Health Information - Musculoskeletal Health Australia (MHA)

31/Jul/2024

And things you can do to manage

This blog was so full of info and strategies we had to split it into 2 parts. You can access part 1 here.

But here’s a recap: We know finding and keeping a job when you have a musculoskeletal condition like back pain, rheumatoid arthritis, osteoarthritis and gout can be really tough.

Pain, fatigue, medication side effects and the unpredictability of your condition can all affect your ability to work.

The extent to which this happens will depend on things such as the condition you have, how severe it is, how well it’s being managed, and the type of work you do. Physically demanding work will be impacted by painful joints or restricted movements. And any work that requires you to focus and concentrate, especially for extended periods, will be affected by brain fog, pain, and lack of sleep.

The good news is there are things you can do to help manage these issues. We’ve listed a bunch of strategies here. This is part 2 of our 2 part blog.

Note: we understand that some of these strategies may not be possible for all workplaces or conditions. However the majority of them can be adapted in some way to suit your needs.

Manage your meds. Sometimes medications cause side effects like nausea, headaches, lightheadedness, and drowsiness. This can make it really hard to concentrate at work, and may in fact make it dangerous to perform some work duties such as driving or operating machinery. If you find that your medications are causing issues for you, talk with your doctor about possible alternatives you can use.

You may also need to have a review of your medications if you find your condition’s not under control or you need more help managing pain and other symptoms. Again, talk with your doctor about this.

Get a good night’s sleep. We all go through periods when sleep is elusive. Chronic pain and anxiety are just a couple of things that can affect our ability to get enough quality sleep. But sleep is important for good physical and mental health, and to give us the ‘get up and go’ we need to get to work and work productively. If you’re having issues sleeping, don’t just put up with it. There are lots of things you can do to get the sleep you need.

Take a break. Get up, move and clear your head. We all need to take breaks for our physical and mental wellbeing. So walk to the photocopier or around the block, do some simple stretches, step outside and do some deep breathing or visualisation. Whatever helps you manage your pain, fatigue, and brain fog, do it.

Dealing with time off work. We all need time off from time to time, but for many people with musculoskeletal conditions, it may happen more often than we’d like. Attending healthcare appointments during working hours or having a flare means you may go through your personal leave quite quickly. If this is a concern or problem for you, discuss your options with your healthcare team. Are you able to attend appointments via telehealth or outside of your usual working hours? An occupational therapist or physiotherapist may have some solutions for working during a flare and to reduce the pain and strain on your joints. And if you’ve disclosed your condition to your employer, discuss your concerns with them. Together you should be able to develop a plan to help you balance time off and the work duties you need to complete. One of the silver-linings of the COVID pandemic is that we’ve discovered that many jobs can be done productively from home. So working from home may be an option. As too are aids and equipment that protect your joints and save energy, or even changing the work you do at your workplace. Being proactive and knowing your rights is key to working well with a musculoskeletal condition.

Managing changes to your abilities and functioning. Unfortunately some musculoskeletal conditions will change a person’s ability to do specific tasks. For example, someone with back pain may find sitting for long periods impossible. Or a person with arthritis in their hands may find repetitive work such as typing extremely painful. Talking with an occupational therapist or physiotherapist can help you find potential solutions to these issues. Whether it’s finding new ways to do work tasks, using special equipment and aids to support you and protect your joints, or managing your pain while at work, they’ll tailor a solution to your specific needs.

These are just some of the things you can do to manage your condition and continue to work. Feel free to share the things you do to help you manage at work with a musculoskeletal condition. We’d love to hear from you!

Call our Helpline

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

Making the invisible visible

Read the report based on our 2020 National Consumer Survey – Making the invisible visible – in which 66% of people said that their ability to work had been impacted by their condition/s.

Watch our webinar

Watch the recording of our webinar from March 2021, as Jessica Dawson-Field, Employment Associate, Maurice Blackburn Lawyers, takes us through employment law – rights and entitlements.

More to Explore

JobsAccess
Australian Government
JobAccess is the national hub for workplace and employment information for people with disability, employers and service providers. It provides:

a wide range of info and services to help people with disability find and keep jobs, get promoted to better jobs, upgrade or expand their workplace skills
advice on modifying your work area, talking about your disability, training for your co-workers, negotiating flexible work arrangements and returning to work
the Employment Assistance Fund (EAF) which gives financial help to eligible people with disability and mental health conditions and employers to buy work related modifications, equipment, Auslan services and workplace assistance and support services.
and much more.

Work Assist
Australian Government
Work Assist can help you stay in work if you risk losing your job through illness, injury or disability.

