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23/Jan/2024


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23/Jan/2024

We’re a country that loves a drink. Wine with dinner, beer at the footy, cocktails at the local bar with friends.

But what if your drinking is getting a little out of hand? What if you’re having too much of a good thing??

It may be time to take a break while you assess your relationship with booze.

What’s a safe amount of alcohol to drink?

The Australian Alcohol Guidelines recommend that ‘to reduce the risk of harm from alcohol-related disease or injury, healthy men and women should drink no more than 10 standard drinks a week and no more than 4 standard drinks on any one day. The less you drink, the lower your risk of harm from alcohol’.

The guidelines also recommend that children under 18 and pregnant or breastfeeding women don’t drink alcohol.

It’s important to note that consuming alcohol within the recommendations of these guidelines will reduce your risk, but there’s still a risk. Read the government’s info ‘How much alcohol is safe to drink’ to find out more.

How does alcohol affect your health?

There are many ways that regular alcohol consumption can negatively affect your health.

It can interact with your meds – including commonly used medications such as non-steroidal anti-inflammatories (e.g. ibuprofen) and disease-modifying drugs (e.g. methotrexate), causing problems such as ulcers, bleeding in the stomach and liver damage. Be aware of the risks, and always read the labels and consumer medicine information for all your medications about side effects and interactions. Talk with your doctor/pharmacist for more information about alcohol and your musculoskeletal or pain meds, as well as any other medications you take.

It increases the risk of a gout attack. If you have gout, drinking too much alcohol, especially beer, can increase your risk of a painful attack.

It affects your sleep. Getting sufficient quality sleep is vital for our overall health and wellbeing. However, people with musculoskeletal conditions often struggle with sleep issues – getting to sleep, staying asleep and feeling fatigued when they wake up. So while the idea of a nightcap to help you wind down and relax in the evening may sound like a good idea, alcohol will actually affect the quality of your sleep. Even if you sleep through the night, you’ll likely wake up feeling unrefreshed and foggy. To find out more about the relationship between alcohol and sleep, read this article from the Sleep Foundation.

It increases your risk of developing cancers and other serious diseases – this includes heart disease, cirrhosis (or scarring) of the liver, diabetes, mental health issues, stroke and high blood pressure. For more info, read ‘What are the effects of alcohol’.

It increases your risk of getting injured. If you’ve been drinking, especially if you’ve become tipsy or drunk, you’re more likely to injure yourself. When you become drunk, you lose your balance and coordination, increasing the risk of falling. You’re also more likely to engage in risky behaviours, such as driving, putting yourself and others at risk.

It can affect your mental health. Many people often turn to alcohol to relax after a stressful day or if they’re feeling a bit down. And it may provide a very temporary boost to their mood, but it doesn’t last. In the long run, drinking can contribute to feelings of depression and anxiety. It can also make it harder to deal with stress.

Benefits of putting a pause on the plonk

Whether you decide to reduce your alcohol intake, have a few alcohol-free days each week, or go without alcohol for a month or longer, you’ll immediately see some benefits. These benefits will be greater the longer you go without alcohol but will include:

Weight loss. If you’ve been struggling to lose weight, cutting your alcohol intake will definitely help. Alcohol is high in kilojoules, which provide no nutritional value. It can also make you feel hungry and may lead to choosing unhealthy foods to fill the hunger (hello 2am greasy kebabs smothered in garlic sauce ?).

Improved sleep. As mentioned earlier, alcohol interferes with the quality of your sleep.

No hangover. A pounding head and nausea are the price we pay for a night of overindulgence. As are the recriminations and the ‘never agains’ ?. Reducing/stopping your alcohol intake will take care of this. And just think of all the things you can enjoy on a Sunday morning without the morning after hangover!

You’ll save money. On the nights out at the pub/bar (wow, cocktails, cha-ching), on the cab/Uber ride home, or on the alcohol you buy to drink at home. It all adds up – to stacks of cash! Use the money you’d typically spend on grog and treat yourself to something special – like a massage, a new outfit or gold class movie tickets.

More meaningful time with family and friends. It’s amazing what you learn about each other when you take the time to listen and interact without alcohol getting in the way. Try doing different things together instead of sitting around drinking or hitting the pub – for example, going for a walk in the local park or bushlands, having a gaming marathon or making yummy mocktails.

