London-wide initiative to tackle chronic joint pain could reduce use of strong painkillers

    March 20, 2018

    London-wide initiative to tackle chronic joint pain could reduce use of strong painkillers

    Leading NHS health innovator and physiotherapist speaks out after London newspaper The Evening Standard’s ‘The Opioid Timebomb: Special Evening Standard investigation into the overuse of prescription painkillers‘.

    Video: The video above provides patient testimony of the effectiveness of the ESCAPE-pain programme.

    A leading London physiotherapist and healthcare innovator has joined calls to reduce the use of opioids for chronic joint pain. Commenting on an Evening Standard investigation that has revealed a sharp increase in opioid painkiller prescribing for chronic pain with experts warning of “a public health disaster hidden in plain sight”, a leading physiotherapist who pioneered the award-winning ESCAPE-pain programme Professor Mike Hurley has urged GPs to adopt other methods to tackle chronic joint pain.

    New figures published by the London paper show that 23.8 million prescriptions were dispensed for opioids such as tramadol in England last year, one for every two adults. This is an 80 per cent rise on the 2007 figure.

    Prof Hurley invented the ESCAPE-pain rehabilitation self-management programme which is shown to reduce pain, improve physical function and reduces healthcare costs for people with chronic pain. The number of sites running the programme has increased rapidly with 12 running across London helping 600 patients aged over 45 each year. He said:

    ‘Chronic pain is devastating – over the years I’ve seen too many people caught in a cycle of physical pain, leading to mental health problems, and in the worst cases ending up with addiction. We simply can’t continue to care for patients like this. I understand that for many GPs, who have tight 10-minute appointments which often overrun, prescribing medication may seem appropriate. But with patients suffering from poor outcomes and osteoarthritis affecting nearly 10 million people, taking up substantial GP resources, this can’t go on.

    ‘These painkillers haven’t been proven to work in the long term. The reality is that a combination of exercise and education does more for patients than a prescription. In London, the NHS has already proven that there’s a better way and is already pioneering an alternative approach that doesn’t involve opioids. We hope that more and more places across the country will also change their approach.’

    ESCAPE-pain changed Arlene Rowe’s life. She was in terrible pain because of Osteoarthritis before taking up the six-week programme. She says:

    ‘Since being on the ESCAPE-pain programme, my life has changed massively. My first goal was just to stand straight. Now, I’m not hunched over, and I’m beginning to walk properly.

    ‘I’m still stiff, I’ve still got arthritis, but what I don’t have is the pain. Occasionally I get twinges, but nothing that makes me miserable. Being able to sleep at night is wonderful. I’m not afraid to go out, I’m not afraid to cross the road, I can get on and off the bus okay, and I can get on the train.’


    For more information contact the Health Innovation Network media team on 077537 60124

    The Opioid Timebomb: Special Evening Standard investigation into the overuse of prescription painkillers:

    Case study
    For more details on Arlene’s story see:

    About ESCAPE-pain
    ESCAPE-pain is a group-based, six-week rehabilitation programme which combines exercise and education in an innovative way. Patients who take part in the programme say they experience less pain, have increased mobility and are better able to undertake activity in their daily life, such as gardening and caring for grandchildren. In addition, mental health improves with results for anxiety and depression improving following the programme. Recent independent evaluations have reinforced how much money the NHS saves, showing that every £1 invested returns over £5 in wider health and social value. For more information on ESCAPE-pain go to:

    NHS support
    ESCAPE-pain is one of 37 high impact, evidence-based innovations on the NHS Innovation Accelerator (NIA); a national initiative delivered by the 15 AHSNs and NHS England.

    About Professor Mike Hurley
    Finding a way to improve the practical support for people experiencing chronic pain has dominated Mike’s 25-year career as a clinical researcher. In 2017 he joined the NHS Innovation Accelerator as an Innovation Fellow:
    Mike qualified as a physiotherapist in 1985 and obtained his PhD in 1992. Between 1990 and 2009 he held the posts of Lecturer, Reader and Professor of physiotherapy at Kings College London before joining St George’s University of London and Kingston University as Professor of Rehabilitation Sciences. Since September 2013 he has been Clinical Director of the Musculoskeletal Programme at the Health Innovation Network, the AHSN for south London.