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    Anti-inflammatory-diet.png
    Lisa Bywaters
    16/Nov/2023
    Health InformationMSK articles

    Anti-inflammatory diets

    Anti-inflammatory diets have been around for some time. There are many websites, books and blogs promoting the benefits of eating anti-inflammatory foods.

    This type of diet sounds tempting, not only because of the foods they promote – which are all delicious – but because the idea that we can fight inflammation with the foods we eat sounds so attractive and natural!

    So what is an anti-inflammatory diet, what are they supposed to do and what’s the evidence (if any) behind them?

    First – the what

    The theory behind these diets is that certain foods have anti-inflammatory properties, while others cause inflammation. So if we incorporate more of the anti-inflammatory foods and less of the pro-inflammatory foods in our diets, it may help lower levels of inflammation for people who have arthritis, psoriasis and other inflammatory conditions.

    Sounds logical, right? Maybe??

    Next – the evidence

    OK, so this is where it gets a little murky. There’s really not a lot of conclusive evidence to support these claims. Studying the effects of diet is a tricky business, as this article in VOX explains. When we look at treating chronic diseases, research “involves looking holistically at diets and other lifestyle behaviors, trying to tease out the risk factors that lead to illness. Nutrition science [is therefore] a lot more imprecise. It’s filled with contradictory studies that are each rife with flaws and limitations. The messiness of this field is a big reason why nutrition advice can be confusing.” (1)

    So we often have to use things like observational studies, self-reporting or information gleaned from studying the effects of dietary changes on lab animals.

    Which means the data we obtain is often contradictory and isn’t conclusive. For more information read: The messy facts about diet and inflammation by Scientific American.

    Does this matter?

    Maybe not. Two popular anti-inflammatory diets are the Mediterranean diet and the DASH (Dietary Approaches to Stop Hypertension) diet.

    Both diets have a heavy emphasis on eating:

    • foods that are as unprocessed as possible,
    • a rainbow of fresh whole fruits and vegetables (not juices),
    • whole grains such as brown rice, quinoa, oats, whole grain breads and pasta,
    • beans, lentils, chick peas and other legumes,
    • nuts and seeds,
    • fish, seafood and poultry,
    • healthy oils such as olive, vegetable, canola.

    They both recommend people eat less:

    • red meat,
    • foods high in sugar, salt and fat,
    • highly processed foods.

    So if we look at this type of diet, it’s actually a healthy, well-balanced diet. Eating a variety of different foods, in a range of different colours means that we’re giving our body a wide range of important vitamins and nutrients.

    In the end, whether you call it an anti-inflammatory diet, a Mediterranean diet or DASH diet, it doesn’t really matter. And whether it has an effect on inflammation, only time and further research will tell.

    But if you eat a nutritious, well-balanced diet you’ll certainly feel better overall. Eating well helps us maintain a healthy weight, is important for our physical and mental health, can help us sleep better, be more active, reduce our risk of developing other health conditions, and just generally makes us feel good.

    Tips to change your diet

    If you want to make your diet more like the anti-inflammatory style of diet, here are our top tips:

    • Talk with your doctor and seek advice from an accredited practising dietitian.
    • Start small. You don’t have to change your entire diet at once if that seems overwhelming. Make small changes such as reducing the amount of processed foods you eat, eating more fruits and vegies each day, swap red meat for fish, lean chicken (skin-off), beans or lentils.
    • Get adventurous. There are a lot of websites that provide easy recipes that follow this type of eating plan. We’ve listed some in the More to Explore section.
    • Portion size is still important. Many of the plates we use, especially for dinner, are far too big. And we tend to fill them. The simple solution is to use a smaller plate. When dishing up your meals, imagine your plate is divided into quarters. Aim to fill two of those quarters (or half the plate) with colourful vegies or salad, one quarter with protein (fish, legumes, tofu, meat) and the last quarter with carbohydrate foods such as rice, noodles, potato or bread roll.
    • Exercise is also important. A healthy diet doesn’t work on its own. We also need to be active every day to maintain our weight, control our pain, improve our sleep and improve our mood and mental health.
    • Reduce your intake of:
      o Sweet foods such as cakes and biscuits. Swap them for fresh, in-season fruit.
      o Refined grains such as white rice and white bread. Swap them for whole grains.
      o Trans-fats and saturated fats.
      o Ultra-processed foods. These are foods that have gone through a LOT of processing and are far from their original state. They generally have salt, sugar, fat, additives, preservatives and/or artificial colours added.

    Final words

    At the end of the day, these diets are all about eating a variety of healthy foods. And as we come into warmer weather, these are the sorts of foods that make us happy, feel lighter and more energetic. So – if you’re not already – why not give it a go?

    FIRST WRITTEN AND PUBLISHED BY LISA BYWATERS IN SEPT 2020

    Call our Help Line

    If you have questions about things like managing your pain, COVID-19, your musculoskeletal condition, treatment options, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

    Reference

    (1) I asked 8 researchers why the science of nutrition is so messy. Here’s what they said.
    Vox, 2016

    CONTINUE READING
    A-weed-by-any-other-name.png
    Lisa Bywaters
    24/Oct/2023
    Health InformationMSK articles

    A weed by any other name

    Medicinal cannabis and you

    Marijuana, dope, pot, grass, weed, Mary Jane, doobie, bud, ganja, hashish, hash, wacky tobaccy…they’re just some of the common names for cannabis.

    Whatever you call it, it’s been used for medicinal purposes for thousands of years, until it became a banned or controlled substance in most parts of the world.

    But for decades there’s been renewed interest in its use in healthcare, with many countries – including Australia in 2016 – decriminalising it for medicinal use.

    Last year alone the Therapeutic Goods Administration (TGA) granted over 25,000 applications from doctors to prescribe cannabis, mostly in the form of an oil.

    So let’s weed out some of the facts and explore the use of medicinal cannabis for pain and musculoskeletal conditions.

    Is it marijuana or cannabis?

    It’s both. They’re just different names for the same plant – marijuana is the commonly used name, cannabis is the scientific name. The preferred name for its use in healthcare is medicinal cannabis, to draw the distinction between medicinal use of cannabis and the illegal, recreational use of marijuana.