Better performance at work. Waking up with a hangover or sleeping poorly because you’ve been drinking affects your ability to perform at your best at work.

Tips to help you reduce the hooch

Make a plan. Once you’ve decided you’re going to reduce the amount of alcohol you drink (or stop drinking entirely), you need a plan of attack. It can be tough going, especially if drinking has become a habit or an addiction.

Consider the following questions, and write down your answers. Put them somewhere prominent so you can refer to them when you need support or encouragement.

  • Why do you want to reduce or quit alcohol?
    Is it for health reasons? The impact it’s having on your personal relationships or work? Why is it important to you that you reduce or stop?
  • What are your limits?
    Are you quitting alcohol entirely or reducing the amount you drink? Choose a limit for how much you’ll drink, but make sure it’s within the safe drinking guidelines. And include some alcohol-free days each week.
  • What are your triggers?
    Why do you drink? And when? Do you always have a glass of wine while preparing dinner? Or have beers with your mates when you knock off work? Do you drink to help manage your anxiety? Or your pain? What makes you pour a drink or head to the pub?
  • What are your strategies to deal with these triggers?
    For example, if you always drink a glass of wine while preparing dinner, swap it for herbal tea or soda water with a slice of lime or lemon. If you always drink with mates after work, let them know you’re trying to reduce or quit drinking, and stick to non-alcoholic drinks, or suggest you all do something else together. If you drink to deal with anxiety or pain, it’s essential to know that alcohol can actually make it more difficult to manage anxiety and can make your pain worse, so finding healthier ways to manage your pain or anxiety will be better for you in the long run.
  • Who’ll support you?
    It can be challenging to quit or reduce alcohol alone. Tell your family and friends what you’re doing. They can encourage you and may even join you. Talk with your doctor and get information and advice to help you achieve your goal. If you’ve been using alcohol to manage your pain, discuss alternative pain management strategies. The same goes if you’re drinking to manage anxiety or depression.

Get professional help. Many people can help you if you want to reduce or quit alcohol. Your doctor is a great person to start with as they know you and your health conditions. There are also many support organisations to help you. DrinkWise has a range of resources to give you the facts about drinking and its impacts on you. They also have a comprehensive list of organisations that can help you. Check out their website for details.

Know a standard drink size. It’s very easy to drink too much if you don’t know what a standard drink is – whether it’s beer, wine or spirits. Read the ‘Standard drinks guide‘ to find out about drink sizes and see if you’re drinking standard drinks. The answer may surprise you.

Remove temptations. Don’t have alcohol out in the open, or remove it from your house altogether. If it’s not within easy reach, you’re more likely to stick to your goal.

Drink slowly. Sip your drink and actually enjoy the flavours. Take a break between alcoholic beverages and drink mineral water or a mocktail instead.

Finish your glass before you top it up. It’s hard to keep track of how many drinks you’ve had if it’s topped up before you’ve finished drinking.

Don’t drink on an empty stomach. Alcohol is absorbed into your bloodstream through your stomach and small intestine. Any food in the stomach will slow the rate at which alcohol is absorbed.

Get adventurous with low/no alcohol drinks. There’s such an enormous range available to try now, from wine to beers and mocktails (that are more than just soda water and fruit ?). There’s a big world of delicious low and no alcohol drinks for you to enjoy.

Avoid people who aren’t supportive of your efforts. Sometimes people just don’t get it – the reason you want to give up or reduce your alcohol intake. They may have the ability to derail your goals, so avoid people that don’t support what you’re trying to do.

Give yourself a break. Quitting or reducing alcohol can be difficult. If you stumble and drink more than you’d planned, just brush yourself off and learn from that misstep. Don’t throw your hard work away over one mistake.

Originally written and published by Lisa Bywaters July 2021.

 

Contact our free national Help Line

If you have questions about managing your pain, your musculoskeletal condition, treatment options, mental health issues, 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@msk.org.au) or via Messenger.

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23/Jan/2024

How to set an achievable goal for 2024

“Life is short, fragile and does not wait for anyone. There will never be a perfect time to pursue your dreams and goals. ” – Unknown.

