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    disco.jpg
    Lisa Bywaters
    22/Feb/2023
    Health InformationMSK articles

    Let’s dance!

    Note: I’ve been listening to great music while writing this article. I’ve embedded some links so you can share the love 💛.

    Bored with your usual exercise program? Why not follow David Bowie’s advice and “put on your red shoes and dance the blues”?

    Dancing is a fun, expressive and social form of exercise. It’s also a great way to meet new people.

    There are many dance styles to try – from salsa to hip hop, ballroom or belly dancing. Or you can shake your tail feather around the house when a great song comes on the radio.

    Why you should be dancing

    If you’re like me, the idea of dancing, especially in public, is terrifying. I’m uncoordinated, clumsy and have never felt comfortable or natural moving to music. My partner is changing that, one ‘box step’ at a time. Not the unco, clumsy part – he’s not a miracle worker 😂. But becoming more comfortable just dancing. You see, he’ll literally dance at the drop of a hat. At home, in his coffee shop, in the supermarket. It makes him happy.

    And when he’s happy, I want to join in on that happiness.

    So that’s a key reason to dance – happiness 😊.

    It’s also a very social activity. Joining a dance class or going to clubs is an opportunity for you and your friends to have a fun, physical outing. And you may make new friends. What’s not to love about that? 💜

    Gonna make you sweat (Everybody dance now): Dancing is exercise

    The Australian physical activity guidelines recommend that adults be active most days of the week, preferably every day.

    That means that each week, adults should do either:

    • 2.5 to 5 hours of moderate intensity physical activity – e.g. a brisk walk, golf, mowing the lawn or swimming. Moderate intensity means you can talk comfortably but not sing.
    • 1.25 to 2.5 hours of vigorous intensity physical activity – e.g. jogging, aerobics, fast cycling, soccer or netball. Vigorous intensity means you can only say a few words without gasping for breath.
    • an equivalent combination of moderate and vigorous activities. (1)

    So dancing – at a moderate or vigorous intensity – is a fun and creative way to contribute to your weekly dose of exercise.

    Everybody dance: Other health benefits

    Chic put it so well in their song, “Dancing helps relieve the pain, soothes your mind, makes you happy again. Listen to those dancing feet. Close your eyes and let go.“ But don’t just take the word of those disco legends… dancing:

    • improves the health of your heart and lungs
    • improves circulation of blood and synovial fluid through joints
    • relieves pain and stiffness
    • reduces fatigue
    • helps you sleep better
    • improves strength, endurance and stamina
    • improves balance, coordination and flexibility
    • helps keep bones strong and prevent falls
    • lowers stress levels and improves your mood
    • helps you maintain a healthy body weight or lose weight when combined with a weight-loss eating plan
    • builds self-confidence
    • improves brain health and cognitive functions
    • nurtures your creative side and allows you to express yourself
    • improves overall health and fitness.

    Dance, dance: Getting started

    OK, if I’ve sold you on dancing, it’s time to get started. And a good way to do that is to think about the different dancing styles and ask yourself…

    • What style appeals to me?
    • What do I want to get out of dancing? For example, do I want to:
      • meet new people?
      • get fit?
      • improve my balance and coordination?
      • get involved in competitions?
    • Do I want to dance on my own or with a partner?

    Thinking about these things can help you choose the style that best meets your needs.

    You also need to be conscious of the physical demands of the dance style. For example, if there’s a lot of jumping or moves that put significant pressure on joints, it may not be suitable if you have arthritis in your hips, knees or feet. That being said, there are so many styles to choose from, including:

    Once you’ve picked a style, as you would before starting any new exercise program, you need to consider your fitness level and other health issues. If it’s been a while since you’ve been active, talk with your doctor before you start.

    Flashdance: What to wear?

    Your clothing needs to be comfortable and allow you to move freely. But you don’t want any trailing sleeves and long skirts. They’ll be a trip hazard. So leave your inner Stevie Nicks at home, at least until you’re a more proficient dancer 😁.

    As far as shoes go, some dance styles, like tap, require special shoes. But for the most part, when starting out, you can generally wear shoes you already have. Just make sure they’re flexible, comfortable and provide good support. And it’s best to start in low shoes that allow you to move smoothly and safely across the floor.

    Other tips for a safe(ty) dance

    Dancing is exercise, so start slowly and learn good technique. You should also:

    • Consider getting family or friends involved. It’s fun to explore new experiences, like dance classes or groups with others, especially if you’re a little nervous or find it difficult to get motivated on your own.
    • Warm up before you start. Don’t just ‘lose yourself to dance’. Give your body time to loosen up and get ready for some exertion.
    • Drink enough water and stay hydrated – before, during and after dancing.
    • Take breaks, and rest when you need to. It’s easy to get caught up and overdo it, especially when you’re having a good time. So listen to your body and take regular breaks.
    • If you feel unusual pain, stop that move or dance sequence, and get advice from your dance instructor, physiotherapist or exercise physiologist. You may be overextending a joint or moving in a way that’s not great for your musculoskeletal condition. So safety first.
    • Cool down when you finish.
    • Have a wonderful time!

    Dance hall days: Finding a place to dance

    • Start at home if you’re nervous about going public with your dance moves. Put some music on, and go for it. Make sure you have plenty of space and there are no slip or trip hazards (e.g. rugs, pets). Other safety issues such as talking with your doc, wearing appropriate clothing and footwear, warming up, cooling down and hydrating still apply.
    • Check out some online groups and classes. There’s so much available online. This has been a positive of the pandemic – an enormous growth in good online resources. You’re sure to find something that suits you. If you’re looking for inspiration, YouTube and TikTok have some great dance content. Just watch them carefully and evaluate them as you would any other online health content. Our article Online exercise – look before you leap provides a list of things to consider before starting any online exercise (including dance).
    • Visit websites of local community houses and clubs as they often provide dance classes as part of their exercise offerings.
    • Dance schools and studios often provide more formal dance training. This may be of particular interest if you want to perfect your dance technique, enter competitions or learn a style unavailable in your local community.
    • Hit a club or pub. And if you’re groaning about a late night (which I do regularly), many venues have afternoon music and dance sessions or dinner dances. You just have to keep an eye on local venues.
    • No Lights, No Lycra. This a place for people to come and dance freely in a friendly, non-threatening, drug and alcohol-free atmosphere. It happens in a dimly lit room with the lights low so people can truly dance without worrying about what they look like. No Lights, No Lycra events happen all over the world. You can find your closest venue here.

    Contact our free national Help Line

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

    More to explore

    More dance tunes to get you in the mood!

    These songs will have you cutting the sleeves off your jumpers to make leg warmers (à la Flashdance) in no time 😅.

    Reference

    1. Australian Government, Department of Health and Aged Care. Physical activity guidelines: For adults (18-64 years) 
    CONTINUE READING
    lupus.jpg
    Lisa Bywaters
    22/Feb/2023
    Health InformationMSK articles

    Sometimes it’s lupus

    Do you remember the TV show House? Hugh Laurie played the brilliant but grumpy, antisocial doctor addicted to pain meds who secretly has a heart of gold. Yep, it had all the tropes 😂.