I have a job and arthritis: Now what?
Arthritis Society Canada

Fatigue
National Rheumatoid Arthritis Society (UK)

Sleep and pain
painHEALTH

Managing flares
National Rheumatoid Arthritis Society (UK)

Musculoskeletal Health Australia

31/Jul/2024

And things you can do to manage

Finding and keeping a job when you have a musculoskeletal condition can be difficult. Pain, fatigue, medication side effects, and the unpredictability of your condition can all affect your ability to work.

The extent to which this happens will depend on many things such as the condition you have, e.g. back pain, rheumatoid arthritis, osteoarthritis, gout, how severe it is, how well it’s being managed, and the type of work you do. Physically demanding work, such as building, nursing, and farming, will be impacted by painful joints or restricted movements. And any work that requires you to focus and concentrate, especially for extended periods, will be affected by brain fog, pain, and lack of sleep.

The good news is there are things you can do to help manage these issues. We’ve listed a bunch of strategies here. This is part 1 of our 2 part blog.

Note: we understand that some of these strategies may not be possible for all workplaces or conditions. However the majority of them can be adapted in some way to suit your needs.

Work with your healthcare team to ensure your condition is under control and well managed. This may involve your GP, rheumatologist, physiotherapist, podiatrist and/or occupational therapist. They’ll also help you develop a plan to cope at work when your condition flares.

Evaluate your workspace. Whatever your setting – office, retail, manufacturing, hospitality, transport – there are options for making it more supportive for you. The first step is to talk with an occupational therapist about the issues you’re facing and develop strategies to help you manage them. They may include simple things such as being aware of your posture throughout the day and changing position regularly to reduce pain, strain and fatigue. They may also involve changing your workspace to make it work for you.

For example:

using a standing/sitting desk
rearranging the setup so that items you use most often are close by
sitting on a chair or perch instead of standing for long periods
using a headset on your phone
getting lumbar supports for your chair or car seat
using a trolley to help you move heavy items.

Some of these options may be easy to do without going through your employer, but some changes may need their involvement. If your employer knows about your condition, then you can discuss these changes together. However if you’ve chosen not to disclose your condition, your employer is still obliged to make reasonable adjustments to your workstation or environment to ensure your comfort and safety. Things such as stand up desks, foot rests, wrist rests, height adjustable chair, ergonomic chair are all considered reasonable. For more information read our information on Employment FAQs and visit Safe Work Australia.

Take control of your pain. Chronic pain can affect your ability to do the things you want and need to do, your sleep quality, your concentration, and mood. Basically it sucks. That’s why you need a toolbox of strategies for managing your pain. There’s no one size fits all when it comes to pain management. So having several strategies you know work for you, is essential. They may include gentle exercise, medications, heat and cold, stretches, massage, splints, braces and aids and equipment. It’ll take some trial and error, but it’s well worth the effort to find what works best for you. You can then pull them out of your toolbox when needed, giving you more control over your pain. Your doctor and physiotherapist can also give you tips for managing your pain while at work. For more information and practical tips for dealing with pain, read Managing your pain: An A-Z guide.

Along with pain, fatigue is a massive issue for people with musculoskeletal conditions. Fatigue is very different from just being a little tired. It’s overwhelming physical and mental tiredness that makes every activity a struggle. But there are things you can do to manage so that it has less impact on your life and your work. Find out how.

Acknowledge the unpredictability of your condition. It’s a fact that musculoskeletal conditions are unpredictable. You often won’t know you’re about to have a flare until one happens. Apart from increased pain, stiffness, and fatigue, having a flare can be really stressful as you worry about getting things done – at work and at home. Having a plan in place for managing – before a flare occurs – means you can be proactive. This may involve developing a plan with your healthcare team that will help you cope at work, prioritising and pacing your activities so that you get any important, time-dependent tasks done when you’re feeling your best, discussing flexible work arrangements (like working from home) with your employer, or taking time off work or reducing your hours until you can get the flare under control. The important thing is that you’re prepared, with a plan of attack in place, ready to go when needed.

Use your scheduled breaks. It’s easy when you’re feeling under pressure – whether it’s from your employer or pressure you’ve put on yourself – to ignore your lunch or tea breaks and just keep working. But this will only add to your stress, pain and fatigue. You need to take some downtime during your day to eat, drink and give your mind and body a break. If you can, get outdoors and breathe in some fresh air. When you return from your break you’ll feel better, have a clearer head, and be more productive.

For more info and tips check out part 2 of this blog.

Call our Helpline

Watch our webinar

Watch the recording of our webinar from March 2021, as Jessica Dawson-Field, Employment Associate, Maurice Blackburn Lawyers, takes us through employment law – rights and entitlements.