    The tongue twisters – cannabinoids

    It’s a tough word to say – far harder than musculoskeletal! – but an important one when we talk about the properties of cannabis. Cannabinoids are the chemicals found in the cannabis plant. They bind onto specific receptors (CB1 and CB2) on the outside of our cells and can affect things like our mood, appetite, memory and pain sensation.

    Cannabis has more than 140 cannabinoids. The two major ones are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the cannabinoid linked with the sensation of feeling ‘high’ that’s associated with recreational marijuana use.

    Cannabinoids also occur naturally in our body (endocannabinoids) and can also be created artificially (synthetic cannabinoids).

    How’s it taken?

    Medicinal cannabis, both plant-based and synthetic, comes in many forms including oils, capsules, oral sprays and vapours. Smoking isn’t an approved preparation as it can cause damage to the lungs and airways.

    Does it work?

    At the moment, evidence for its use to treat pain associated with arthritis and musculoskeletal conditions is lacking.

    Cannabis has been illegal for so long that we don’t have the thorough, scientific evidence we need about: side effects, which cannabinoids (e.g. THC, CBD or a combination) may be effective, dosages, the best form to use (e.g. oil, capsules etc), the long-term effects, or the health conditions or symptoms it may be beneficial for. Research is emerging, but we need a lot more.

    Because of this lack of research, the Australian Rheumatology Association doesn’t support the use of medicinal cannabis for musculoskeletal conditions. Their concern is that we don’t have enough info to ensure cannabis is safe and effective for people with musculoskeletal conditions.

    The Therapeutic Goods Administration (TGA) has also stated that there’s “not enough information to tell whether medicinal cannabis is effective in treating pain associated with arthritis and fibromyalgia”.

    Possible side effects

    As with any medication – and medicinal cannabis is a medication – it can have side effects. They include: dizziness, confusion, changes in appetite, problems with balance and difficulties concentrating or thinking.

    The extent of side effects can vary between people and with the type of medicinal cannabis product being used.

    How do I access it?

    Unfortunately it’s a complicated process. We aren’t at the stage where a doctor can just write a prescription that you can fill at any chemist. Medicinal cannabis is an unregistered medicine, which means your doctor must be an Authorised Prescriber or must apply for you to have access to it through the TGA’s Special Access Scheme.

    But if it’s something you’d like to try, talk with your doctor about whether it’s a possible option for you. Together you can weigh up the risks and benefits for your specific situation.

    You need to be aware that medicinal cannabis is not on the Pharmaceutical Benefits Scheme (PBS), so if you can access it, you’ll likely have to pay significant costs.

    Another option for gaining access to medicinal cannabis is to consult a doctor at a specialised cannabis clinic. This also comes at a price, however it may be an option if your doctor isn’t an authorised prescriber or they’re not well-informed in the use and prescribing of medicinal cannabis.

    Driving and medicinal cannabis

    If you’re using medicinal cannabis it’s important that you know exactly what’s in it. If you’re taking a product that you’ve obtained through legal prescribers that only contains CBD, you can drive. However if you’re using a product that has any THC in it, whether on its own or in combination with CBD, you can’t drive. It’s currently a criminal offence to drive with any THC in your system.

    Talk with your doctor and/or pharmacist for more information.

    Interactions with other medications

    As with any substance you ingest, there’s the potential for medicinal cannabis to interact with other medications and supplements you’re taking. So before prescribing medicinal cannabis, your doctor will review your current medications to reduce the risk of any negative effects.

    However if while using medicinal cannabis you experience any unusual symptoms, discuss these with your doctor.

    Finally

    For many people the use of medicinal cannabis could be a long way off. And unlike the way it’s often portrayed in the media, it’s unlikely to be a panacea or magic bullet that will cure all ills.

    It also won’t work in isolation – you’ll still need to do all of the other things you do to manage your condition and pain, including exercise, managing your weight, mindfulness, managing stress, pacing etc.

    The important thing is to be as educated as you can and be open in your discussions with your doctor.

    And be aware that cannabis for non-medicinal purposes is still illegal in Australia.

    First written and published by Lisa Bywaters, Dec 2020.

    For more detailed information about medical cannabis in Australia watch our webinar

    Medicinal cannabis in Australia: Weeding out the facts 
    Dr Richard di Natale, outgoing Senator and former leader of the Australian Greens, and Prof Iain McGregor, Lambert Initiative for Cannabinoid Therapeutics, University of Sydney discuss the use of medicinal cannabis in Australia – what it is, available forms, access issues in Australia and the current evidence for use.

    Call our Help Line

    If you have questions about things like managing your pain, your musculoskeletal condition, treatment options, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

    CONTINUE READING
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    Lisa Bywaters
    04/Oct/2023
    Health InformationMSK articles

    Visiting a rheumatologist

    If you’ve been experiencing persistent joint or muscle pain, stiffness and/or inflammation that you can’t explain (e.g. from a fall or strenuous physical activity), you should discuss your symptoms with your general practitioner (GP).

    Many conditions can cause these symptoms, so to work out what’s causing your symptoms, your GP will:

    • Take your medical history. They’ll ask you about your symptoms, when they started, how they affect you, your family medical history and other health issues you may have.
    • Do a physical examination. They’ll look for redness and swelling in and around the joint and test your joint’s range of movement. They may also look for rashes, check your eyes and throat, and take your temperature.
    • Order scans and other tests. Depending on the condition your GP thinks you might have, they may send you for tests to check for levels of inflammation in your blood or specific genetic markers. You may also have scans such as x-rays, ultrasound or CT (computed tomography) to get a clearer picture of what’s happening inside your body.

    When your GP has gathered all of this information, they may refer you to a rheumatologist.

    Rheumatologists are doctors who specialise in diagnosing and treating problems with joints, muscles, bones and the immune system. You need a referral from your GP to see a rheumatologist, whether they’re in private practice or a public hospital outpatient clinic.

    Your GP may refer you to a rheumatologist if:

    • they think you have, or they’ve diagnosed you with, an inflammatory type of arthritis such as rheumatoid arthritis or ankylosing spondylitis, so that treatment can be started as soon as possible
    • your symptoms improve with treatment but come back when you stop taking medicine
    • your symptoms don’t respond to treatment or get worse over time
    • you develop unexpected complications, such as a fever, rash, or fatigue
    • you have unusual test results.