    The show created a lupus meme – where a diagnosis of lupus was often mentioned on the show to which House’s reply would always be, ‘it’s not lupus’. And most of the time, he was right.

    The meme highlights the fact that lupus is rare, complex, and difficult to diagnose.

    And sometimes, it is lupus (as was the case in an episode in season 4).

    So what is lupus?

    Lupus (systemic lupus erythematosus) is a chronic condition that can cause inflammation and pain in any part of your body. Symptoms vary from person to person and can range from mild to severe.

    Anyone can get lupus; however, women are more likely to develop it than men. It’s usually diagnosed in people aged between 15-45.

    Certain ethnic groups are also more likely to develop lupus, such as Indigenous Australians, Africans, Hispanics, Asians and Native Americans.

    Causes

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

    Your immune system is designed to identify foreign bodies (e.g. bacteria, viruses) and attack them to keep you healthy. But in the case of lupus, your immune system mistakenly targets healthy tissue.

    This causes pain and inflammation in parts of the body such as the skin, joints, and internal organs (e.g. kidneys, heart and lungs).

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

    Symptoms

    Symptoms can vary greatly between people and may include:

    • skin rashes
    • joint and muscle pain
    • sensitivity to light
    • hair loss
    • fatigue
    • fever
    • mouth ulcers
    • weight changes
    • organ involvement (e.g. kidneys, heart, lungs)
    • pale, blue, or red fingers or toes triggered by cold or stress (Raynaud’s phenomenon)

    It’s unlikely that one person will experience all of these symptoms. At times the symptoms you experience as a result of your lupus (e.g. rash, pain, fatigue) will become more intense. This is a flare.

    Flares are unpredictable and can seem to come out of nowhere. They’re often triggered by stress or exposure to ultraviolet light.

    Diagnosis

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

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

    • Your medical history. Your doctor will ask about your symptoms, family history and other health issues.
    • A physical examination – including your joints and skin to look for any signs of change, inflammation and rashes.
    • Blood and urine tests.
    • Tissue biopsies of the skin or kidneys.

    Test results also help rule out other conditions that may have similar symptoms.

    Your GP should refer you to a rheumatologist if they think you have lupus. Rheumatologists are doctors who specialise in diagnosing and treating problems with joints, muscles, bones and the immune system.

    Treatments

    While there’s no cure for lupus, treatments are available to help control disease activity and improve symptoms. They include medicines and self-care.

    Medicines

    Medicine can help manage your symptoms and assist in controlling your immune system.

    Because people with lupus experience different symptoms, and to varying degrees, there’s no ‘one size fits all’ treatment. You might need to take a combination of medicines.

    • Hydroxychloroquine is very effective at reducing inflammation and reducing flares. It’s the first-line medicine for most people with lupus.
    • Non-steroidal anti-inflammatory drugs or NSAIDs may temporarily relieve pain and inflammation. NSAIDS should be avoided by people with kidney disease.
    • Corticosteroids (or steroids) are used to quickly control or reduce inflammation. They come in different forms: tablets, injections, or a cream to apply to skin rashes.
    • Disease-modifying drugs may be needed to suppress your immune system and control symptoms if you don’t respond to hydroxychloroquine and/or steroids.
    • Biological disease-modifying medicines (biologics and biosimilars) also suppress the immune system. They may be used in more severe cases of lupus that aren’t responding to treatment. These medicines target the specific cells and proteins that cause inflammation and tissue damage rather than suppressing your entire immune system.

    All medicines can have side effects. It’s important you discuss these with your doctor and know what to do if you experience any. Your doctor will also monitor your response to the medicines closely. You may need regular blood tests depending on the medicines you’re taking.

    You should also inform your doctor of any other medicines or complementary therapies you take. They can potentially affect your lupus medicines.

    Self-care

    There are many things you can do to manage your lupus.

    • Learn about your condition. Understanding lupus allows you to make informed decisions about your healthcare and actively manage it.
    • Manage your exposure to ultraviolet (UV) light. UV light, especially sunlight, can cause a flare. This can include skin rashes in sun-exposed areas. Remember to wear 50+ UVA and B sunscreen every day (even if it’s cloudy). You should also cover your skin and wear a hat and sunglasses outdoors. Less commonly, UV light from fluorescent lights, including low-energy light bulbs, may cause rashes in some people with lupus.
    • Stay active. Regular physical activity has many health benefits, including helping you to manage your symptoms. When you start exercising regularly, you should notice an improvement in the quality of your sleep, an increase in energy levels, a reduction in fatigue, and improvements in your overall strength and fitness. Exercise can also help prevent long-term consequences of lupus, such as heart disease and osteoporosis.
    • Learn ways to manage your pain. Pain is one of the most common symptoms of lupus, so it’s crucial to learn ways to manage it effectively. Read our A-Z guide for managing pain for more information.
    • Manage stress. Stress can aggravate your symptoms, so learning to deal with stress is very helpful. Things you can do to manage stress include planning your day and setting priorities, using relaxation techniques, getting a massage or listening to music. And, where possible, avoiding people and situations that cause you stress.
    • Quit smoking. Smoking cigarettes can worsen your lupus symptoms and reduce the effectiveness of particular lupus medicines. It can also affect your bone health and increase inflammation.
    • Ask your GP about your vitamin D, calcium and cholesterol levels. Lupus can affect them all, and you may need to take supplements or medicines to correct any problems.
    • Sleep well. Not getting enough quality sleep can worsen your symptoms; however, getting a good night’s sleep when you have chronic pain can be difficult. If you’re having problems sleeping, talk with your doctor about ways you can address this.
    • Eat a healthy, balanced diet. While there’s no specific diet for lupus, it’s important to have a healthy, balanced diet to maintain general good health and prevent other health problems, such as diabetes and heart disease. Lupus can also cause weight loss or gain depending on how it affects your body and the medicines you take. A healthy balanced diet may help prevent this. Talk with your doctor if you’re concerned about your diet or weight.
    • Pace yourself. Pacing is an effective strategy to help you do the things you want to do by finding the right balance between rest and activity (both physical and mental). This will help reduce your risk of flares and fatigue.
    • Get support from others. Research has shown that people with positive social support cope better with pain. Family, friends, colleagues, and health professionals can help you manage. A peer support group may be another option.

    Pregnancy

    Most women with lupus can have children. However, there’s an increased risk of complications such as premature labour, high blood pressure, blood clots and miscarriage.

    For these reasons, it’s essential that you plan your pregnancy carefully.

    The healthier you are before you get pregnant, the greater the chance you’ll have a healthy pregnancy and baby. Aim to have your condition under control and be in the best possible health.

    Talk with your doctor and specialist before you get pregnant. They may need to change your medicines to ensure a safe pregnancy.