Did you start 2024  with a goal? Eating more healthfully, quitting smoking, exercising regularly, learning a new skill, changing careers, buying a house?

If so, you’re not alone. Lots of us start a new year with lofty goals, wanting to start fresh. It’s like the first day of school when you’d open a brand new notebook, and it felt so bright and shiny with endless possibilities (aaah, new stationery 😉).

And we start on our path with gusto – we try new recipes, visit the Quit website, pull the walking shoes out of the cupboard. But then life interferes. A tough day at work leads to takeaway for dinner instead of cooking. You’re out with mates, and everyone’s smoking, so you do too. You wake up exhausted and toss your walking shoes back into the cupboard. The enthusiasm for achieving your goal wanes.

So why bother with goals? What’s the point if they can be hard to achieve?

Simply put, having goals gives us control in a world where so much is out of our control. They provide us with something to work towards, and give us the steps we need to get there.

So let’s look at some simple ways you can live your life and still achieve your goals.

First – let’s address the elephant in the room. It starts with ‘C’ and ends in ‘OVID’.

We’re living in a global pandemic, and we’re a little tired. Two years of pandemic fatigue, fear, stress, and worry mean our physical and mental energy levels are lower than they’ve ever been.

These feelings can’t be ignored or pushed aside in order to achieve your goals. They need to be acknowledged and factored into your goal setting.

Make your goals meaningful

When setting a goal, think of something important to you and not something you think you should do. You’re more likely to be successful if you aim to do something that makes you happy and has meaning. And you’ll be more likely to recover from stumbles or overcome obstacles if your goal is significant to you.

Start with small goals

When we set ourselves a goal we often begin with great excitement, but then something – pain, work, illness, family life, pandemic-life – gets in the way. However if we create small goals, we’re putting ourselves in a better position to succeed.

For example, say you want to read more books. Great! There are so many amazing books out there. But having the goal of reading a book a week may not be realistic (been there done that 😆).

A more feasible way to read more books is to read a chapter in the evening. Or read for 15 minutes in the morning. You’re still reading, but it’s a smaller, more realistic goal.

Be flexible

If you’re having difficulties achieving your goal, ask yourself why? If it has meaning for you and it’s realistic, what’s the barrier? If we use the reading example again, it could be that you can’t find the time to sit and read. Or your eyes are tired after staring at a computer screen all day.

A way to solve this problem could be to listen to audio books. You can do this while doing other things, and your tired eyes don’t have to focus on the words. You can access many titles free through your public library, or you can access a subscription service such as Audible.

The point is that if you’re flexible, there are ways you can still achieve your goal if the original plan didn’t work. Discuss it with family or friends if you can’t think of solutions. Talking through the issue can help you gain some clarity. And the support and advice from the people who care for us is invaluable.

Be kind

When working towards a goal, it’s realistic to expect that there’ll be some trips and stumbles along the way. When this happens, be kind to yourself. When things don’t go according to our plans, we can be very critical. So avoid berating yourself. Instead, look at the stumble as a chance to learn. What happened? Why did it happen? How can you avoid it happening again? Does your goal need some adjustment to make it more achievable?

Another thing to remember is that we’re all different. So don’t compare yourself with others. This can be tough when you’re surrounded by carefully curated, touched up and filtered images, stories and posts about people who seem to have it all together, while you feel like a red hot mess (hmm, that may be just me?). But comparing yourself to others won’t help you achieve your goal and can make you feel like you’re failing somehow. So avoid these comparisons, be kind to yourself and give yourself credit for doing your best.

Be SMART

A common acronym used for goal setting is SMART: Specific, Measurable, Achievable, Realistic and Timeframe. It can help you create a goal that works for you and your life.

Be specific. What is it you’re aiming for? Ask yourself the 5 W’s – who, what, when, where, why. What do you want to accomplish? Why? When and where will you do this? Who can help you?

Let’s use meditation as an example to create a SMART goal. You enjoy meditating. It helps you manage your pain and deal with anxiety. So in 12 months, you’d like to be meditating for 30 minutes a day, 5 days a week.