    Preparing for your first consultation

    When you make an appointment to see a rheumatologist, you should ask them some questions so that you’re prepared. This may include:

    • What do I need to bring with me?
    • How much will my out-of-pocket expenses be?
    • How long will my appointment be?
    • Is there parking available, or accessible public transport?

    Armed with this information, you can be proactive and prepare for your consultation.

    It can be helpful to make notes about your symptoms – when you first noticed they appeared, how they affect you day-to-day – as well as other health conditions you have, medicines or supplements you take regularly and information about your family medical history.

    It’s also helpful to write down questions you want to ask your rheumatologist. Put them in order of the most important first, in case you don’t get through your entire list.

    Your consultation

    Seeing a specialist can sometimes be overwhelming, especially if you’re feeling unwell or anxious. There can also be a lot of information to absorb. That’s why it can be helpful to bring a family member or a friend to your appointment. They can provide emotional support, help you ask questions or write down any important information. They can also be a second set of ears to hear what the specialist says and help you recall this information later. It can be hard to remember everything, especially when you’re feeling anxious.

    Wear comfortable clothing that can be easily adjusted or removed if necessary, so that the rheumatologist can examine you.

    And don’t forget your referral, x-rays, scans and other test results, your list of questions and any other bits and pieces you were asked to bring!

    Your first consultation with your rheumatologist will be more thorough than your consultation with your GP. They’ll:

    • review your medical history
    • ask lots of questions about your symptoms, such as when you’re most stiff or sore, and how long you’ve had pain and symptoms
    • do a comprehensive examination of your joints, including counting the number of tender and swollen joints
    • refer you for further blood tests and imaging if required.

    It’s important to know that there are many different types of musculoskeletal conditions, and many have similar symptoms. So it can take time to get a diagnosis. Your rheumatologist may provide you with a prescription for medicines and suggest some self-care options that you can do while you wait for your diagnosis.

    Follow-up consultations

    Once your diagnosis has been made, your rheumatologist will provide you with information about your condition and a treatment plan.

    Your treatment plan will fit your specific symptoms, needs and preferences. However, it will usually involve a combination of:

    Depending on your diagnosis, you may need regular consultations with your rheumatologist.

    How often they occur will depend on your condition, how well it’s responding to treatment and the medicines you’re taking, as some specialised medicines can only be prescribed by a rheumatologist. Some people see a rheumatologist regularly, while others are mainly treated by their GP, with the rheumatologist on hand for specialist advice. Some consultations with a rheumatologist may be done via telehealth.

    Follow-up consultations are generally shorter than your initial one. Your rheumatologist will talk with you about how you’ve been doing since you began treatment. They’ll assess how well you’re responding to treatment and if you need to change your medicines or add additional ones. They’ll also do a physical exam and order any further blood tests or imaging if required.

    Your rheumatologist will also talk with you about your self-care and other things you can do to manage your condition.

    It’s important to take an active role in these consultations. Ask questions, and if you don’t understand the answers, ask them to explain further or for more information. Talk with your rheumatologist about your goals for treatment – they may be things like reducing pain and fatigue, but also more personal goals such as getting back to playing golf regularly or planning an overseas trip. Together you can ensure your treatment plan supports your goals.

    Ongoing care

    The aim of treatment for musculoskeletal conditions is low or no disease activity. This is called remission. It doesn’t mean your condition has been cured, but your treatments keep it under control.

    With the significant advancements we’ve had in medicines in the past few decades and targeted treatments for many types of musculoskeletal conditions, achieving remission can be a real possibility.

    If you achieve remission, your rheumatologist may reduce the dosage and/or frequency of the medicines you’re taking. They’ll monitor you to see how you’re doing and make changes as required. And you won’t need to see them as often.

    If you haven’t achieved remission, the aim will be to control your condition and its effects on your body and life as much as possible. This will determine how often you need to see your rheumatologist in the future.

    Costs

    The cost to see a rheumatologist varies. Part of the cost is subsidised by Medicare, but there is usually a gap payment that you’ll need to make. When making an appointment, ask about out-of-pocket costs.

    If you have a Medicare card, you may be able to attend a rheumatology clinic at a public hospital if you cannot afford out-of-pocket expenses to see a rheumatologist privately. Talk with your GP about your options.

    Contact our free national Help Line

    Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

     

    First written and published by Lisa Bywaters in May, 2022.

    CONTINUE READING
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    Lisa Bywaters
    04/Oct/2023
    Health InformationMSK articles

    What is inflammation?

    We talk about inflammation a lot. But what is it? What’s happening in your body when you have inflammation?

    Acute and chronic inflammation

    There are two types of inflammation – acute and chronic.

    Acute inflammation

    Acute inflammation is your body’s reaction to things such as an infection (e.g. a cold or infected wound) or an injury (e.g. a sprained ankle or bee sting).

    Symptoms associated with acute inflammation are:

    • pain
    • redness
    • swelling
    • heat
    • loss of function (e.g. difficulty moving a swollen ankle after spraining it or difficulty breathing through your nose when you have a cold).

    What’s happening in your body with acute inflammation?

    When you sprain your ankle, or get an infection, your immune system automatically springs into action.

    Cells close to the source of the injury or infection release chemicals known as inflammatory mediators (e.g. histamine). They increase blood flow to the area, widening blood vessels and allowing more blood to reach the injured tissue. As a result, the area becomes red and feels hot.

    The extra blood to the area enables more immune cells to reach the injured tissue. This includes white blood cells, or leukocytes, whose role it is to defend your body against infections and disease and start the healing process.

    Depending on the cause, acute inflammation can occur quickly and generally goes away quickly.

    Chronic inflammation

    Chronic inflammation is persistent, low-level inflammation that lasts for months or years. With chronic inflammation, the inflammatory process often begins when there’s no injury or illness present; and it doesn’t end when it should. When this happens, white blood cells may target and damage nearby healthy tissues and organs.

    We don’t really know why chronic inflammation occurs. It doesn’t seem to serve a protective purpose as acute inflammation does.

    However researchers have identified factors that increase your risk of developing chronic inflammation, including:

    • chronic infections
    • physical inactivity
    • poor diet
    • obesity
    • imbalance of gut bacteria
    • disturbed sleep
    • smoking
    • stress
    • ageing.