More to Explore

JobsAccess
Australian Government
JobAccess is the national hub for workplace and employment information for people with disability, employers, and service providers. It provides:

a wide range of info and services to help people with disability find and keep jobs, get promoted to better jobs, upgrade or expand their workplace skills
advice on modifying your work area, talking about your disability, training for your co-workers, negotiating flexible work arrangements and returning to work
the Employment Assistance Fund (EAF) gives financial help to eligible people with disability and mental health conditions and employers to buy work-related modifications, equipment, Auslan services and workplace assistance and support services.
and much more.

Work Assist
Australian Government
Work Assist can help you stay in work if you risk losing your job through illness, injury or disability.

I have a job and arthritis: Now what?
Arthritis Society Canada

Fatigue: Beyond tiredness
National Rheumatoid Arthritis Society (UK)

Sleep and pain
painHEALTH

Managing flares
National Rheumatoid Arthritis Society (UK)

Musculoskeletal Health Australia

23/Jul/2024

WalkingBack to Health

A recent study led by Dr Natasha Pocovi (PhD) from Macquarie University focusing on the effectiveness and cost-effectiveness of individualised, progressing walking and education on low back pain has shown promising results.

The randomised controlled trial findings have recent been published in the Lancet with promising results.

Reoccurring low back pain is a significant problem and can severely impact the quality of life of those experiencing it. The WalkBack study focused on adults who had recently recovered from an episode of non-specific low back pain that wasn’t attributed to a specific diagnosis with the pain/episode lasting over 24 hours. The randomised control trial randomly assigned participants to one of two groups. Group one was an individualised, progressive walking and education intervention supported by a physiotherapist for 6 months. Group two received no treatment from the study team but were able to seek out any treatment or prevention strategies and use them during the trial.

The researchers were investigating two effectiveness outcomes: 1. How many days from randomisation (that is being placed in Group 1 or Group 2) to the first recurrence of activity-limiting low back pain lasting at least 24hours and 2. An economic evaluation that included quality-adjusted life-year (QALYs) and costs associated with the delivery of the intervention (including health-care costs, work absenteeism etc.).

The outcomes of the trial showed that the individualised, progressive walking and education intervention substantially reduced low back pain recurrence compared to no treatment. There were also reductions in back pain-related disability for up to 12 months in the participants who received the intervention. The findings also indicated the intervention had a high probability of being cost-effective.

This research shows some promising findings that have the potential to help millions of Australians Walk Back to a life free from low back pain.

For further information on WalkBack click HERE

Contact our free national Helpline

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 Monday to Thursday between 9am-5pm on 1800 263 265; email (helpline@muscha.org) or via Messenger.

Just keep walking – Musculoskeletal Health Australia
I’m walking on sunshine – Musculoskeletal Health Australia
These shoes are made for walking – Musculoskeletal Health Australia

Musculoskeletal Health Australia

18/Jul/2024

Self-care is a trending concept at the moment with many different definitions and uses.

You often see social media posts promoting self-care with pictures of day spas, yoga retreats and people exercising on the beach at sunset. All wonderful things, but when you live with a chronic condition, pain and sometimes-crippling exhaustion, life’s not always that glamorous!

So what is self-care?

The World Health Organisation defines self-care as “the ability of individuals, families and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a health worker”.(1)

That’s a pretty dry definition, so for the everyday person with a musculoskeletal condition, we describe self-care as the things you consciously and deliberately do to take care of your physical, mental and emotional health and wellbeing.

It includes everything from exercising regularly and staying active, eating a healthy diet, getting a good night’s sleep, caring for your mental health, managing pain and fatigue, seeing your healthcare team regularly, learning about your musculoskeletal condition, and staying connected with family and friends. It also involves good hygiene, avoiding risky behaviours and actions, and using medicines and treatments appropriately.

The International Self-Care Foundation (ISF) has developed seven pillars of self-care. They aim to help people understand the breadth and importance of self-care, and provide information about the steps you can take to care for yourself better.

Let’s explore them.

Pillar 1. Knowledge and health literacy

Knowledge, as the saying goes, is power – so understanding your body, how it works, how it’s affected by your musculoskeletal condition/s, as well as any other health conditions you have – gives you the ability to make informed decisions about your healthcare.

Health literacy refers to how we “understand information about health and health care, and how we apply that information to our lives, use it to make decisions and act on it”.(2)

Together, health literacy and knowledge give you the tools you need to actively manage your healthcare. By understanding your body and health, you can discuss your options with your health professionals, critically evaluate information from various sources, adjust your lifestyle and behaviours, understand risk factors, and the appropriate use of treatments and tests.

In fact, research shows that people who have high levels of knowledge and health literacy have much better health outcomes.