    Complications

    Lupus is an unpredictable condition that can affect any part of your body, including your internal organs. Working closely with your healthcare team, following your treatment plan, and staying informed about lupus is the best thing you can do to reduce your risk of complications.

    Contact our free national Help Line

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

    More to explore

    CONTINUE READING
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    Lisa Bywaters
    21/Feb/2023
    Health InformationMSK Kids Blogs

    Choosing the right footwear

    To manage foot and lower limb pain in children

    Guest blog written by podiatrist Daniel van Hoof-Harkin, B. Pod (Hons)

    When a child starts to complain of pain in their legs or feet for whatever reason – after activity, ‘growing pains’ at night, or joint inflammation caused by a condition like juvenile arthritis (JIA) – often the first thing I’ll look at is their footwear. Specifically, what footwear they wear and when and how they wear them. I’ll then spend time discussing and trying to recommend footwear. That’s because good shoes can be a first-line treatment in relieving pain.

    To help you choose the best footwear for your child, here are my suggestions for things to look for.

    Getting the right support

    To a large extent, you get what you pay for with shoes. Cheaper shoes are usually made with lower quality materials and have less support than more expensive footwear. This is why quality shoes can cost significantly more.

    When I look at a pair of shoes for someone in pain, I’m looking primarily at four things:

    • Heel pitch – Also known as drop or offset, it is the difference in height between the heel and forefoot within the shoe. Ideally, shoes should have approximately 10mm, as this helps to reduce the effects of reduced ankle range of motion, or for high arched people whose forefoot sits lower than their heel.
    • Torsional rigid shank – This is the stiffness of a shoe between the heel and the forefoot and helps to stabilise mobile feet, especially on graded surfaces.
    • Heel counter – This is usually a piece of plastic that wraps around the heel in shoes and helps to reduce inversion and eversion of the rearfoot during lower impact activities.
    • Upper fixation – This will normally be achieved with either Velcro or laces, but also aided by the upper of a shoe.

    Most brand-name sneakers will have all of these qualities, which will help support the feet and legs of children, whether they’re walking or running. However, if a shoe lacks any of these qualities, it’ll provide less support for your child’s feet.

    For example, Mary Jane style school shoes don’t have as much upper, and only a single strap to secure them. That means they’ll offer less support than a pair of laced shoes.

    Mary Jane school shoesLaced school shoes

    Orthotics – Yes or no?

    Orthotics can often be a controversial subject, but just like any form of therapy, if used correctly, they can make a big difference for a child with leg or foot pain. And there’s evidence that they have a place in managing JIA and hypermobility-related disorders.

    But when should they be considered? Sometimes I’ll recommend foot orthotics immediately, and other times I’ll let people know they’re unlikely to help their symptoms. As a general rule of thumb, if your child has good quality footwear and wears them appropriately, but they’re still experiencing ongoing pain, they may require some form of in-shoe support. In this case, visiting a podiatrist for an assessment would be worthwhile.

    School shoes vs trainers

    A good quality trainer is usually a more comfortable and better option for most active kids. This is because trainers have thicker midsoles that provide a good balance between structure and cushioning, especially when kids play on hard graded surfaces like concrete. School shoes are usually more of a dress shoe, which means they have less cushioning and generally don’t tolerate as much punishment as trainers.
    At the end of the day, school shoes are often determined by the uniform requirements of the school, and if dress shoes are required, then fit and comfort when wearing need to be the most important factors.

    Alleviating foot pain

    When recommending shoes to parents, I’ll often ask how active their child is. I’ll then ask, ‘if you were going to be doing the same things as your child, which shoes would you choose to wear?’ Imagining yourself in your child’s place means you’ll have a better understanding of what’s most appropriate.

    The other aspect we don’t often realise is how hard graded surfaces can be on our feet and ankles. If your child is susceptible to experiencing pain, then I’d recommend they wear structured sneakers more often. It’s also important they wear them on outings to places like shopping centres, theme parks, or on days with lots of walking. Less structured footwear like thongs, or ballet flats, should only be used for short outings, where there won’t be much walking involved.

    Leg length discrepancy and heel lifts

    Differences in the length of legs, or leg length discrepancies, happen more frequently than we think. It’s been reported between 40-70% of the population have a difference in leg length, and one in every 1000 people can have a difference of greater than 20mm.

    Leg length discrepancies can be difficult to assess clinically and almost impossible to measure accurately without performing scans to assess bone lengths and joint alignment. Also, kids can often grow asymmetrically, meaning one leg may grow faster than another. However, I often see these leg length differences have disappeared 6 months later.

    So I’m usually not too concerned when I come across a leg length discrepancy unless the child has pain I believe is being influenced by it or the leg length difference is such that I see significant postural problems occurring. Once again, if there’s concern about the presence of a leg length discrepancy, it’s worth having it assessed by a health professional, and whether it is indicated to include a heel lift under the shorter leg.

    Finding the right fit

    Ultimately, the most important thing when it comes to footwear for any child is fit. Given how quickly children can grow, keeping up with their shoe size can become a frequent and sometimes costly exercise. However, it’s vital for growing feet.

    Making sure that shoes aren’t too small is essential, as small footwear can cause pain, injury, and difficulty with movement. When checking shoe fit, try and establish their size when they’re standing. This is because feet may become longer when standing, changing the shoe size compared to sitting. It’s also important that the footwear isn’t too big, as this can cause increased movement within the footwear that can affect stability. If shoes are too long, they can also pose a trip hazard to a child.

    This advice is, of course, very general, and individual needs will vary. But as a starting point for parents of children with lower limb pain, this advice can be a useful for reducing symptoms.

    Contact our free national Help Line

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

    CONTINUE READING
    stem-cell.jpg
    Lisa Bywaters
    25/Jan/2023
    Health InformationMSK articles

    Stem cell treatments and osteoarthritis

    In October 2022, the Albanese Government announced that they would invest almost $7 million in stem cell research. The ARISTOCRAT project, led by MSKs Director Emeritus, and orthopaedic surgeon Professor Peter Choong, will allow researchers to develop new therapies to improve the lives of people with conditions like osteoarthritis.

    So what does this mean? What are stem cells? And, will they be the miracle treatment we’ve been waiting for?

    Let’s take a look.

    But first, what’s osteoarthritis?

    Osteoarthritis, or OA, is the most common form of arthritis. It most frequently affects the joints in the knees, hips, feet, spine and hands.

    OA was once thought to be a natural part of ageing or a lifetime of ‘wear and tear’ on joints. But we now know it’s much more complex than that and may occur due to many factors.

    With OA, the cartilage that lines the ends of bones in a joint, enabling them to move smoothly over each other, becomes brittle and breaks down. Because the cartilage no longer has a smooth surface, the joint becomes stiff and painful. Eventually, the cartilage can break down so much that it no longer cushions the two bones.