    Many people don’t know they have chronic inflammation, but they may feel symptoms such as:

    • body and joint pain
    • fatigue and insomnia
    • weight gain or loss
    • frequent infections
    • depression, anxiety and mood disorders
    • digestive problems (e.g. constipation, diarrhoea, acid reflux)
    • skin rashes.

    Chronic inflammation is associated with many diseases, such as rheumatoid arthritis, lupus, heart disease, diabetes, cancer, and bowel diseases like Crohn’s disease and ulcerative colitis.

    If you’re concerned about chronic inflammation and have symptoms like those above that have been troubling you for some time, see your doctor . They’ll talk with you about your symptoms, do a physical exam, and may decide that blood tests are necessary to look for signs of inflammation.

    The blood test will look for elevated C-reactive protein (CRP), which rises in response to inflammation.

    Inflammation is helpful until it’s not

    It’s important to remember that inflammation isn’t inherently bad. Acute inflammation serves a vital role in our health and survival. It helps us recover from injury and infection. However, when it’s chronic, it can negatively affect our health.

    Always talk with your doctor if you have symptoms that are distressing you or making you feel unwell.

    Contact our free national Help Line

    Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

    This article was first written and published by Lisa Bywaters in April, 2022.

    CONTINUE READING
    Grow-Your-Knowledge.png
    Lisa Bywaters
    02/Oct/2023
    Health InformationMSK articles

    How much do you really know about your condition?

    It occurred to me today that I really don’t understand as much about my condition as I should. I see my doctor regularly, I take my meds, exercise and manage my pain as best as I can.

    But I actually don’t understand exactly what’s happening to my body at the basic level. How my condition works, progresses, and the nitty gritty of potential causes.

    Don’t get me wrong, I don’t want to know the cellular level stuff – though some of you may want to know that – I just think I should know more, so that I can make informed decisions and play a more active role in the management of my health.

    So where to start?

    There’s information everywhere and it can be overwhelming. It can sometimes be difficult to work out what information is good and helpful, and what information is wrong, misleading and even dangerous.

    As a general rule, libraries, your health professionals, peer support groups, reputable websites/social media sites and peak organisations like Musculoskeletal Australia can give you great information to help you learn about, and understand, your condition.

    And the information they provide will help in different situations. For example, your doctor can provide evidence-based information about your condition and treatment options, whereas members of a peer support group can give you practical information about the experience of living with a chronic condition.

    I also find that asking lots of questions and being sceptical is key. The information you get – from any source – could potentially affect your health, so you should be cautious.

    Some questions I ask when looking at new health information:

    • Who wrote/gave me the information? Do they have the proper qualifications?
    • Where does the information come from? Does it have the scientific evidence to support it?
    • Is the information balanced? Does it give me a variety of options, or provide only one?
    • Does the information provide links to scientific evidence? Or does it only use personal anecdotes from satisfied customers or celebrity endorsements?
    • Is the information up-to-date?
    • Is the information regularly reviewed and updated?

    Information is power. So use it to take control over your health and your body.

    And if you get confused about any information you find, talk with your doctor. You can also contact our National Arthritis and Back Pain+ Help Line on 1800 263 265 for information and support.

    “Information can bring you choices and choices bring power – educate yourself about your options and choices. Never remain in the dark of ignorance.” – Joy Page

    Originally written and published by Lisa Bywaters in 2018

    CONTINUE READING
    money.jpg
    Lisa Bywaters
    09/Aug/2023
    Health InformationMSK articles

    Money, money, money

    Not much has changed since ABBA sang in 1976 “All the things I could do, if I had a little money.” Money – or the lack of it – has been causing us headaches and stress since we started using it.

    Living with a musculoskeletal condition – or multiple conditions – can be expensive. Medications, healthcare appointments, time off work (or not being able to work), exercise classes, complementary therapies, and aids and equipment are costly on top of everyday expenses.

    When you add rising living costs, financial stress is almost inevitable.

    Fortunately, there are things you can do if you’re in this situation. And it starts now.

    Acknowledge the situation.

    This is the crucial first step. As much as we’d like to bury our heads in the sand when we feel anxious or worried about anything (I know that’s my go-to reaction 😑), it won’t solve the problem. We need to look it in the eye, acknowledge it exists and start to deal with it – one step at a time.

    Create a budget.

    This may sound daunting, but you need to know where your money’s going. You need to be able to track what money is coming in and what you’re spending it on. MoneySmart is an Australian Government website with many tools and resources to help you manage your money. They have a section on budgeting to help you create a budget that works for you and your circumstances.

    By understanding where your money’s going, you can start to see where you can make some savings or cut some costs. It’ll also put you in a better position when/if it comes time to talk with your bank, utility companies etc.

    Know your rights.

    When you’re struggling and stressed, it’s easy to become overwhelmed. But there are laws to help protect you if you’re suffering from financial hardship. The National Debt Helpline has information to help you understand your rights and protections.

    Seek help.

    If you’re finding it challenging to create a budget or find a way out of your financial problems, contact the National Debt Helpline and talk with a financial counsellor. They’re free, confidential, and independent. You can call them on 1800 007 007 weekdays 9.30am-4.30pm. They also have a live chat function on their website, available weekdays from 9.00am-8.00pm, or you can also send them a message outside of hours, and a counsellor will get back to you. National Debt Helpline also has a huge range of other resources to help you if you’re struggling with debt or controlling your finances.

    Talk to your bank.

    If you’re having difficulties paying your mortgage, personal loans or credit card repayments, talk with your lender about your options, such as making smaller repayments over a longer period or pausing repayments.

    The Australian Banking Association has some useful resources on their website, including information about your rights and what your bank can do to help you.

    Talk to your utility companies.

    Contact your supplier if you can’t afford to pay your gas, electricity, water, and phone bills. But first, check out this information from the National Debt Helpline about how to do this.

    Be wary of buy now, pay later schemes, payday loans, and consumer leases.

    If you’re under financial stress, these options may seem like a convenient way to pay for things you need. However, they’re also an easy way to get into even more debt. Learn more by reading MoneySmart’s info on the potential problems with payday loans, consumer leases, and buy now, pay later schemes.