If you want to know more about your health and musculoskeletal condition/s, or you need help to improve your health literacy, there are many people who can help you.

Talk with your doctor and other members of your healthcare team. Contact the MSK Help Line and speak with our nurses. Visit authoritative websites (like ours).

And never be afraid to ask questions.

Pillar 2. Mental wellbeing, self-awareness and agency

Incorporating things you enjoy and that make you feel good into your daily/weekly routine – such as mindfulness, exercise, alone time, relaxation, massage, and staying connected with family and friends – is a simple thing you can do to look after your mental wellbeing and increase your resilience.

Self-awareness involves taking your health knowledge and applying it to your specific circumstances. For example, if you’re having problems sleeping, and you know exercise can help, you can ensure you’re getting enough exercise each day. Or if you’re carrying more weight than you’d like, and this is causing increased knee pain and self-esteem issues, talk with your doctor about safe ways you can lose weight. Or if you have rheumatoid arthritis and a family history of osteoporosis, talk with your doctor about how you can look after your bone health.

Agency is the ability and intention to act on your knowledge and self-awareness.

Pillar 3. Physical activity

OK, so this one’s fairly self-explanatory since we talk about the importance of exercise and being physically active all the time 😊.

Regular exercise helps us manage our musculoskeletal condition/s, pain, sleep, mood, weight, and joint health – and that’s just the tip of the iceberg! It keeps us moving, improves our posture and balance, helps us stay connected and helps prevent (or manage) other health conditions such as diabetes and heart disease.

Pillar 4. Healthy eating

This one’s also easy to understand, as along with exercise, healthy eating plays a vital role in our overall health and wellbeing.

Being overweight or obese increases the load on joints, causing increased pain and joint damage, especially on weight-bearing joints like hips, knees, ankles and feet. The amount of overall fat you carry can contribute to low but persistent levels of inflammation across your entire body, including the joints affected by your musculoskeletal condition, increasing the inflammation in these already painful, inflamed joints.

Being overweight or obese can also increase your risk of heart disease, diabetes, some forms of cancer, poor sleep and depression.

Being underweight also causes health issues. It can affect your immune system (meaning you’re more at risk of getting sick or an infection), and you may feel more tired than usual. Feeling tired and run down will affect your ability to be active and do the things you want to do.

If you need help to eat more healthfully or manage your weight, talk with your doctor or dietitian.

Pillar 5. Risk avoidance or mitigation

Simply put, this pillar is about taking responsibility for your actions and behaviours. In particular, those that increase your risk of injury, ill-health or death.

To avoid these risks, you can drink alcohol in moderation, drive carefully, wear a seatbelt, get vaccinated, protect yourself from the sun, quit smoking, wear a helmet when riding a bike, and practise safe sex.

Seeing your doctor and healthcare team regularly is also important to stay on top of any changes to your health.

Pillar 6. Good hygiene

You’re probably wondering what this has to do with self-care for people with musculoskeletal conditions living in Australia. After all, most Australians have access to clean water and clean living/working spaces.

However, the last few years have shown how vital good hygiene is for protecting all of us from bugs and germs. It’s even more important if your condition or meds have weakened your immune system.

Practising good hygiene is a simple thing you can do to reduce the risk of getting sick or developing infections. So continue to regularly wash your hands, cough/sneeze into your elbow, stay home when sick, and keep your home/work environment clean. And although they’re not yet mandated in most places, wearing a mask is recommended and a really good idea when you’re indoors and can’t physically distance yourself from others.

All of these things will help maintain good health and avoid catching (or spreading) any nasties.

Pillar 7. Rational and responsible use of products, services, diagnostics and medicines

Another fun one! 😁 Although the title doesn’t roll off the tongue, this is an important pillar.

ISF calls these self-care products and services the ‘tools’ of self‐care, as they support health awareness and healthy practices.

They include medicines (both prescription and over-the-counter), aids and equipment (e.g. TENS machine, heat or cold pack, walking stick), health services (e.g. physiotherapy, massage therapy), wellness services (e.g. exercise classes, weight loss groups), and complementary therapies.

ISF also says that the use of these tools should be ‘rational and responsible’. That means only using safe and effective products and services.

