Looking differently at leisure places as spaces for chronic pain management
by Ben Wilkins, CEO, Good Boost
15.5 million people in England live with chronic pain. Approximately 5.5 million (12% of the population) have high-impact chronic pain, where pain makes it an on-going challenge to take part in daily activities (Versus Arthritis, 2021). The main contributing factor for 8-in-10 people living with chronic pain are musculoskeletal conditions, such as osteoarthritis, back and neck pain. For people living with this, it’s not just a ‘ache in your back’ or a ‘twinge in your knee’, it’s an unrelenting and all-consuming part of everyday life.
In April 2021, the National Institute for Clinical Excellence (NICE) updated the guidelines on the role of non-pharmacological treatments for the management of chronic pain. These guidelines included an emphasis on exercise programmes and psychological therapies. The Arthritis and Musculoskeletal Alliance (ARMA) put forward a core offer proposition for chronic pain with an emphasis on these services being better delivered in “community rather than medical settings”.
The waiting list for NHS pain services are varied, with some people waiting over a year for treatment and many people not being able to access support for many months, sometimes with heart breaking consequences. In no way do I want to point fingers at the NHS, because the efforts of health teams nationwide have been nothing short of heroic. But with growing waiting times as a result of the pandemic, that are projected to worsen considerably yet, we need to face up to the role and opportunity of community and leisure services taking the NICE guidelines and supporting the NHS and the millions of people living with chronic pain.
Leisure services lessening the pain
There are some excellent examples of areas where leisure and community services provide local options for pain management. ESCAPE-pain is a combination of exercise and education for people living with osteoarthritis that affects their hips and knees and the programme for back pain too. It’s been delivered across the nation and has published the research to demonstrate its effectiveness.
There is a key role for swimming pools and exercise with chronic pain – as being submerged in water reduces people’s experience of pain. This has been highlighted in articles by Swim England and their pro-active work through their Water Wellbeing programme.
These are two examples, but there are numerous more options for exercising with chronic pain. The key requirements are education and understanding, both for leisure staff to keep confidence and competent to work with people living with pain, and for people living with pain to be aware of the options leisure venues offer, and feel comfortable and confident in attending. There is still a huge opportunity to design more options for exercising with chronic pain, because choice is key. What works for one person may not for another, and having many options for self-management in the community increases the likelihood of finding something that works for them, and something they’ll stick with as part of a long-term lifestyle change.
The opportunity on top of exercise is peer-support and talking therapies. The next step in leisure health and wellbeing services and their integration with social prescribing is creating more holistic services in leisure spaces.
The New Health & Wellbeing Memberships Base
Surveys throughout 2020 and 2021 have highlighted that the ‘traditional’ gym members of 18 to 54-year-olds are contemplating an exercise future focused around online apps, rather than brick-and-mortar facilities. Surveys by RunRepeat and Women’s Health Magazine suggest that between 47-72% of people are not planning to return to physical gyms, and interviews by the BBC highlight the motives of consumers permanently switching to digital gyms.
But even if this isn’t the case, leisure centre and gym members still only represent a minority of the total adult population. The Fitness Report 2019 highlighted some key stats: pre-pandemic, 15.6% of UK adults attended gyms and leisure centres, leaving 84.4% of the UK population as potential members, with more than four-fifths of people living within two miles of a leisure centre or gym.
There is an untapped potential in the 84.4%
What’s more, mindsets are shifting. The Sports Participation: Impact of COVID-19 report highlights that two thirds of people are more concerned with staying fit now than before the pandemic and would like to take part in more sport activities. With the growing prioritisation of personal fitness and wellbeing as supporting overall health, this is the ideal opportunity for the leisure industry to design and deliver services that appeal to the non-traditional gym member. Sessions with a focus on personalisation, individual growth and peer-communities, rather than high-tempo, competitive and intimidating classes, could provide the most direct path to participation.
This vast majority of the population have not previously viewed the gym as their space. With the prospect of declining memberships and revenues due to the plethora of digital options available, designing options for people living with health conditions can allow leisure centres to do right by their communities and their bottom line.
Now is the time to tap into this potential: with calls to action from the Strength campaign, all long-term health condition charities advocating the role of physical activity, the roll-out of social prescribing and the shift in the public’s mindset, the planets are aligning for an integrated leisure solution. Virtual classes are luring in traditional members from gyms, but leisure centres and gyms, physical assets, have attributes no digital service can replicate. A local, in-person service that’s inclusive, accessible and tangible, and delivers the critical ingredient of emotional support.
For more details on social prescribing and the role of leisure in health and social care, please read the Leading the Change, Social Prescribing within the Fitness and Leisure Sector report by UK Active. Adapted from blog for UK Active. UK Active’s vision is to get more people, more active, more often.