You need to be able to measure your goal so that you know when/if you’ve achieved it. Meditating more often isn’t a measurable goal, but committing to meditating for a specific amount of time in a day is.

Next, your goal needs to be achievable for you. It should challenge you and stretch you a little but still be attainable, especially considering the uncertainties of the world we’re living in.

Planning to meditate for 60 minutes every day probably isn’t achievable, especially if you’re just starting out. But committing to meditate 10 minutes a day, twice a week is. You can increase the amount of time and the number of days you meditate as you progress.

You need to be realistic, and your goal needs to be doable – for you and your own circumstances. Meditating 10 minutes a day, twice a week is realistic because you enjoy it, and it helps you relax. You’ve discussed it with your family, and they understand that they can’t interrupt you during this time. You’ve organised a quiet space to meditate, and you’ve downloaded a meditation app that you like. You’re committed, and you’ve put in place the things you need to make your goal possible. That makes your goal realistic.

Finally, your goal should have a timeframe. In this example, your goal is to meditate for 30 minutes, 5 days a week in 12 months. You’ll be starting at 10 minutes a day, twice a week increasing this over the coming 12 months. A timeframe gives you motivation and an endpoint to work towards.

Sticking to it

Once you’ve decided on your goal, write it down, along with the steps you need to get there. Stick it on your fridge, bathroom mirror or somewhere you’ll see it often. Refer to it regularly. And remember, if you have any hiccups along the way, that’s okay. Just don’t give up. Learn from what happened and move on.

“I hope that in this year to come, you make mistakes. Because if you are making mistakes, then you are making new things, trying new things, learning, living, pushing yourself, changing yourself, changing your world. You’re doing things you’ve never done before, and more importantly, you’re doing something.” —Neil Gaiman.

 

Originally written and published by Lisa Bywaters 19 January 2022.

Contact our free national Help Line

If you have questions about managing your pain, your musculoskeletal condition, treatment options, mental health issues, 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@msk.org.au) or via Messenger.

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We all know that when our muscles and joints are stiff or painful, it can be hard to move. But we also know that regular exercise is essential for managing musculoskeletal conditions. It helps reduce pain and stiffness, and improves joint mobility and strength. It can also improve balance, sleep quality, lower stress levels, improve mood and help us maintain a healthy weight. It’s practically magic!

But when you’re in pain, exercise can feel like the very last thing you want to do. So what to do?

Just add water!

There are so many benefits to exercising in warm water:

  • the warmth is soothing and helps relieve pain and stiffness
  • the buoyancy supports your body and lessens the strain on your joints
  • water resistance enables you to gradually build up flexibility, strength and stamina
  • anyone can do it – no matter your age or level of fitness.

What is water exercise?

A water exercise program is much more than just going for a swim. Swimming regularly is an excellent way to improve your heart and lung fitness without putting too much strain on your joints, but for a complete workout you need to do a range of exercises which move all your joints and work all your muscles. You can easily do this in a warm water pool.

There are different ways you can exercise in water

1. Water exercise classes
You can enjoy the fun, motivation and social interaction of exercising with others in a class that suits your capabilities and fitness level. In these classes all participants follow the same general exercises.

Many recreation and fitness centres run water exercise classes and cater to a wide range of abilities and fitness levels.

Contact your local centre and talk with an instructor to find out what’s available and to discuss your exercise goals. And ask if you can visit the centre and observe a class before you sign up so that you can be sure it’s the right fit for you.

2. Hydrotherapy
Hydrotherapy is specialised exercise therapy run by a health professional such as a physiotherapist or exercise physiologist in a specially heated warm water pool. The exercises are tailored to you and your specific needs. You can do hydrotherapy on your own with the health professional or in a small group.

3. Going solo
You can do your own water exercises in a warm water pool at home or in recreation centres, fitness clubs, swimming schools and retirement villages.

Here are some tips for getting started with your own program:

  • If you’re not sure what exercises to do, talk with a qualified instructor or health professional. We’ve also included links to some general exercises in the More to explore section below.
  • Choose a time when the pool is fairly quiet so you can move safely and confidently around the pool area and you’re less likely to be knocked by enthusiastic swimmers and others enjoying more boisterous water activities.
  • Check the ease and safety of access into the centre, around the dressing area and into the pool.