Contact our free national Helpline

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

More to explore

45 simple self-care practices for a healthy mind, body, and soul
Tiny Buddha
Developing a self-care plan
This information was developed for mental health professionals, however there are a lot of useful resources that are helpful for anyone wanting to learn more about self-care.
ReachOut
Does your self-care plan need some TLC?
Musculoskeletal Australia
Self-Care Starter Kit ℠
University at Buffalo, School of Social Work
This information was developed for students studying social work, and professionals working in the field, however there are a lot of useful resources that are suitable for anyone wanting to learn more about self-care.
The seven pillars of self-care
International Self-Care Foundation
How and why to practice self-care
Mental Health First Aid USA, National Council for Mental Wellbeing
How to make a self-care checklist that actually works for you
Healthline

References

(1) Self-care interventions for health, World Health Organization.
(2) Health literacy, Australian Commission on Safety and Quality in Health Care

Musculoskeletal Health Australia

18/Jul/2024

I think there’s a reason we respond so positively to the memes, social media posts and jokes that poke fun at pain, chronic illness and the trials and tribulations that come from living with both.

Having a foggy brain isn’t particularly funny, being unable to sleep isn’t a joke, and pain – wow, that’s probably the un-funniest thing you can think of 😣. But we all tend to laugh at and share the well-crafted meme or post that pokes fun at these things because we identify with the truth behind them. And with the best ones, you can tell it’s been created by someone who knows what it’s like to live with pain and illness. You recognise a fellow traveller.

Laughter and humour are such powerful forces. Just think about the last time you had one of those huge, spontaneous belly laughs with family or friends. Something was said, a joke was told, or you all saw something ridiculous. You snort, giggle, and guffaw. Your eyes water, you gasp for breath, and your belly starts to hurt. When you look at each other, you laugh some more. When you finally do stop laughing, you feel euphoric. Everything seems better, and you feel happier 😊.

However, when you’re in the grips of pain, laughing is probably the last thing you feel like doing. But laughter can actually help you deal with your pain better. A good joke, a funny movie, or just seeing something silly can distract you from your pain and make you feel better, at least for a while.
Laughter also causes your brain to release some feel-good chemicals that boost your mood and make you feel more optimistic. They include endorphins, serotonin and dopamine. Endorphins are your body’s natural pain reliever; releasing them into the body temporarily reduces your feelings of pain. Serotonin produces feelings of calmness and happiness. And dopamine is part of your brain’s reward system and gives you a sense of pleasure. It also helps reduce feelings of anxiety.

Other health benefits of a good giggle

As well as helping you cope with your pain and the stress of living with chronic health issues, laughter has many other health benefits. Laughing regularly:

Is good for your lungs. It increases the amount of oxygen you breathe in, and if you do it often enough, it increases lung capacity by promoting deep breathing.
Is good for your heart and improves blood pressure and circulation.
Lifts your mood and provides relief from stress and anxiety.
Is exercise! That’s why it’s often called ‘internal jogging’. 🏃🏃
Decreases muscle tension.
Helps you relax.
Brings you closer to the people you’re laughing with.
May improve immune function.
Helps manage depression.
Improves sleep quality.
Is free! 😊

LOL ideas

To bring on the laughs, giggles, chortles, snickers, cackles and guffaws, give these ideas a go:

Watch/stream a funny movie or sitcom – check out these lists from Flickchart and Rolling Stone for their top picks.
Listen to a funny podcast – this list from Time Out will get you started if you need ideas.
Run through a sprinkler on a hot day.
Talk with a friend and reminisce about a funny experience you had together.
Watch cat / dog / panda videos (you’re welcome!). 😹
Grab the kids, friends, partner or housemates and play. Anything! … Keep a balloon off the floor. Throw a frisbee. Charades. Pub quizzes. Truth or dare. Never have I ever. The floor is lava…
Have a pillow fight.
Think about the funniest joke you ever heard or your best (worst) dad jokes.
Jump on a trampoline.
Take silly selfies and send them to your bestie.
Grab a microphone (or a hairbrush) and sing out loud!
Join a laughter club. Simply google ‘laughter clubs’ for your state or territory.

Sadly it’s not all fun and games

It’s important to remember that laughter and humour are temporary distractions from pain. They’re great, and we should definitely cram as much into our day as possible. Just for the sheer joy of it 🤡.

But when you have a chronic illness and persistent pain, a balanced treatment approach should include self-care, appropriate medications and medical care, a healthy lifestyle, exercise, mindfulness and, yes, laughter.

Laughter may not be the best medicine (as the old saying goes), but it’s pretty close to perfect.

So, make sure you take a dose (or better yet – several!) every day!