    Talk with your doctor about GP management plans.

    Living with a chronic condition (or multiple conditions) can cost a lot of money. Discuss accessing a GP Management Plan and Team Care Arrangement with your doctor so that you can get coordinated care to manage your health condition. You may be eligible for Medicare rebates for certain allied health services. You can find out more on the Department of Health website.

    Talk with your doctor and pharmacist about safety nets.

    They exist to help lower the out-of-pocket medical costs for people who, due to their health condition/s, spend a lot of money on Pharmaceutical Benefits Scheme (PBS) medications. Your doctor and pharmacist can give you more information about these safety nets.

    Talk with your doctor about 60-day scripts.

    From 1 September 2023, eligible people living with chronic conditions can buy 60 days’ supply of some medicines. This will reduce the cost of some medicines for people with stable, chronic conditions. For more info, check out the Consumers Health Forum 60-day scripts website, and talk with your doctor about whether this is an option for you.

    Find out about government allowances and benefits.

    The Australian Government provides a wide range of allowances and benefits you may be eligible for, including:

    The Australian Government’s Services Australia website provides a lot of information about these payments (and others), including information about eligibility criteria.

    You can also talk with our nurse on the MSK Help Line if you’re having trouble navigating through these social services schemes. Contact them on 1800 263 265 weekdays or email helpline@msk.org.au.

    Find out about the National Disability Insurance Scheme (NDIS).

    The NDIS helps people under 65 with permanent and significant disability get care and support. It pays for reasonable and necessary support that a person needs to live and enjoy their life. The NDIS also provides information and connections to local services to people who aren’t eligible for funding. Find out more about the NDIS.

    There’s light at the end of the tunnel.

    When you’re in debt or dealing with financial hardship, it can seem like there’s no way out. But there are a lot of organisations and services available to help you. This article has just scraped the surface of them.

    There are more for you to explore in the links below.

    If you need help with debt or just want to learn how to manage your money better, I’d urge you to look at MoneySmart, National Debt Helpline and The Salvos. They provide excellent, easy-to-understand resources on a wide range of issues relating to money.

    Contact our free national Help Line

    Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265, email (helpline@msk.org.au) or via Messenger.

    More to explore

    CONTINUE READING
    DNA.jpg
    Lisa Bywaters
    09/Aug/2023
    Health InformationMSK articles

    Pharmacogenomics… huh???

    Your genetics and personalised medicine

    You may have heard something about personalised medicine and the tongue twister – pharmacogenomics. But what is it? And might it be beneficial? We take a quick look at this exciting field of research and things to consider before diving in.

    Let’s start with the word… it’s a mouthful!

    The word “pharmacogenomics” is a combination of pharmacology and genomics:

    • Pharmacology is the study of the uses and effects of medicines.
    • Genomics is the study of all of a person’s genes (their genome), including how genes interact with each other and with your environment.

    A (very) little bit of biology 101.

    Almost all the cells in your body contain DNA. DNA is the genetic information that helps make people who they are.

    DNA is a double helix. You’re probably familiar with the image – it’s shown on practically every crime or detective show. 😉 It looks like a twisted ladder.

    Four different chemicals (nucleotides) pair up to make the ladder’s rungs.

    Genes are stretches of DNA. They can be long or short. You inherit your genes from your parents – one copy of each gene from each parent. They contain the instructions to build your body and make you uniquely ‘you’.

    Where drugs come into the story.

    Your genetic makeup affects the way you respond to medicines.

    It can affect whether a medicine is effective, whether it has no effect or whether you have a bad reaction or side effect. It can also affect the dosage you may need. For example, some people absorb medicines too quickly, meaning they need a higher dose to experience any benefit; others process them too slowly, leading to side effects.

    Knowing this information about your genes has the potential to help your doctor provide more personalised medicine and a more effective treatment plan.

    So how do you know how your genes will react to medicines? You can take a test.

    Pharmacogenomic tests are available via some GPs and pharmacists and through direct‐to‐consumer services. They’re generally not covered by Medicare, so you’ll have to pay the total cost of about $150-200.

    These tests usually require a cheek swab, salvia sample or blood sample. The sample is sent to be analysed, and a report is provided. If you have gone through your doctor or pharmacist, they’ll explain the results.

    Before you jump.

    Before jumping on board and spending your hard-earned dollars on a test, there are some things to consider.

    • Do you need another test? Many people with chronic conditions already have lots of routine tests to manage their condition. This is not only costly but time-consuming. So ask yourself, “Am I experiencing significant problems with my medicines? And does this test have the potential to provide real benefit?” If so, talk with your doctor. It may be alternative medicines or treatments are an option. Or it might be that your doctor thinks a pharmacogenomic test will help. But first, have the conversation. And read Choosing Wisely Australia’s 5 questions to ask your doctor or other healthcare provider before you get any test, treatment, or procedure.
    • The cost. It’s not covered by Medicare, so you’ll have to pay for it yourself.
    • Pharmacogenomic tests aren’t available for all medicines. And not all genes and gene variants are tested. International guidelines have so far identified about 15 genes for which testing can inform the prescribing of 30 different medications with good evidence of clinical benefit.
    • Not all GPs or pharmacists have the experience or training to understand how to best use these tests and understand the results.
    • Your genes aren’t the only player in this game. It’s much more complicated, and many other factors affect how your body reacts to medicines. They include your general overall health, age, other medicines and supplements you’re taking, body size, inflammation, and kidney or liver problems. Your genetics are just one part of the puzzle.
    • Safety of your information. Many direct-to-consumer companies offering these tests are overseas, even if the initial delivery address is within Australia. Australian law protects your privacy rights for services provided in Australia, but these protections don’t apply to overseas services. So ask questions about the company – where’s it located, where’s your data stored, who has access to it.

    Pharmacogenomics in practice.

    We’ve just touched on the briefest of info about pharmacogenomics, so for more comprehensive information about pharmacogenomics in practice in the real world, read this excellent fact sheet from the NSW Government Centre for Genetics Education.

    Finally.

    The field of pharmacogenomics is growing, and it’s an exciting new world. But you also need to weigh up whether this is something that will benefit you now.