Swimming is also a good form of water exercise you can do on your own. While it doesn’t work all of your muscles and joints through their range of movement, it’s excellent for your heart and lungs.

What if you can’t swim?

If you can’t swim, that’s ok. Water exercise classes take place in water that’s about chest height. So you can stand with your head above the water. You can also use flotation devices to give you the confidence to get moving in water if you’re feeling a bit apprehensive.

Tips for exercising in warm water

Whether you’re exercising at home or in a community pool, participating in a class or doing your own exercises, you’ll get the most benefit from your exercise session and ensure your safety and wellbeing by following these tips:

  • Don’t go into the water if you’re sick, have any wounds or skin irritations/infections.
  • Check out the venue to see if it’s suitable for you. For example, is the pool easy to access? Are the change rooms accessible and comfortable? Is the venue close enough for you to go to regularly? Do the class times and opening hours of the venue work for you?
  • Begin your exercise program with short sessions and gradually build up over time.
  • Perform each movement as gracefully and smoothly as you can.
  • Keep the body part you’re exercising under the water. This may require you to squat or bob down at times.
  • Come out of the water immediately if you feel light-headed, dizzy, drowsy, extremely fatigued or nauseous. These reactions are possible if you spend too long in very warm water. Drink some water and sit or lie down for a while.
  • Stop doing an exercise which causes severe pain or discomfort. Consult your doctor, physiotherapist or exercise physiologist if your joint symptoms increase significantly after an exercise session.
  • Ease up if you experience mild to moderate joint or muscle pain for more than a few hours after your exercise session. Some increased pain is normal after exercise, especially when you’re starting out, but if you’re in pain hours after your visit to the pool, you’ve likely overdone it. Reduce the intensity next time – but don’t stop.
  • If you’ve had a joint replacement, keep in mind the movements you were instructed to avoid by your surgeon or physiotherapist.
  • Consider wearing water shoes if you find you’re slipping and sliding in the pool. They’ll give you some grip to help you keep your balance.
  • Have a drink after a water exercise session to replace the fluid you’ve lost through perspiration.
  • Take care when moving in wet areas around the pool, including in change rooms, to avoid slipping and falls.
  • Rest afterwards if you feel tired. Exercising in warm water can be quite draining.

And as always, follow COVID-safe practises and abide by any rules that are in force in your state or territory.

So there you have it. Exercising in the water. It’s a great addition to your exercise routine that’s effective, fun and safe. Why not give it a go?

Call our Helpline

If you have questions about things like managing your pain, your musculoskeletal condition, treatment options, 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.

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16/Nov/2023

Or how to manage fatigue

We all get tired. We overdo things and feel physically exhausted. It happens to us all. Usually after a night or two of good quality sleep the tiredness goes away and we’re back to our old selves.

But fatigue is different.

It’s an almost overwhelming physical and/or mental tiredness. And it usually takes more than a night’s sleep to resolve. It generally requires multiple strategies, working together, to help you get it under control.

Many people living with a musculoskeletal condition struggle with fatigue. It may be caused by a chronic lack of sleep, your medications, depression, your actual condition (e.g. rheumatoid arthritis, lupus, fibromyalgia) or just the very fact that you live with persistent pain.

Fatigue can make everyday activities difficult, and can get in the way of you doing the things you enjoy. The good news is there are many things you can do to manage fatigue and get on with life.

Exercise and being active. While this may sound like the last thing you should do when you’re feeling fatigued, exercise can actually boost your energy levels, help you sleep better, improve your mood, and it can help you manage your pain. If you’re starting an exercise program, start slowly, listen to your body and seek advice from qualified professionals. Gradually increase the amount and intensity of activity over time.

Take time out for you. Relaxation – both physical and mental – can help you manage your fatigue. I’m not just talking about finishing work and plonking down in front of the TV – though that may be one way you relax and wind down. I’m specifically referring to the deliberate letting go of the tension in your muscles and mind. There are so many ways to relax including deep breathing, visualisation, gardening, progressive muscle relaxation, listening to music, guided imagery, reading a book, taking a warm bubble bath, meditating, going for a walk. Choose whatever works for you. Now set aside a specific time every day to relax – and choose a time when you’re unlikely to be interrupted or distracted. Put it in your calendar – as you would any other important event – and practise, practise, practise. Surprisingly it takes time to become really good at relaxing, but it’s totally worth the effort. By using relaxation techniques, you can reduce stress and anxiety (which can make you feel fatigued), and feel more energised.