Contact our free national Help Line

More to explore

How laughter works
HowStuffWorks
How laughter brings us together
The Greater Good Science Center at the University of California, Berkeley
How to use laughter to lift your mood
Happiful
Humor in psychology: Coping and laughing your woes away
PositivePsychology.com
Laughing is good for your mind and your body – here’s what the research shows
The Conversation
Laughter
Psychology Today
Laughter has serious benefits
Michigan State University
Laughter is the best medicine
Help.Guide.org
Mayo Mindfulness: Laughter for stress relief is no joke
Mayo Clinic
The health benefits of humor and laughter
Verywell Mind
The health benefits of laughter
Verywell Mind
Ways that humor can heal
PsychCentral

Photo by MI PHAM on Unsplash

Musculoskeletal Health Australia

02/Jul/2024

Do you feel like your diet has gotten away from you? Have you spent the first part of winter eating yummy, warm and kilojoule dense foods? Are your clothes starting to fit a little more snugly than you’d like? Now may be a good time to review your eating habits to make sure you’re eating as well as you can to improve your health, energy levels and mood.

Here are some handy hints to help you get started.

Musculoskeletal Health Australia

01/Jul/2024

A PBS News Update

Ref: ** Pharmaceutical Benefits Scheme (PBS) | Closing the Gap (CTG) PBS Co-payment Program **

Expansion of the Closing the Gap Pharmaceutical Benefits Scheme Co-payment Program – Information for First Nations People

What is the Closing the Gap (CTG) Pharmaceutical Benefits Scheme (PBS) Co-payment Program?

The CTG PBS Co-payment Program improves access to affordable PBS medicines for First Nations people living with, or at risk of, chronic disease.

Under this program, eligible First Nations people who are registered on the CTG PBS Co-payment Register and who would normally pay the full general PBS co-payment amount, pay the concessional rate when obtaining PBS medicines from their local community pharmacy, approved medical practitioner, or private hospital. Eligible patients who would normally pay the concessional rate receive their PBS medicines for free, without having to pay a co-payment.

What is changing?

From 1 July 2024 the CTG PBS Co-payment Program has been expanded to apply to all PBS medicines dispensed by community pharmacies, approved medical practitioners, and private hospitals.

Answers to Frequently Asked Questions and further information for First Nations people, community pharmacies, hospital pharmacies, prescribers and Aboriginal and Torres Strait Islander Health Practitioners are provided at the links below:

** Ref: Pharmaceutical Benefits Scheme (PBS) | Closing the Gap (CTG) PBS Co-payment Program **

Call our Helpline

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

Musculoskeletal Health Australia

01/Jul/2024

MeTeOR2 Clinical Trial

The MeTeOR2 Clinical Trial compares meniscal allograft transplant surgery to a type of physiotherapy for people who experience post-meniscectomy pain.

Clinical trials

Clinical trials are an important part in improving healthcare outcomes. If you are not familiar with what a clinical trial is, you’re not alone! Clinical trials are research studies involving people like you and me, to evaluate if a treatment is safe and helpful. The new treatment under testing may be a medicine, procedure, technique, vaccine, device, or lifestyle/behaviour. Clinical trials are carefully designed and must undergo a thorough review to ensure the procedures have merit, are safe and ethical. Ultimately, clinical trials are essential to help us improve the management of health conditions!

People participate in clinical trials for various reasons. Some people who are aware of clinical trials understand their participation helps inform how to manage health conditions. However, many may not be aware of the other benefits. These benefits include playing an active role in your healthcare, receiving treatment from leading medical practitioners, and accessing treatments for your condition which may not be possible otherwise. One clinical trial is the MeTeOR2 trial, which compares meniscal allograft transplant surgery to a type of physiotherapy for people who experience post-meniscectomy pain.

What is a meniscectomy?

The meniscus is a c-shaped cartilage that distributes loads at the knee joint. A torn meniscus is common, especially among young people engaged in sport activities. Conservative treatments are available including activity modification, medication (e.g., non-steroidal anti-inflammatories, paracetamol), and physiotherapy. Some tears may be surgically repaired depending on the location of the tear. Other tears cannot be repaired, so the torn parts are removed with a keyhole surgery called arthroscopic partial meniscectomy. Although this procedure can improve pain and locking symptoms in most people, some patients may still experience pain and functional limitations after the surgery. This scenario can be very disabling and emotionally distressing, particularly at a young age when people are expected to be active, healthy, and free of disability. When this is the case, only a few treatment options are available.

Treating pain and functional limitation after a meniscectomy

For people with considerable pain or functional limitations after meniscectomy, surgical and non-surgical treatment options are available. One surgical option is the meniscal allograft transplant (MAT), which involves inserting a donated meniscus into the injured knee. The MAT surgery is thought to improve symptoms by restoring normal load distribution within the knee, along with the rehabilitation after surgery. Non-surgical management, such as personalised rehabilitation – which consists of many different types of treatment, including exercise, weight management, and lifestyle and activity advice – is also a viable option. Although the mechanisms of how personalised rehabilitation reduces symptoms are unknown, improvements have been observed in people with post-meniscectomy pain. However, it is still unknown which treatment option is better, in terms of safety and cost-effectiveness, to improve health-related outcomes.

