ESCAPE-Pain: exercise to reduce the pain of osteoarthritis

What have we achieved?

Our research has transformed the care of people with hip and knee osteoarthritis through the development and delivery of a six-week programme of education, exercise and self-management, called ESCAPE-pain. Over 15,000 people have now taken part in this programme, which has been shown to improve quality of life for people with arthritis, whilst also saving the NHS time and money.

What problem were we trying to solve?

Osteoarthritis is the most common form of arthritis, affecting millions of people in the UK.

What is osteoarthritis?

Osteoarthritis is often managed poorly, with many people experiencing pain most days, unable to go about their everyday activities. People are frequently taking long-term pain relief and are not provided with self-management strategies as recommended by the National Institute for Health and Care Excellence (NICE) guidelines, which include weight management and exercise.

Improved access to a self-management and exercise programme has the potential to significantly improve quality of life for people with arthritis, as well as reducing physiotherapy waiting times, pressure on GPs, and medication use.

What research did we fund, and what was the result?

Our funding enabled Professor Mike Hurley at St George’s, University of London, to develop an exercise programme called ‘Enabling Self-management and Coping with Arthritis Pain through Exercise’ – or ESCAPE-pain.

ESCAPE-pain is a six-week programme of education, integrated exercise and self-management delivered in a group setting by a physiotherapist or a fitness instructor.

As well as a tailored exercise routine, participants learn about the causes of pain and self-management techniques.

The programme aims to:

  • improve people’s understanding of their problem
  • advise them what to do and what not to do
  • help them realise that exercise is a safe self-management strategy that can reduce the impact of joint pain and improve their quality of life.

Versus Arthritis & ESCAPE-Pain

What impact has this research had?

The impact of ESCAPE-pain has been vast. The programme has been shown to:

  • reduce pain
  • improve physical function
  • increase quality of life and general well-being
  • reduce use of healthcare services and medication.

Ken, who took part in ESCAPE-pain, said “I’m feeling good, better than I was and it’s all through exercise.”

ESCAPE-pain in numbers:

  • Over 15,000 people have now benefitted from the programme.
  • Delivered at 265 locations across the UK.
  • Over 1100 physiotherapists and healthcare professionals across the trained to deliver programme.
  • Over £22 million in savings to health and social care providers to date.
  • For every 1000 people who take part, approximately £1.5 million saved in healthcare costs.

The ESCAPE-pain programme won the MSK Care Initiative of the Year award at the HSJ Value Awards 2020. Read more about how the programme has taken action and made a difference to people's lives.

Ken’s story

Ken has had osteoarthritis in his left knee for 20 years. Having always been active, it came as a shock when pain put his life on hold.

“I couldn’t sleep at night, I was then tired all day, and that made me not want to do anything. I was struggling to get out of my chair, put my shoes and socks on and it was making me depressed.”

Ken took part in the ESCAPE-pain course, and now that he has finished the course, he goes to his local gym three times a week.

“My diabetes is under control and I have lost some weight. I have improved the strength of the muscles in my leg.”

Read more about Ken’s story and how exercise has changed his life.

Physiotherapist’s point of view

Physiotherapists and exercise professionals can use the ESCAPE-pain programme in their local organisations. ESCAPE-pain provides training, resources and support to help get classes started.

Watch this video below to find out how a physiotherapist has seen the programme change the lives of people with osteoarthritis.

How can I access the programme?

ESCAPE-pain is predominately recommended to people who are aged 45+ with osteoarthritis, who are experiencing some knee or hip pain and may have other conditions.  

People of all ages can attend many of the groups and the best place to find out where your nearest class is via If you are a physiotherapist or exercise professional, you can also find out how to become a programme facilitator.

During the time of COVID-19, developers of the programme have launched Escape-pain online, a free online exercise resource to help people living with chronic pain.