    Take the time to do your research, ask questions, and talk with your doctor. These tests aren’t going anywhere. In fact, they’ll likely become more comprehensive and more mainstream as time goes on.

    Contact our free national Help Line

    Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265, email (helpline@msk.org.au) or via Messenger.

    More to explore

    References

    1. A brief guide to genomics, National Human Genome Research Institute
    2. Pharmacogenomics in general practice: The time has come. Australian Journal of General Practice 2019; 48
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    Teeth.jpg
    Lisa Bywaters
    13/Jul/2023
    Health InformationMSK articles

    The importance of good oral health

    Hate going to the dentist? You’re not alone. Many of us become anxious or worried about visiting the dentist.

    But for people with a musculoskeletal condition, taking care of their teeth and gums – including the dreaded visit to the dentist – can also be painful.

    We’ve got some tips to help make this a little easier.

    But first, why should we care about oral health?

    Looking after the health of your mouth, teeth, gums, and the structures that support them helps you keep your teeth healthy and intact for longer as you age. This is important because it makes you feel more confident and comfortable when speaking, smiling, eating, and laughing.

    Poor oral health is also linked to diabetes, heart disease, stroke and respiratory conditions. And in some studies, gum disease has been linked to rheumatoid arthritis.

    So oral health is important. Got it. 👍

    Musculoskeletal conditions and oral health.

    There are various reasons why people with musculoskeletal conditions may have difficulties with their oral health, such as:

    Pain. Pain can affect your ability to open your mouth for the time it takes to clean and floss your teeth or to keep your mouth open during a check-up. It can also affect your ability to hold and use a toothbrush or dental floss.

    Dry mouth. Whether it’s due to a health condition such as Sjogren’s syndrome or taking certain medicines, having a dry mouth reduces the amount of saliva in your mouth. And that’s a problem because saliva washes away food remnants, neutralises the acids in your mouth, helps prevents bad breath, tooth decay and gum disease, and protects your teeth’s enamel.

    Being immunosuppressed or having a weakened immune system due to your condition or medicines can increase your risk of infections, including oral thrush and mouth ulcers.

    Taking care of your oral health.

    Get brushing.

    While it sounds obvious, you need to clean your teeth, tongue and gums twice a day for at least two minutes for good oral health. But according to the Oral Health Tracker, only about half of us do this 😮.

    And yes – I did say brush your tongue. Gently brushing your tongue removes any bacteria, other microbes or bits of food lurking there.

    For more info, check out the Australian Dental Association’s brushing basics.

    Oh – and if you need some help knowing if you’ve brushed for two minutes, or to make it fun for the kids, check out Spotify and YouTube for music to brush your teeth by. There’re plenty of playlists and songs out there! 🎶🎵 Or get creative and make your own. 😉🎵🎶

    Choose your tools.

    Toothbrushes. I don’t know why, but I always thought using a hard toothbrush and giving my mouth a good old scrub was the way to clean teeth. Turns out, a softer brush is the best choice. And you shouldn’t use too much pressure when brushing; it’s bad for your teeth and gums and can aggravate your joint pain. Brushing too hard also wears down the bristles of your toothbrush faster.

    If the handle of your toothbrush is difficult to hold, you can make it thicker and easier to grip by adding some thick rubber or foam tubing to the handle. You can pick this up at the hardware store.

    An electric toothbrush is another option, especially if pain or dexterity affects your ability to brush. Electric toothbrushes also generally have a bigger handle that may be easier for some people to grip; however, they’re also a bit heavier than a standard toothbrush, so you’ll need to consider that.

    Whether you use a standard or electric toothbrush, you need to change the brush regularly. That’s generally every three months or sooner if you notice the bristles falling out or pointing in the wrong direction.

    Toothpaste. There are so many varieties of toothpaste available it can be hard to choose one! The good news is that a Choice article reports that ‘most toothpastes contain essentially the same ingredients’ and do the same thing – remove plaque and prevent tooth decay and cavities. So choose the toothpaste you like.

    But if you have a dry mouth or sensitive teeth and gums, talk with your dentist about the best toothpaste for you.

    Dental floss. Flossing is essential to teeth cleaning as it helps remove food particles and microbes from between your teeth. Not flossing increases your risk of developing tooth decay and gum disease. However, according to the Australian Dental Association, many of us forget to floss our teeth, with only one in four people saying they floss daily 😐.

    But using dental floss can be a challenge if you have sore hands. Talk to your dentist about other options, such as dental floss picks (not toothpicks), interdental brushes, water flossers and electric flossers.

    Mouthwash. Most people don’t need mouthwash, especially if you’re cleaning and flossing regularly and properly.

    Many types of mouthwash kill the bacteria in your mouth, both good and bad. They can also mask bad breath, which may indicate an infection or other problem. And they can be irritating if you have a sensitive mouth.

    But mouthwash may be helpful if you have a dry mouth, as certain types can help stimulate saliva.

    So what to do? Have a chat with your dentist about whether or not a mouthwash is appropriate for you.

    Check yourself out. 😁

    The best way to stay on top of any problems is to regularly check your teeth and gums for changes. That way, if you notice any bleeding, inflammation, signs of infection, or other issues, you can see your doctor or dentist and get on top of it quickly.

    See your dentist regularly.

    You should see your dentist every 6-12 months to ensure good oral health. Or sooner if you have toothache, damage to your teeth and gums, or pain or sensitivity when eating or drinking. When combined with regular brushing and flossing, seeing your dentist regularly will reduce your risk of needing more invasive and costly procedures in the future.

    If you have problems keeping your mouth open for long periods and/or lying in the chair while having a check-up, discuss this with your dentist. There are options to make this less painful, such as:

    • Using pain-relieving medicines or heat/cold packs before and after your visit.
    • Taking breaks. Have an agreed signal with your dentist – for example, raising your hand – if you need to move, close your mouth, or relax your jaw.
    • Distraction, for example, put on some headphones and listen to music, a podcast or a book.
    • Using your supports, for example, a cushion or blanket that helps you relax and get comfortable.
    • Visiting your dentist more frequently but for shorter visits, so you don’t have to spend so much time in one sitting. Though this can become costly, so talk with your dentist about your options.

    Your dentist may also suggest using a mouth prop. Mouth props are rubbery, flexible tools that dentists can place between your teeth to help reduce muscle fatigue caused by keeping your mouth open wide.