The MeTeOR2 study

MeTeOR2 is a clinical trial designed for people suffering from pain and/or functional limitations after partial meniscectomy. This study aims to compare two knee treatments – meniscal allograft transplant (MAT) surgery and personalised knee therapy (rehabilitation) – and evaluate if one treatment is superior to another in improving knee pain and function.

How to participate/who to contact

If you are interested in the study and consent to participate, you will have a 50% chance of being put into one of the two groups. The first group will receive the meniscal allograft transplant (MAT) surgery, while the second group will receive personalised knee therapy (rehabilitation). Participants in both groups will be asked to complete a series of questionnaires at baseline and 3, 6, 12, 18, and 24 months following randomisation.

You may be eligible to participate in this study if you have:

Inclusion Criteria:

Pain and / or functional limitation from the knee, severe enough to warrant potential meniscal allograft transplant.
Previous meniscectomy ≥ six months ago.

Exclusion Criteria:

Symptomatic ligament instability, not previously corrected, as determined by the assessing clinician.
Coronal limb alignment that requires surgical correction, as determined by the assessing clinician.
Age < 16, or if ≥ 16, open growth plate at the proximal tibia as judged by the clinical team on imaging as part of standard care.
Full thickness cartilage loss (exposed bone) > 1 cm2, on routine clinical MRI, prior to surgery, or any other form of clinical imaging or evaluation.
Inflammatory arthritis affecting the study knee as determined by the assessing clinician.
Unable or unwilling to engage in rehabilitation.
Unable to adhere to trial processes.
Previous randomisation in the present trial, (i.e., the other knee).

If you are interested in being part of this important and exciting clinical trial, please contact the study facilitator: meteor2.study@sydney.edu.au

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Musculoskeletal Health Australia

27/Jun/2024

It’s 2am and you’ve been tossing and turning for hours. You’re so tired, but you just can’t sleep. You lay on your left side, but your neck hurts too much in that position. So you roll on to your back, but your lower back aches. You turn on to your right side, and success (!) that feels ok. But now your knees hurt, your brain’s counting down the hours until you have to get up for work, and you need to go to the toilet. Sigh.

Sound familiar? We’ve all experienced the dreaded ‘painsomnia’ – or insomnia caused by persistent pain.

Without the distractions of our daily activities, the dark of night can become a long, painful expanse of time. Even when we’re exhausted, sleep can be elusive. It might take longer to fall asleep, we can’t get comfortable, we wake frequently, or we just don’t get enough sleep. Or all of the above.

When you add anxiety about sleep into the mix, it becomes a vicious cycle. Poor sleep lowers your pain threshold which affects the quality of your sleep. Pain can affect your ability to be active – which affects your sleep quality and your pain levels. This can make you anxious or stressed – which again will affect how well you sleep and the amount of pain you experience.

And when you’re stuck in this cycle, exhausted and in pain, it affects your mood, your ability to concentrate and it’s very easy to become depressed. So it’s important that you act quickly as soon as you start having issues sleeping.

The good news is there are many things you can do to break the cycle. The not-so-good news is they may not work immediately. And they’ll require some effort on your part. But they’re all tried and true ways to develop good sleep habits and get the good night’s sleep you crave.

