to make you more comfortable and confident in your abilities and to progress on the exercises that you do each session.
The exercises can be progressed in different ways depending on the exercise. Some can be progressed by trying to do more repetitions of the exercise in one minute. Others can be progressed by doing them for a longer time. Others can be progressed by doing them for longer but also doing them slowly, in a controlled manner. The facilitator during your classes will work with you to ensure that you are progressing based on your abilities and goals.
You will be asked to complete some questionnaires about your pain and management during your first class. You’ll also be asked to complete questionnaires again at the end of the 6-week programme. This information is useful to see how much progress you have made, and to keep track of how ESCAPE-pain is helping people.
Please be sure to wear loose-fitting clothing and comfortable shoes, bring along a water bottle, and reading glasses (if required).
Your facilitator will explain that it is easier to become more active and do more exercise if you set yourself a goal. You can start by thinking about something that you really want to do, for example, going to the park with your grandchildren or working in the garden for 30 minutes daily. You can then put together an action plan, explaining:
- What you want to achieve (your goal, for example, working in the garden daily)
- When you will achieve it (e.g. 3 months)
- How you will achieve it (e.g. completing ESCAPE-pain and continue to exercise twice a week after that)
- Where you will achieve it (e.g. exercising at home and at the local gym)
Your facilitator can help you in setting some short-term goals as stepping stones to achieve your main goal.
At the beginning and end of the programme we ask you to complete 2 questionnaires, each one of which will result in a score. This will allow you to measure the progress you made throughout the programme. The outcome forms are anonymized. Please do ask your facilitator to help you with the forms if you have any questions.
We generally advise that if you have other medical conditions that prevent you from taking part in exercise programmes (such as unstable heart conditions, severe angina, blood pressure, your doctor has recently been altering your medication, you often fall or exercise makes you very breathless very soon after you begin to exercise), you should seek advice from your GP, nurse or other healthcare practitioner.
You can also contact the Versus Arthritis helpline by phone (0800 5200 520) or email email@example.com. Versus Arthritis have a team of advisors who can provide tips and advice on managing pain and arthritis. You may also wish to visit their website (https://www.versusarthritis.org/) which has a range of patient resources and information which you may find helpful.