    Eat well.

    A healthy diet with a variety of nutritious foods and plenty of water is best for your oral health and general wellbeing. You should also limit your intake of foods high in sugar and snacks between meals.

    Quit smoking.

    Smoking and vaping increase your risk of gum disease.

    Contact our free national Help Line

    Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

    CONTINUE READING
    sunflower.jpg
    Lisa Bywaters
    13/Jul/2023
    Health InformationMSK articles

    Shining bright

    Every year on 29 June, people mark World Scleroderma Day. This year, many landmarks around Australia shone gold like sunflowers in June to support people living with scleroderma.

    What’s the connection between scleroderma and sunflowers? 🌻 🌻 🌻 And what exactly is scleroderma?

    According to Scleroderma Australia, just as sunflowers follow the sun for warmth, people with scleroderma find the warmer weather more comfortable. That’s why sunflowers have become a hopeful symbol representing scleroderma in many parts of the world, including Australia.

    “I want to be like a sunflower; so that even on the darkest days I will stand tall and find the sunlight.” – Unknown

    Scleroderma is a chronic (or long-term) condition that affects your connective tissue. The word scleroderma literally means ‘hard skin’; as you’ll see, it’s an apt name for this condition.

    Connective tissue is the cells and fibres that hold together the millions of cells of your body. It ‘connects’, or supports and holds together your joints, muscles, internal organs, skin and other body tissues. Types of connective tissue include bone, cartilage, fat, blood, and lymphatic tissue.

    The connective tissue of people with scleroderma has too much collagen, which causes it to become hard and tight.

    Anyone can develop scleroderma, but it’s more common between the ages of 30 and 60 and is more common in females.

    There’s no cure for scleroderma, but it can be managed effectively.

    We don’t know the cause.

    Scleroderma is an autoimmune disease. That means it occurs as a result of a faulty immune system.

    Your immune system is designed to identify foreign bodies (e.g. bacteria, viruses) and attack them to keep you healthy. But in the case of scleroderma, your immune system mistakenly targets healthy tissue. This triggers connective tissue cells, especially a cell type called fibroblasts, to make too much collagen and other proteins. This leads to the hardening and scarring of the skin and other tissues.

    We don’t know why this happens. Scientists believe a complex mix of genes and environmental factors may be involved.

    There are different types of scleroderma.

    There are two broad classifications of scleroderma based on the amount of skin and other organs affected.

    Localised scleroderma mainly affects the skin. It can affect both adults and children. There are two types of localised scleroderma, morphea and linear. Both have distinctive signs and symptoms. Localised scleroderma can sometimes restrict normal joint movement due to the hardening of the skin over the joint.

    Systemic scleroderma (or systemic sclerosis) affects internal organs like the heart, lungs, kidneys, and skin. Systemic means it affects several organs and tissues, or the entire body, rather than a single organ or body part. Sclerosis means abnormal hardening of body tissue.

    Systemic scleroderma can also be broken into sub-types depending on the symptoms. They are limited scleroderma and diffuse scleroderma.

    Symptoms vary.

    The symptoms of scleroderma vary from person to person and will depend on the type you have.

    Symptoms can include:

    • thickening and hardening of the skin
    • skin dryness and ulcers
    • sudden constriction of the blood vessels, resulting in pale, blue, or red fingers or toes (Raynaud’s phenomenon)
    • stiffness and pain in the muscles and/or joints.

    If some of your internal organs are involved, you may experience:

    • digestive issues, such as heartburn, bloating, constipation, stomach pain
    • lungs problems, such as shortness of breath
    • heart problems, such as chest pain
    • kidney problems may lead to high blood pressure.

    While these symptoms sound very scary, your doctor and specialist/s will monitor your condition and symptoms to prevent/treat complications.

    “Keep your face to the sunshine and you cannot see the shadow. It’s what sunflowers do.” – Helen Keller

    It can be difficult to diagnose.

    Scleroderma can be a difficult condition to diagnose. Symptoms vary significantly from one person to another and are similar to those of other conditions. They can also change or fluctuate. So, it may take some time to get a definitive diagnosis of scleroderma.

    No single test can diagnose scleroderma, so your doctor will use a combination of tests to confirm your diagnosis. They may include:

    •  Your medical history.
    •  A physical examination.
    •  Blood and urine tests.

    There’s no cure, but there are effective treatments.

    While there’s currently no cure for scleroderma, medicines can help ease your symptoms. Your doctor will develop a treatment plan based on your symptoms. You’ll generally start on the lowest possible dosage and, if necessary, slowly increase the dose until your symptoms are under control. All medicines have side effects, so you should discuss these with your doctor.

    Medicines may include:

    • Topical corticosteroid (steroid) creams that you apply to your skin.
    • Anti-inflammatory medicines to help manage pain and control inflammation.
    • Corticosteroids taken as a tablet, injection, or into the vein (intravenous or IV) act quickly to control or reduce inflammation and may be used in the short term. They aren’t used for long periods as they’re associated with serious side effects.
    • Medicines that suppress your overactive immune system and control symptoms. These medicines may also be in the form of topical creams, tablets, injections, or IV infusions.

    As well as seeing your GP, you’ll likely see a skin specialist (dermatologist) and a specialist in joint and muscle conditions (rheumatologist). Other healthcare providers, like respiratory physicians and gastroenterologists, may be involved in your ongoing treatment.

    There are things you can do to manage your condition.

    Learn about scleroderma. Knowing as much as possible about your condition means that you can make informed decisions about your healthcare and actively manage it.

    Lifestyle changes. Avoid exposure to cold temperatures, dress warmly and don’t smoke. This will help you manage Raynaud’s phenomenon.

    Stay active with regular exercise. Exercise will reduce tightness and help keep your joints moving, especially those areas affected by scleroderma, such as the hands and wrists. Exercise will also strengthen your muscles and improve overall health. Talk with a physiotherapist or exercise physiologist about an exercise program tailored to your condition and symptoms.

    See a hand therapist. They’re qualified physiotherapists or occupational therapists with extensive knowledge and skill in understanding and treating problems with the fingers, wrists, elbows and shoulders. They can help you keep your hands and wrists flexible and moving well.

