CHAIN: Managing hip pain to improve health and wellbeing to avoid hip surgery

CHAIN: Managing hip pain to improve health and wellbeing to avoid hip surgery featured image

A new exercise and education programme is helping patients avoid surgery and supporting their improved fitness. The programme is also saving the NHS money and freeing up valuable bed space by putting patients at the heart of managing their conditions.

The CHAIN (Cycling Against Hip Pain) programme is a six week exercise and education treatment pathway for people with hip pain. 

The programme was first launched in 2013, and was created by Professor Robert Middleton and Associate Professor Tom Wainwright, of the Orthopaedic Research Institute, Bournemouth University in partnership with the Royal Bournemouth Hospital and BH Live.

Professor Robert Middleton says: “CHAIN is a great success for both patients and the NHS. Over 70% of people completing the CHAIN programme have less pain, are able to do more activities and have avoided surgery. It is the go to first line treatment for hip pain.”

With a hip replacement costing the NHS over £6,000, this represents a big saving, while ensuring other patients requiring surgery do not have to wait as long. It provides better outcomes for the patient, as depending on their job role, patients generally take at least six weeks off work to recover, in addition to time off needed for any follow up appointments and aftercare.

Neil Cowan, Director of Operations for Surgery at the Royal Bournemouth and Christchurch Hospitals, says: “This fantastic collaboration between Bournemouth University, BH Live and The Royal Bournemouth and Christchurch Hospitals is helping people to manage their hip pain and avoid complex surgery. Furthermore, patients are supported in the longer term with lifestyle and wellbeing help, alongside all the marvellous benefits that increased exercise brings. We are very excited about the results of this programme and look forward to developing it further for the benefit of more NHS patients both locally and nationally.”

So far, one hundred people have been referred onto the CHAIN programme out of 500 who have been commissioned by the Royal Bournemouth and Christchurch Hospitals.

The results for those patients who have completed the programme have been extremely positive, with 100% of participants reporting that they would recommend the programme.

The trial has also seen improvements to patient reported function and pain as well as strength, walking speed and balance.

Associate Professor Tom Wainwright, also of Bournemouth University, says: “We continue to be delighted with the results of the CHAIN course. Participant feedback is excellent, with 100% recommending the course to others, and many achieving life changing results. It is an excellent example of how working across organisations in partnership can bring benefits to our patients”

The programme is designed to promote the self-management of hip pain and is based on the latest NICE guidelines for the treatment of osteoarthritis. These guidelines recommend local muscle strengthening, aerobic exercise, and education as a core part of the treatment. Cycling strengthens muscles around the hip, helps to reduce pain, and is an excellent form of aerobic exercise.

You can read the full presentation here

There are a number of papers which you can read here and here

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