    There are currently no treatments, including medicines, that can affect the underlying disease process of OA. Instead, symptoms (e.g. pain and stiffness) are managed using exercise, weight management and medicines that provide temporary relief.

    The lack of targeted treatments to prevent OA from worsening or reversing the damage it causes makes the promise of new and innovative treatments, such as stem cells, very exciting.

    So what are stem cells?

    Cells are the basic building blocks of all living things. They provide structure for the body, take in nutrients from food, convert those nutrients into energy, and carry out specialised functions. Cells also contain the body’s hereditary material and can make copies of themselves. We have many different types of cells, such as nerve, bone, fat, blood, and stem cells.

    Stem cells differ from other cells in the body in three ways:

    1.  they can divide and renew themselves over a long time
    2.  they’re unspecialised, so they can’t do specific functions in the body
    3.  they can become specialised cells, such as muscle cells, blood cells, and brain cells.

    There are many types of stem cells. However, the type of stem cell most often promoted as a treatment for osteoarthritis is the mesenchymal stem cell or stromal cell. They’re generally referred to as MSCs (because no one can say mesenchymal 😉). These cells can be obtained from many parts of the body, including bone marrow and fat.

    MSCs can become bone cells (osteoblasts), cartilage cells (chondrocytes), muscle cells (myocytes), or fat cells (adipocytes). They can also release substances that may alter how the immune system responds to injury and encourage other cells to grow.

    This has led scientists and doctors to explore whether MSCs can restore function to damaged joints and tendons.

    EuroStemCell has an interesting article that explains MSCs – what they are, what researchers are investigating when it comes to MSCs, and the challenges they face.

    More research is needed

    For most conditions, stem cell treatments are still considered experimental. They have yet to prove safe or effective in clinical trials for osteoarthritis.

    While there’s a lot of excitement about the future, we need more research to understand how to best obtain, handle and administer stem cells or the cells made from them.

    We need to know some of these answers to ensure that new stem cell treatments don’t cause more harm than good.

    We also need more information about potential side effects and the long-term safety of stem cell treatments.

    Be wary

    Unfortunately, despite the lack of reliable evidence that stem cell treatments work and are safe to use, they’re actively promoted for osteoarthritis and many other health conditions by clinics in Australia and overseas.

    Some clinics use cells obtained from the person on the same day they’re collected, while others may grow the person’s or donor cells in the lab over several weeks before returning them to the person. It’s important to know that even when the cells are taken from a person and returned to the same person, there’s still risk involved. Even though they’re your own cells, the fact that they’ve been removed means there’s the risk that they may have become contaminated.

    Most clinics charge substantial fees (thousands of dollars). They encourage multiple treatments and may imply they’re doing research but aren’t usually part of a registered clinical trial. They also often use celebrity patients’ testimonials or endorsements to support their claims of success.

    That’s why participating in a clinical trial is currently the safest way to access stem cell treatments. Researchers must follow strict rules to ensure that participants are safe. Each clinical trial also follows a careful study plan or protocol that describes what the researchers will do.

    Before joining a clinical trial, you’ll be told what to expect as a participant and all the things that might happen. For example, someone from the research team will explain possible side effects or other risks of the treatment. You’ll also have a chance to ask questions about the trial. In most cases, you won’t be required to pay any costs involved in participating in a clinical trial. There may be out-of-pocket expenses, such as travel, which may be reimbursed to you.

    Ask questions

    If you’re considering trying a stem cell treatment, you need to be well-informed – so ask lots of questions. For example:

    • Is this treatment part of a registered clinical trial listed on the Australian New Zealand Clinical Trial Registry (ANZCTR), ClinicalTrials.gov, or elsewhere?
    • Was ethics review and approval obtained, and by whom?
      Note – All clinical research projects in Australia must be approved by a Human Research Ethics Committee (HREC), which checks that the research conforms to the National Statement on Ethical Conduct in Human Research requirements.
    • Does the doctor, or any of the researchers involved, have any conflicts of interest, including financial?
    • What are the total costs of the treatment, and how much will I be expected to pay? Remember, if you’re taking part in a clinical trial, no costs should be involved.
    • Will you use my own cells, or are they from a donor or other source?
    • How does this treatment compare to other treatments?
    • Is there any scientific evidence (not testimonials or anecdotes) that the treatment improves my health condition?
    • What are the potential side effects or risks involved?
    • How many treatments are required?
    • How long do you monitor the effects of my treatment?

    Stem cell treatments are still considered experimental for osteoarthritis, so don’t be embarrassed to ask lots of questions. Learn as much as possible about the treatment and how it might affect you. You should also have a chat with doctor or specialist about your intentions and get their input.

    Stem cells and cell therapy are an exciting new frontier in medicine, but it’s still early days. So watch this space.

    And watch our video, Stem cells and muscle, bone and joint health: Hope, hype and reality, presented by Professor Megan Munsie, Deputy Director – Centre for Stem Cell Systems, The University of Melbourne; Head – Education, Ethics, Law & Community Awareness Unit, Stem Cells Australia.

    Contact our free national Help Line

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

    More to explore

    Peak bodies
    Research registries
    CONTINUE READING
    bacteria-in-kitchen.jpg
    Lisa Bywaters
    25/Jan/2023
    Health InformationMSK articles

    Reactive arthritis

    Did you know that there’s a link between certain bacteria and a type of arthritis? It’s strange but true. Find out how a case of food poisoning, or a sexually transmitted infection, can sometimes cause arthritis.

    Reactive arthritis (ReA) is a relatively uncommon form of arthritis that occurs as a ‘reaction’ to a bacterial infection in another part of your body.

    Usually, when you have an infection, your immune system fights the foreign body (e.g. the bacteria) and then settles down. However, with reactive arthritis, the immune system stays active after the infection has cleared and targets healthy parts of the body, causing pain and inflammation.

    Although it’s caused by bacteria, it’s not contagious. However, the bacteria can be passed on to others through sexual activity or contaminated food.

    The types of bacteria that cause reactive arthritis are:

    • salmonella, shigella, yersinia or campylobacter bacteria – they cause food poisoning and bowel infections
    • chlamydia bacteria causes genital infections (though some people may not have any symptoms) and is spread through sexual contact.

    Most people who become infected with these bacteria won’t develop reactive arthritis. So the big question is why some people develop arthritis and others don’t 🤔.

    Researchers believe that your genes may play a role. You’re more likely to develop reactive arthritis If you have the gene HLA-B27. However, lots of people have this gene and never develop reactive arthritis.

    Reactive arthritis can occur at any age, but it tends to affect people aged between 20 and 50.

    The good news is that for the majority of people, their condition disappears within 6 months. However, some people experience symptoms for a longer period.

    Symptoms

    The symptoms of reactive arthritis develop some weeks after the infection and may include:

    • pain, swelling or stiffness in a joint (arthritis), most commonly the knees, feet and ankles
    • pain in the lower back and buttocks
    • pain and inflammation of tendons, such as the Achilles tendon at the back of your heel
    • pain and redness in your eyes – some people may develop conjunctivitis (inflammation of the outer layer of the eye) or uveitis (inflammation of the middle layer of the eye)
    • extreme tiredness, or fatigue
    • rash on the palms of your hands or soles of your feet
    • mouth ulcers
    • diarrhoea.