Eat a well-balanced diet. A healthy diet gives your body the energy and nutrients it needs to work properly, helps you maintain a healthy weight, protects you against other health conditions and is vital for a healthy immune system. Make sure you drink enough water, and try and limit the amount of caffeine and alcohol you consume.

And take a note out of the Scout’s handbook and ‘be prepared’. Consider making some healthy meals that you can freeze for the days when you’re not feeling so hot. You’ll then have some healthy options you can quickly plate up to ensure you’re eating well without having to use a lot of energy.

Get a good night’s sleep. Good quality sleep makes such a difference when you live with pain and fatigue. It can sometimes be difficult to achieve, but there are many things you can do to sleep well, that will decrease your fatigue and make you feel human again. Check out our blog on painsomnia for more info and tips.

Pace yourself. It’s an easy trap to fall into. On the days you feel great you do as much as possible – you push on and on and overdo it. Other days you avoid doing stuff because fatigue has sapped away all of your energy. By pacing yourself you can do the things you want to do by finding the right balance between rest and activity. Some tips for pacing yourself: plan your day, prioritise your activities (not everything is super important or has to be done immediately), break your jobs into smaller tasks, alternate physical jobs with less active ones, and ask for help if you need it.

Write lists and create habits. When you’re fatigued, remembering what you need at the shops, where you left your keys, if you’ve taken your meds or what your name is, can be a challenge. And when you’re constantly forgetting stuff, it can make you stress and worry about all the things you can’t remember. Meh – it’s a terrible cycle. So write it down. Write down the things you need at the supermarket as soon as you think of it –a notepad on the fridge is a really easy way to do this. Create habits around your everyday tasks – for example always put your keys in a bowl by the door or straight into your bag, put your meds in a pill organiser.

Be kind to yourself. Managing fatigue and developing new ways to pace yourself is a challenge. Like any new behaviour it takes time, effort and lots of practice. So be kind to yourself and be patient. You’ll get there. It may take some time, and there may be some stumbles along the way, but you will become an expert at listening to your body, pacing yourself and managing fatigue.

Talk with your doctor. Sometimes fatigue may be caused by medications you’re taking to manage your musculoskeletal condition. If you think your medications are the issue, talk with your doctor about alternatives that may be available.

Fatigue may also be caused by another health condition – including anaemia (not having enough healthy red blood cells to carry oxygen around your body), diabetes, high blood pressure, fibromyalgia and being overweight. If you’re not having any success getting your fatigue under control, your doctor may suggest looking into other potential causes.

So that’s fatigue…it can be difficult to live with, but there are lots of ways you can learn to manage it.

Tell us how you manage. We’d love to hear your top tips for dealing with fatigue.

FIRST WRITTEN AND PUBLISHED BY LISA BYWATERS IN OCTOBER  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.

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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?

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@muscha.org) 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


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You know what it’s like. It’s 3.00am and you’ve just woken up. Again. You glance at your clock and do the maths – only 4 hours until it’s time to get up. This is really taking a toll on you – your mood, your performance at work, and your pain levels.

So what can you do?

  1. Avoid using technology in bed. The blue light from laptops, tablets and smartphones suppresses the hormone melatonin, which makes us sleepy at night. So be sure to stop screen use at least one hour before bed.
  2. 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.
  3. 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.
  4. 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.
  5. 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. Consider trying mindfulness, visualisation, deep breathing or a warm bath before bed. These techniques will help you become more relaxed and may help you manage your pain better so that when you go to sleep, you sleep well.
  6. 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.
  7. Seek 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.

And check out our A-Z guide to managing pain. It’s full of tips and strategies to help you manage your pain.

First written and published by Lisa Bywaters in June 2018

 


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24/Oct/2023

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


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04/Oct/2023

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 painmusculoskeletal 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.


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04/Oct/2023

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 painmusculoskeletal 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.


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