6 TALKBACK PAIN MANAGEMENT
Self-management and coping strategies for the ESCAPE-pain groups, professionals are required to attend facilitator training. The training is open to healthcare professionals and exercise instructors who meet the prequalification criteria. Each e-learning session takes approximately 20-30 minutes to complete, with the aim of improving providers’
understanding of what the programme involves and to prepare for the facilitator training. The research, evidence and endorsements for each programme can be found on the ESCAPE-pain website. The programme will not cure nor eliminate pain completely. However, it aims to reduce
pain, improve physical function, self-confidence, sense of being in control of problems, and the depression and frustration that is often felt with chronic pain. ESCAPE-pain for backs is delivered as two classes a week for six weeks (12 classes in total). Class size is usually about 8-10 people. Each class Image: pressfoto/Freepik
ESCAPE-pain is an evidencebased and cost-effective group rehabilitation programme for people with chronic joint pain – specifically people living with chronic back pain and those with chronic knee and hip pain. Designed to increase physical function and improve quality of life, the concept integrates education, self-management and coping strategies, with a personalised exercise regimen for each participant. Two new e-learning resources have been developed by Health Education England’s e-Learning for Healthcare and its partners to help practitioners understand the principles behind the programme and how it may be implemented in their organisation.
Variety of locations The ESCAPE-pain programme can be delivered in a variety of locations including outpatient physiotherapy departments, leisure centres and local community settings by healthcare professionals and exercise instructors. To deliver to either of
Sessions can be delivered by healthcare professionals and exercise instructors
Antidepressants could be more helpful than COMMONLY used treatments for chronic pain can do more harm than good and should not be used, National Institute for Health and Care Excellence (NICE) has said in recent draft guidance. Paracetamol, non-steroidal antiinflammatory drugs (these include aspirin and ibuprofen), benzodiazepines or opioids should not be offered for people with a type of chronic pain called chronic primary pain. This is because, while there was little or no evidence that they made any difference to people’s quality of life, pain or psychological distress, there was evidence that they can cause harm, including possible addiction.
TALKBACK l AUTUMN 2020
Instead, the draft guideline says that people with this type of pain should be offered supervised group exercise programmes, some types of psychological therapy, and says that some antidepressants can be considered. Chronic primary pain represents chronic pain as a condition in itself and which can’t be accounted for by another diagnosis, or where it is not the symptom of an underlying condition (this is known as chronic secondary pain). It is characterised by significant emotional distress and functional disability. Examples include chronic widespread pain and chronic
musculoskeletal pain, as well as conditions such as chronic pelvic pain. The draft guideline also says that antiepileptic drugs including gabapentinoids, local anaesthetics, ketamine, corticosteroids and antipsychotics should not be offered to people to manage chronic primary pain. Again, this was because there was little or no evidence that these treatments work but could have possible harmful effects. The draft guideline emphasises the importance of putting the patient at the centre of their care, and of fostering a collaborative, supportive relationship between patient and healthcare professional.