    The good news is most people won’t experience all of these symptoms.

    Diagnosing ReA

    There’s no specific test for diagnosing reactive arthritis, so your doctor will use a combination of tests to confirm your diagnosis. They may include:

    • discussing your medical history – e.g. your current symptoms, as well as any recent illness, infections or other health problems
    • a physical examination of your joints, spine, eyes and skin to check for inflammation and other changes (e.g. changes to joint movement, rashes)
    • lab tests – e.g. blood, urine or stool (poo) samples may be taken to check for the presence of infection, look for signs of inflammation and to rule out other conditions
    • swabs of your throat, penis or vagina to check for signs of infection
    • x-rays – may be used to look for signs of arthritis
    • arthrocentesis – a sample of fluid is taken from your joint and tested in a lab (this is done to rule out conditions such as gout that may cause similar symptoms).

    Treating ReA

    Treatment aims to manage the symptoms until you get better and may include:

    • Antibiotics to treat the infection. Antibiotics don’t treat the symptoms of reactive arthritis, just the bacterial infection. If you developed reactive arthritis due to a sexually transmitted infection, your sexual partner/s will also need antibiotics.
    • Non-steroidal anti-inflammatory drugs (NSAIDs) are the main medicine used to treat reactive arthritis because they quickly reduce joint inflammation and pain. But they do have the risk of side effects, so you’ll be given the lowest effective dose for as short a time as possible to reduce this risk.
    • Corticosteroids may be necessary if you have severe joint pain and inflammation. They can be taken as tablets or injected directly into a joint, muscle or other soft tissue.
    • Disease-modifying anti-rheumatic drugs (DMARDs) may be given if your condition doesn’t respond well to other treatments. DMARDs suppress your overactive immune system. They help relieve pain and inflammation and reduce or prevent joint damage. It can take several weeks to months before you begin to notice any effect, so you may also need to take other medicines to help control pain and inflammation until then.
    • Eye drops to treat conjunctivitis or steroid eye drops to treat uveitis.
    • Physiotherapy can help keep affected joints mobile and strengthen the surrounding ligaments, tendons and muscles.

    Uveitis requires specialist treatment. If you develop uveitis, your doctor may refer you to an ophthalmologist, a specialist who deals with eye diseases.

    Your doctor may also refer you to a rheumatologist, a specialist who treats problems with joints, muscles, bones and the immune system.

    Self-care

    As well as following the treatment plan your healthcare team has given you, there are many things you can do to manage your reactive arthritis.

    Become more informed about your condition. Understanding reactive arthritis allows you to make informed decisions about your healthcare and actively manage it.

    Stay physically active. We know that regular physical activity has many health benefits. But it can also help you manage the symptoms of your condition. When you start exercising regularly, you should notice an improvement in your pain levels, the quality of your sleep and an increase in energy levels. However, when your joints are very swollen or painful, avoid strenuous activity or straining the joint. Gentle exercise or movement is best and will help prevent the joint from becoming stiff.

    Pace yourself. Pacing is an effective strategy to help you do the things you want to do by finding the right balance between rest and activity (both physical and mental). This will help reduce your risk of flares and fatigue.

    Eat a healthy, balanced diet to improve your energy levels, help maintain your weight, and give you a greater sense of wellbeing. And ensure you handle and store your food safely to avoid any contamination.

    Learn ways to manage your pain. Pain is a common symptom of reactive arthritis, so it’s important you learn ways to manage it effectively. Read our A-Z guide for managing pain for more information.

    Practise good hygiene and safe sex.

    Preventing ReA

    You can reduce your risk of getting reactive arthritis by avoiding sexually transmitted infections and food-borne bacteria. So:

    • Wear a condom during sex with new partners.
    • Wash your hands regularly or use hand sanitiser if you don’t have access to water and soap (we’re experts at this now!) 😉
    • Make sure your food is prepared and stored correctly.

    Contact our free national Help Line

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

    More to explore

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    driver.jpg
    Lisa Bywaters
    25/Jan/2023
    Health InformationMSK articles

    Taking the stress out of getting to medical appointments

    Travelling into the city for medical appointments – either from the ‘burbs or a more rural or regional area – can often be stressful, time-consuming, costly and difficult. Planning your journey, becoming familiar with different types of transport, and potential forms of assistance can make it easier.

    We’ve got some info, tips and tricks to help you get to your appointments safely and calmly – no matter what transport you use.

    I’m travelling by car…

    If you’re travelling to your appointment by car – either as the driver or passenger – it’s important to plan and be prepared.

    Get comfortable in the car
    If you’re the driver, make sure you can reach and operate all of the controls, pedals, steering wheel etc. comfortably, and you have good visibility through your windows and mirrors. Whether you’re the driver or passenger, remember to pack your supports (e.g. lumbar cushion), water, and any other necessities you need for a road trip.

    Take breaks
    Avoid driving for more than an hour without a break. Stop, get out of your car, and stretch or massage tight muscles. Build these breaks into your overall trip time so that you have plenty of time to get from point A to point B safely and comfortably.

    Know your route
    Have a map or set your GPS to your destination. It’s easy to get confused or take a wrong turn if you’re anxious or worried about an appointment.

    Be prepared for public works and road closures
    Nothing can disrupt your trip and add to your stress like road works, especially when you weren’t expecting them 😤.

    Allow extra time in your journey so that you don’t feel rushed or stressed if you encounter any public works and have to change your route. If you don’t experience any delays, you can use the extra time before your appointment to grab a coffee, read a book or just relax.

    You also need to be mindful of damage to our road networks caused by storms and floods. Before you head out, check the traffic websites in your state/territory for information about roadworks, road closures and other traffic alerts.

    Tolls
    Be aware of any tollways you may need to go on. If you have an electronic tag, the toll will automatically be added to your account. If you don’t have a tag, you’ll need to purchase a pass before you set out on your journey or pay soon after you use the tollway.

    Parking
    Is there parking at the medical centre or hospital you’re going to? If you’re not sure, call them before you leave. If there’s parking available, is it free or do you have to pay a fee to use it? And if so, do you need coins, or can you pay with your debit/credit card?

    I’m travelling by public transport…

    When travelling by public transport, many factors, like cancellations and delays, are out of your control. So being proactive and prepared will give you some control over your trip.

    Plan your trip
    Your state/territory government website has tools to help you find the best way to get from point A to point B (and back).

    Simply enter the place you’re departing from (e.g. Wodonga) and where you’re going to (e.g. Royal Melbourne Hospital). You then choose the time you want to depart or arrive by and your journey date. You’ll be given several journey options to choose from. It’s a good idea to plan to arrive much earlier than your appointment so that if something does go wrong (a cancelled train or you get a little lost 😐), you have time up your sleeve. You won’t be rushing or worrying about running late.