    Aids and equipment. Scleroderma can make some actions difficult, for example, using door handles or getting dressed. An occupational therapist can advise on aids and other gadgets that may help and provide additional solutions to make life easier.

    Eat well. Eating a balanced diet can help provide you with better energy levels, help to maintain your weight, and give you a greater sense of wellbeing.

    Get support from others. Research has shown that people with positive social support cope better with pain and chronic conditions. Family, friends, colleagues, and health professionals can help you manage. A peer support group may be another option. Contact Scleroderma Australia for details on support options in your state or territory.

    “Someone was sitting in front of a sunflower, watching the sunflower, a cup of sun, and so I tried it too.
    It was wonderful; I felt the whole universe in the sunflower. That was my experience. Sunflower meditation.
    A wonderful confidence appeared. You can see the whole universe in a flower.“ – Shunryu Suzuki

    Contact our free national Help Line

    Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

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    Vikings.jpg
    Lisa Bywaters
    21/Jun/2023
    Health InformationMSK articles

    A disease of the bone

    What do a 10th-century Viking/poet, the subject of a 16th-century painting, and an 18/19th-century composer have in common?

    Researchers at one time or another speculated they all had Paget’s disease of bone. That the physical features of Egil Skallagrímsson and the Ugly Duchess, and Beethoven’s deafness resulted from living with untreated Paget’s disease.

    Later research has thrown shade on these speculations. And in reality, we may never know if they did or didn’t have Paget’s disease. And remember, one’s a painting! But it’s an interesting bit of trivia to store away in the back of your brain. You never know when it might come in handy. 😉

    So what is Paget’s disease?

    Paget’s disease of bone is a chronic condition that causes abnormal enlargement and weakening of bones. Any part of the skeleton can be affected, but the most common sites include the skull, spine, pelvis, thigh bone, shin and upper arms. It can affect one bone or many bones.

    Paget’s disease tends to affect people over the age of 50. It affects slightly more men than women.

    Paget’s disease of bone is named after Sir James Paget, a 19th-century English surgeon and pathologist. Paget was quite the go-getter and was the first to describe many medical conditions, several of which bear his name. However, they shouldn’t be confused with Paget’s disease of bone.

    Bones and Paget’s disease

    To understand how Paget’s disease affects bones, it’s helpful to know how bones work.

    Although we often consider them dry and lifeless, bones are living tissue that are constantly changing throughout life. This is called ‘remodelling’.

    Bone cells called osteoblasts build new bone (formation), while other bone cells, osteoclasts, break down and remove old bone (resorption). This process is controlled by hormones such as calcitonin, parathyroid hormone, oestrogen (in women), testosterone (in men), and vitamin D.

    In a person with Paget’s disease, the osteoblasts become overactive, producing too much bone tissue. The abnormal growth results in the affected bones becoming deformed (e.g. bowed leg bone), enlarged and weak. The new bone also contains more blood vessels than normal bone.

    The reason for this accelerated bone growth is unknown. A combination of genetic and environmental factors (e.g. a virus) is suspected.

    Causes, symptoms and diagnosis

    As with most musculoskeletal conditions, we don’t know the cause of Paget’s disease. However, some factors increase your risk of developing it. They include:

    • Genetics. You’re more likely to develop it if you have a family history of Paget’s disease.
    • Ethnicity. It’s more common in people from England, Scotland, central Europe and Greece, and countries settled by European immigrants (e.g. Australia and New Zealand).
    • Age. Paget’s disease becomes more common with age, but it’s rare before age 55.

    Many people don’t realise they have Paget’s disease because they don’t have any symptoms or only mild symptoms. Symptoms vary but may include:

    • bone pain
    • enlarged or misshapen bones
    • warmth over affected bones due to increased blood supply to the bone
    • osteoarthritis.

    Paget’s disease is often discovered by accident when x-rays are taken for another reason or a bone is broken. Diagnosis can be confirmed with further x-rays, bone scans or a blood test that checks for an enzyme crucial to bone growth called alkaline phosphatase.

    Treatment

    There’s no cure for Paget’s disease; however, your symptoms can be effectively managed with medicines and self-care.

    Your doctor may refer you to a specialist, such as a rheumatologist or endocrinologist. Rheumatologists are doctors who specialise in diagnosing and treating problems with joints, muscles, bones and the immune system, while endocrinologists specialise in diagnosing and treating problems of the endocrine system.

    Medicines.

    The types of medicines used for Paget’s disease include:

    Calcium and vitamin D may be recommended as both are essential for good bone health. You can get calcium through your diet and vitamin D through safe exposure to sunlight. If you’re concerned you’re not getting enough calcium and vitamin D, talk with your doctor about whether you need supplements.

    Stay active.

    Exercise helps maintain bone health and joint mobility and strengthens muscles. However, as bones are weaker and more susceptible to fracture, some exercises may not be suitable for people with Paget’s disease. It’s best to talk with a physiotherapist or exercise physiologist about the most appropriate exercise plan for you.

    Enjoy a healthy, well-balanced diet.

    This can help you maintain a healthy weight and reduce your risk of other health problems. Make sure you include calcium-rich foods.

    Learn new ways to manage pain.

    There are many ways to manage pain, and different strategies will work for different situations. Read our A-Z guide for managing pain for more information.

    Complications

    For most people, Paget’s disease progresses slowly and can be managed effectively. However, in some cases, complications can arise, including:

    • Osteoarthritis. In joints close to bones affected by Paget’s disease, the cushioning cartilage on the ends of the bones can break down, causing pain and stiffness.
    • Broken bones. The new bone growth is fragile and more susceptible to breaking than healthy bone.
    • Hearing loss may be caused by pressure on nerves in the ear.
    • Numbness or tingling in the spine caused by pinched nerves in the spinal cord.
    • Too much calcium in the blood. When several bones have active Paget’s disease, the increase in bone breakdown can lead to an elevated blood calcium level. This is rare, but it can cause symptoms such as fatigue, weakness, abdominal pain, constipation, and loss of appetite.
    • Very rarely, Paget’s disease can cause heart failure or bone cancer.
    • In severe cases, surgery may be required to relieve pinched nerves or bone fractures or to replace a joint severely affected by arthritis.

    Contact our free national Help Line

    Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

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