Acknowledge your painsomnia. Although it’s tempting to pull the covers over your head and ignore the problem, that won’t make it go away. Actually acknowledging the situation, and that there are things you can do to change it, is the first important step.
Develop a sleep routine. There’s a reason we do this with babies and small children – it works! As often as possible, go to bed and get up at the same time each day. Your body will become used to this routine and you’ll find it’s easier to fall asleep and stay asleep.
Manage your pain. You can’t have painsomnia if your pain is under control. Check out our A-Z pain management guide for simple, practical ways you can take control of your pain.
Try some relaxation techniques. There are as many ways to relax as there are stars in the night sky (well, almost) so there’s bound to be something that suits you. Try a warm bath before bed, reading (though nothing too engrossing!), deep breathing, listening to music, mindfulness, or visualisation. These techniques will help you become more relaxed so that when you go to sleep, you sleep well.
Exercise and be active during the day. As well as the many other benefits of regular exercise, it’ll help you fall asleep and stay asleep longer.
Don’t look at the clock. Constantly checking the time can make you anxious, which makes it hard to sleep. Try removing your clock from the bedside, or cover it up at night.
Manage your thoughts, all of the pesky voices in your head that are focusing on the things you need to do tomorrow, or the current state of the world, or the latest stress of the day. One way to deal with them is to write them down and get them out of your head. Put them down on paper and tell yourself you’ll deal with them tomorrow when you’re rested and have the brain power to deal with them.
Get out of bed. Don’t lie in bed tossing and turning. Have a warm drink (e.g. milk, no caffeine), do some gentle stretches or breathing exercises and go back to bed when you feel more comfortable.
Avoid tech before bed. It’s easy to get caught up in news, social media and emails, and before you know it you’ve lost a few hours. Also the blue light on our devices suppresses the hormone (melatonin) that makes us sleepy at night, so be sure to stop screen use at least one hour before bed. That being said, there are some useful apps that may help you with your painsomnia – including sleep diaries, apps that provide soothing sounds to help block out other noises (like traffic or snoring), and apps that help you relax so you fall asleep more easily.
Consider cognitive behavioural therapy for insomnia (CBTI). This is a therapy that aims to challenge and change unhelpful ways of thinking about sleep. It also changes your behaviours when it comes to sleep. Find out more about CBTI in this article from the Mayo Clinic.
Evaluate your environment. What’s your bed like? Too hard, too soft or just right? Do you need to make some changes to your mattress, pillows and/or linen that will make your bed as comfortable as possible? Is there too much light or noise? Can you control that with simple fixes such as eye masks or earplugs? Is your room too hot? A slightly cool room is the best for a good night’s sleep. Consider all of these things as you take a long, hard look at your bedroom.
Get professional help. If pain is constantly keeping you awake at night, talk with your doctor about other things you can do to manage your pain and get some decent sleep.

Call our Helpline

More to explore

Sleep
Musculoskeletal Health Australia
Getting a good night’s sleep
Musculoskeletal Health Australia
How to sleep well despite chronic pain
Pathways
Painsomnia: What to do when ankylosing spondylitis keeps you up at night
Everyday Health
Sleep hygiene
SleepFoundation.org

Musculoskeletal Health Australia

26/Jun/2024

Not just a fashion statement from the 70s!

From time-to-time many of us experience a flare, when symptoms like pain, inflammation and fatigue are worse, or more intense. This is a flare.

Flares are temporary, but can be frustrating and painful while they last. We don’t always know why they happen – and sometimes they seem to come out of the blue.

So it’s important that you have a plan for how you manage a flare when it happens.

Your flare plan

Write down what you were doing before the flare as this can help you identify potential triggers.
Talk with your doctor about what you should do when you have a flare. You may need to adjust your medications, or alter the dosage during a flare.
Have a plan in place for how you will deal with your commitments – family, work, social activities – when you’re in the middle of a flare. Can you alter your work hours, work from home, get your family to help out?
Prioritise your tasks and activities. This can reduce the risk of overdoing things.
Pace yourself. If the flare is the result of overdoing things, think about getting people to help you, or spread the activity over a greater period of time, e.g. if you want to clean your house, get the family involved and give each person a room or zone that they’re responsible for; or spread the job over a few weekends and assign yourself a room, a zone or a period of time to clean that’s achievable for you. When you’ve cleaned that area, or reached that time limit, stop. You can go back to it later.
Manage your stress, it can increase your pain levels. If you feel yourself becoming stressed, try relaxation techniques such as meditation, breathing exercises and visualisation.
Pull out all of your pain management strategies. Use heat or cold packs, get a massage, go for a walk, distract yourself…use all the things you know help you manage your pain.
Rest when your body needs it – but not for too long. Going to bed and not being active during a flare can make your pain and fatigue worse. Continue to exercise, but at a lesser intensity than usual. Listen to your body.
Use aids and other gadgets when your joints are painful and swollen. This will help protect your joints, and reduce some of the pain you feel when doing everyday tasks.

Some of the suggestions listed here are easy, however others involve a bit of thought, as well as input from others. But taking the time to work out a plan that works for you will help you manage your flares better, and with less disruption to your life.

Get advice from your doctor, and others in your healthcare team. Or, contact our free helpline on 1800 263 265 and speak with a nurse or email us at helpline@muscha.org

MORE INFORMATION

NPS MedicineWise: Managing Your Flare

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A recent study led by Dr Natasha Pocovi (PhD) from Macquarie University focusing on the effectiveness and cost-effectiveness of individualised, progressing walking and education on low back pain has shown promising results.

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What is the Closing the Gap (CTG) Pharmaceutical Benefits Scheme (PBS) Co-payment Program?

What is changing?

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MeTeOR2 Clinical Trial

The MeTeOR2 Clinical Trial compares meniscal allograft transplant surgery to a type of physiotherapy for people who experience post-meniscectomy pain.

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How to participate/who to contact

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Not just a fashion statement from the 70s!

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