    Mobility aids
    The experience of travelling with mobility aids will vary between trains, trams, cabs, ferries, buses and coaches, as each form of transport is different. It will also depend on the mobility aid – scooter, wheelchair, walker, crutches etc. – as they can vary significantly in size and space required to safely transport them. Before you set out on your journey, contact the relevant operator and let them know you’re travelling with a mobility aid. This gives you a chance to provide them with the details of your mobility aid and ask any questions.

    I need help to get to my appointment…

    Sometimes travelling by car or public transport isn’t an option, or you may need extra help.

    Community transport
    Community transport services are run by not-for-profit organisations and some local councils. The service is often operated by volunteers who take people to medical appointments, shopping centres and social outings if they can’t use other transport. Eligibility requirements and costs vary from place to place and with different operators. Search online for ‘community transport’ or contact your local council to find out about options in your area.

    Subsidised taxi fares
    All states and territories have subsidised taxi schemes for people with disability and health issues. They all vary in the concessions offered and eligibility criteria. Contact your relevant government department to determine if you’re eligible to participate in this scheme.

    Patient transport assistance schemes
    If you need financial support with travel and/or accommodation to receive your medical treatment or care because the services are unavailable locally, patient travel assistance schemes may be an option. These services are generally available for people who travel large distances or interstate to access necessary health care. Again, they vary in the support provided and eligibility criteria.

    Red Cross Patient Transport Service
    If public transport isn’t an option for you, the Red Cross operates a transport service for medical appointments. Cars are driven by volunteers, not medical staff, so you may need a carer if you’re unwell.

    Angel Flight Australia
    This volunteer-run charity operates non-emergency flights to help rural and remote Australians get to medical appointments in other parts of the country. All flights are free, and people are transported to medical facilities across Australia. Find out more.

    Contact our free national Help Line

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

    More to explore

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    bursitis.jpg
    Lisa Bywaters
    07/Dec/2022
    Health InformationMSK articles

    What’s the deal with bursitis?

    If you’ve ever had bursitis, you know how painful it can be. I had the displeasure of experiencing it several years ago when I slipped in the bathroom and fell heavily. Unfortunately, my shoulder took the full brunt of the fall 😫. I honestly thought I’d broken a bone; it was so painful! But after seeing my doctor, it turns out I had bursitis. And so began several weeks of ice packs, rest and gentle exercise. The good news is that my shoulder recovered completely. But I realised that although I’d heard of bursitis, I didn’t know what this common, painful condition was.

    So let’s look at bursitis – what it is, what causes it (apart from falls 😉) and what are the treatment options.

    What is bursitis?

    Simply put, bursitis is the inflammation of a bursa. A bursa (plural bursae) is a small fluid-filled sac that cushions your bones and soft tissues (muscles, tendons and skin) in and around your joint.

    They reduce friction between moving parts (e.g. between a bone and a tendon), enabling them to move smoothly over each other.

    When a bursa becomes irritated or inflamed, it fills up with excess fluid. This causes pain and restricts movement.

    What causes bursitis?

    Bursitis can develop quickly (acute bursitis) or more slowly (chronic bursitis). Common causes include:

    • injury, e.g. having a fall and landing hard on your shoulder or hip
    • overusing a joint, especially if the movements are repetitive, e.g. typing, playing tennis
    • prolonged pressure, e.g. kneeling for long periods while laying carpet or scrubbing floors
    • joint stress, e.g. from being overweight or having an uneven walk (gait)
    • other health conditions, e.g. rheumatoid arthritis, gout, diabetes
    • infection, e.g. if a joint is injured and bacteria enter the bursa.

    What are the symptoms of bursitis?

    The signs and symptoms of bursitis include:

    • pain, especially when moving the joint
    • joint stiffness and swelling
    • restricted movement of the joint
    • warmth and reddening of the skin in the affected area.

    The joints most commonly affected are the shoulder, elbow, hip, knee and heel.

    How is it diagnosed?

    If you have a painful, swollen joint or you’re finding it difficult to move a joint, it’s important that you discuss your symptoms with your doctor. Getting a diagnosis as soon as possible means that treatment can begin immediately.

    To diagnose your condition, your doctor will:

    • Take your medical history and ask about your symptoms, recent injuries, the work you do, and other health issues.
    • Do a physical examination and look for redness and swelling in and around the joint, and test your joint’s range of movement.

    If your doctor thinks your bursa is infected, they may remove a sample of fluid from your bursa. This will be examined under a microscope for signs of infection.

    Scans such as x-rays and ultrasounds are usually unnecessary; however, your doctor may send you for a scan to rule out the possibility of another condition.

    How is bursitis treated?

    Some people can manage the pain, inflammation and stiffness of bursitis with self-care, such as cold packs, rest and gentle exercise. However, other people will require medical treatment to manage.

    In this case, your doctor may recommend using over-the-counter non-steroidal anti-inflammatories (NSAIDs). They can be taken as a tablet (orally) or applied directly to the skin (topically) as a cream or gel. In cases of severe pain, your doctor may prescribe stronger anti-inflammatory medicines or inject a corticosteroid into the bursa.

    You may also see a physiotherapist or exercise physiologist who can recommend exercises to help your joints move more easily and prevent bursitis from occurring again.

    If your bursitis is caused by an infection, your doctor will prescribe antibiotics to treat the infection. In some cases, a needle is inserted into the bursa to remove the infected fluid. This may happen several times until the infection has cleared.

    If the bursitis was triggered by a particular form of overuse, it‘s important to avoid that activity or modify how you perform it. An occupational therapist or physiotherapist can help you find solutions to this problem.

    What can I do to control my symptoms?

    You can do many things to relieve your pain and inflammation.

    • Protect and rest the joint to help the bursa recover. Your doctor or physiotherapist will advise you on how to rest the joint and for how long. This could include using cushions or pads when sitting or kneeling for long periods, using a sling or walking stick, modifying your activities etc.
    • Ice packs can help soothe red, inflamed joints, and heat packs and rubs can relax tense, painful muscles.
    • Maintain a healthy weight to reduce the pressure and stress on weight-bearing joints such as hips and knees.
    • Continue to stay active as much as you can while following any instructions provided by your healthcare team to protect your bursa.
    • Your doctor, physiotherapist and/or occupational therapist can offer other suggestions and strategies to reduce your risk of developing bursitis again.

    Contact our free national Help Line

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

    More to explore

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    Lisa Bywaters
    07/Dec/2022
    Health InformationMSK articles

    Surviving the most wonderful time of the year

    The year’s drawing to a close, and we’re exhausted. It’s been another tough one. 😯 It’s no wonder we’re all in the mood to forget the trials and tribulations of 2022 and eat, drink and be merry! ✨

    But we also need to be mindful and take care. In our excitement to get into the festive spirit 🍸, there’s a very real chance we could end up in a painful heap.

    So we’ve made a list (and checked it twice 😉🎄) of tips to help you celebrate without the stress, pain and fatigue. Because all we want for Christmas is family, friends and fun. 😊

    It’s beginning to look a lot like Christmas: Brace yourself for the shopping madness

    • Plan around your pain and fatigue. Wear your most comfortable clothes and shoes, including orthotics if you have/need them. Shopping at this time of the year is almost an extreme sport! So you need to dress for it.
      Grab your walking aid, your shopping list (a foggy brain makes remembering almost impossible) and your shopping buggy/bags.
      Be kind to yourself, as you may feel exhausted for hours/days after your trip. If your battery was already low before you hit the shops, it might take some time to recharge and feel yourself again.
    • Consider wearing a mask and sanitising your hands regularly when you go into the crowded craziness of shopping centres and markets. Although many of us have gotten out of this habit, COVID is still around. Masking and sanitising are the best strategies to reduce your risk of getting sick.
    • Use a trolley or a shopping buggy, even if you only plan to buy a few things. It’ll do the heavy carrying for you, so you can avoid muscle and joint pain.
    • Use your assistive devices, such as walking aids, braces, and orthotics. If you have them, use them. They can make a big difference in how you cope while shopping and how you feel afterwards.
    • Take breaks. Shopping is exhausting and stressful, so take breaks when you need them. Be kind to your body, and don’t push yourself too hard, or you’ll pay for that over the coming hours/days.
    • Shop online. During the past few years, we learned just how many things could be purchased with a few quick mouse clicks (hello, shiny new shoes 😁). So visit your favourite stores online and save yourself some trips to the shopping centre. Just be sure to check the shipping details to ensure your goods arrive on time.
    • Shop local. You don’t need to visit the big shopping centres to find unique gifts or fresh produce. Small, independent local stores often have most of what you need. And many of these businesses have been doing it tough. So share the love and shop local.
    • Be kind to others. Your fellow shopper isn’t the enemy. Be patient, give them space, and be tolerant. The retail staff also deserve our kindness and empathy – they’ve been on the frontline for a long time. And if you feel yourself getting a little hot under the collar, just breathe… and remember we’re all going through tough times.

    Dance of the sugar plum fairy: Festive feasting!

    • Rule #1 – don’t skip meals. It’s a common mistake to make. You’re anticipating a delicious lunch and/or dinner with all your favourite foods, so you skip meals to make space. But this can lead to overeating because you’re so hungry 😫 when you finally do get to eat. It’s also not a great idea to have an empty stomach when taking certain meds or drinking alcohol. So make sure you eat, even if it’s a small meal, to tide you over until you get to the main event.
    • Stay hydrated. The silly season is usually a hot time of the year, and it’s easy to become dehydrated. Especially if you’re drinking alcohol and/or playing backyard cricket, so keep the water flowing.
    • Cook/bake things ahead of time. Many foods we enjoy at our holiday gatherings can be made days and sometimes weeks before the big day. That means you don’t have to work yourself into a cooking frenzy on Christmas Eve and Christmas Day. And you’re more likely to enjoy yourself on the day if everything’s prepped and ready to go.
    • If you’re hosting, ask your guests to bring a plate. This shares the work and the cost and ensures those with special dietary requirements can bring food that accommodates their needs.
    • Slow down and relax. Really take the time to catch up with the important people gathered around the table 🧡 and enjoy sharing a delicious meal 😋.

    Santa baby: Buying gifts

    • Take a leaf out of the big guy’s book 🎅 – write a list and check it twice. Knowing what gifts you’re looking for before you hit the shops will save you time, energy and money.
    • Consider spending less. It’s been a tough year financially for many of us, and things are only getting tougher. So it makes sense to be economical and save some dollars. You don’t want to head into 2023 with massive debts.
    • Make your own gifts. Embrace your inner creative guru and bake, paint, draw, build, knit or sew your presents. Another option is to make your own gift vouchers – for example, 1 hour of babysitting or dog walking.
    • Talk with your people about doing a Kris Kringle or Secret Santa gift exchange 🎁. It’s perfect if you have a lot of people to buy for. And they save money, time, stress and frustrating shopping expeditions.
    • Give gift cards and vouchers. They’re an excellent idea for someone who’s hard to buy for or already has everything. And you can get many of them online – without the hassle of changing out of your pyjamas or leaving the comfort of your couch 😄.
    • Donate to charity. Instead of buying a gift for those who have everything they want or need, consider donating in their name to their favourite charity.
    • When it comes to wrapping, gift bags are easier on sore hands than cutting paper and using sticky tape. They’re also a lifesaver for those of us who are hopeless at wrapping 😉.

    Deck the halls: Decorating

    • Get the family involved. Put on some music and have fun with it. Decorating your home and your tree is all about the joy of the festive season, being together and the love of shiny tinsel 😊.
    • Keep it simple. Remember, what you put up has to be packed away. So if that thought fills you with dread, choose the ‘less is more’ option. Or plan to do it over a period of days, rather than all in one go.
    • Save your back when decorating the tree by putting your baubles and tinsel on a table or bench. That way, you’re not constantly bending over to pick them up.
    • Use a step ladder rather than overstretching. And if you have any balance issues, ask someone else to do the high stuff.
    • Remember, things don’t have to be ‘perfect’. That’s too much pressure. Things should be happy and festive, so fling some tinsel over the banister, a wreath on the door, and presents under the tree. Job done! 🎄

    Rockin’ around the Christmas tree: Hosting gatherings

    • Keep it COVID-safe. As we know, COVID’s still around, as are many other bugs and germs. So it’s important to have plenty of soap and hand sanitiser available.
      If you feel unwell, get tested, stay home, or cancel your gathering. That last one will be incredibly tough, as we’re so used to soldiering on through our aches, pains and fatigue, but if you think there’s even the smallest chance you have COVID, get tested and keep everyone safe by isolating until you know you don’t have the virus.
      And ask your guests to do the same. Again, it’s a tough thing to do, but no one wants to get sick. Especially at this time of the year, when we’re already run down and are just looking forward to a break.
    • Keep it simple. As with decorating, keep your celebrations simple. Seriously after the year we’ve had, any celebration will be epic!
    • Take a seat. Get off your feet and rest when you need to.
    • Be medicine-wise.
      • Over-the-counter and prescription medicine may help you manage pain and inflammation so you can enjoy your day. If you’re not sure what will work best for you, talk with your doctor or pharmacist.
      • Watch the alcohol. Many medicines don’t mix well with alcohol, so find out if drinking while taking your meds is okay. If you can drink, avoid drinking to excess. Try mixing a small amount of bubbles with orange juice or soda water with white wine. Or choose zero-alcohol drinks and mocktails.
    • Give yourself a break when it comes to cleaning and packing up. Get the family and your guests involved – even if it’s simple things like folding up chairs or bringing dishes to the kitchen. And ask yourself – do you really need to do everything immediately? As long as you put away any perishables and get rid of rubbish, everything else can be done the next day after you’ve had a rest.

    Have yourself a merry little Christmas: Taking care of you

    • Manage stress. Christmas and the holidays can be stressful, but you need to manage your stress as best you can or risk having a flare. So pull out your best stress management strategies and use them as often as you need to.
    • Pace yourself. When you’re hosting an event, it’s easy to get carried away and be constantly on the move. Gatherings can be a marathon, so pace yourself so you don’t run out of steam before the end. The same goes if you’re visiting others. Travelling to and from your home to theirs, being a witty conversationalist 😉 and just interacting with others can be exhausting.
    • Get some sleep, and rest when you need it. With so many events and gatherings happening at this time of year, it’s easy for our sleep to be disrupted. And we have enough problems with sleep at the best of times! Try as much as possible to stick to your sleep schedule and take rest breaks or naps when needed.
    • Stay active. Regular exercise is essential all year round for managing a musculoskeletal condition and chronic pain. It’s also important to help offset some of the extra kilojoules you may be consuming at this time of year. And it’ll help you deal with excess stress and sleep issues.
    • Listen to some tunes. Music helps to reduce anxiety, fear, depression, pain-related distress and blood pressure. And it’s an easy, cost-effective and enjoyable way to relieve pain🎵. Happy holidays everyone! From all of us at Musculoskeletal Australia, we wish you a happy, fun, safe and pain-free festive season. 🎄🎁🥗🍹

    Contact our free national Help Line

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

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    road-trip.jpg
    Lisa Bywaters
    16/Nov/2022
    Health InformationMSK articles

    11 tips for safe, comfortable and happy road tripping

    “Roadtripophobia (n.) The fear of not having any road trips currently booked.“

    With the weather improving (finally), many of us are looking out our windows and dreaming about road trips to anywhere but here. We’ve been stuck in one place for too long, and it’s time to explore new places! 😎

    However, living with arthritis, back pain, and other musculoskeletal conditions can sometimes affect your ability to drive. Pain, fatigue, joint and muscular pain, and brain fog can make driving and sitting for long periods difficult.

    That really sucks when your road trip playlist is ready to go, and a bag of kool mints is waiting in your console!

    But we’ve got some tips to help you get your motor runnin’… so you can head out on the highway and look for adventure.

    “Never underestimate the therapeutic power of driving
    and listening to very loud music.” – Unknown

    1. Talk with your doctor before you hit the road

    If your condition sometimes affects your driving ability, talk with your doctor. Depending on the problems you’re experiencing, your doctor may suggest a range of self-management strategies to help ease muscle tension, reduce pain, prevent you from stiffening up too much, and allow you to move more freely. You can use these strategies in the weeks leading up to your trip and as you travel all over the countryside.

    For example, simple things like regular exercise, pain management techniques, aids and devices, and supportive cushions can be a great help on a road trip.

    Your doctor may also review your medicines to ensure they’re managing your condition as effectively as possible, with as few side effects (e.g. drowsiness) as possible.

    This brings us to the next tip…

    2. Know how your medicines affect you

    Do your medicines affect your concentration? Do they make you sleepy? Or affect your coordination or reaction time? If so, talk with your doctor about whether there’s another medicine you can use that won’t have this effect on you.

    Understanding the effect medicines can have and whether or not they’ll affect your ability to drive safely is extremely important. If you’re unsure, chat with your doctor or pharmacist.

    Remember to pack any medicines you may need on your trip, whether you’re gone for an hour or days. Pain and flares can appear unexpectedly, so take a leaf out of the Scout guidebook and ‘be prepared’.

    3. Wear comfy clothes

    There’s nothing worse than driving for a while and realising you’re wearing the absolute worst clothes for the trip. Your shoes are restrictive, your top doesn’t breathe, and your jeans are giving you an atomic wedgie! 😫

    Road trips are fun, so you should feel relaxed and comfortable in the clothes you wear. Choose clothes with some give that allow you to stretch and move around easily, and are appropriate for the weather.

    If you want to look more put together at the end of your trip, take a change of clothes and get changed at a rest stop close to your destination.

    And don’t forget to pack a raincoat, sunhat and sunscreen – it’s Australia, after all. We can have all the seasons in one day! 🌞☔🌈⚡

    4. Plan your trip

    Planning and prepping will make you more confident during the drive and reduce the risk of stressful surprises. It also helps to build anticipation for the journey ahead.

    • Make sure your car is ready for the trip. Book it in from a service to ensure tyres, fluids, brakes etc., are up for the drive.
    • Print your maps or enter the route into your GPS. Plan your rest stops, fuel stops, and places you want to visit along the way.
    • If you’re making a long trip, stop every hour, get out of your car and stretch. Give yourself plenty of time; you don’t want to feel tense or rushed. Tension and stress can make your muscles tight and increase your pain levels. So take time to go slow and enjoy the ride. 😊
    • Be aware of changing road conditions. Much of Australia has had extensive rain and floods. This has caused many potholes to form, making driving stressful and potentially damaging to your car. Hitting a pothole can also cause significant jarring, increasing your muscle and joint pain. Read the RACV article: Stay alert, slow down, don’t swerve for info on how to safely navigate potholes.
    • As far as flooding goes, the information is clear – avoid flooded areas, and never drive through floodwaters. If you’re not sure about the state of the roads on your route or where floodwaters are, visit the website of your local roads authority and state emergency services.

    “There is nowhere to go but everywhere,
    so just keep on rolling under the stars.”- Jack Kerouac

    5. Get comfortable in the car

    Before you hit play on your playlist and set off, carefully adjust your seat and mirrors. If your feet and ankles are stiff, move your seat forward to push the pedals with your entire foot, not just your toes. Make sure your seat’s height lets you control the pedals without being uncomfortable. You should be able to reach and operate all of the controls, pedals, steering wheel etc., and have good visibility through your windows and mirrors.

    If you have pain in your hips or legs, consider using a cushion that supports the lumbar spine, hips and buttocks. You can find these at chemists, auto shops, and any store that sells aids and equipment. Or you can see an occupational therapist for info and advice. Just be sure to do all of this before your trip, so you can try out the cushion to ensure it helps and doesn’t aggravate your condition.

    Remember to empty your pockets of keys, wallet, small change and other bits and pieces. They can cause irritation and pain – especially if you have a long drive ahead.

    6. Take breaks and notice the world around you

    Don’t drive for more than an hour without a break. Stop, get out of your car, and stretch or massage tight muscles. Walk around. Drink some water. Check out what’s nearby – a coffee shop, a historical marker, or a breathtaking view. It’s incredible how much you can discover when you stop and look around. And the break will help you feel better and more relaxed at your destination than if you’d driven straight through.

    Build these breaks into your overall trip time so that you have plenty of time to get from point A to point B safely and comfortably.

    “Because the greatest part of a road trip isn’t arriving at your destination.
    It’s all the wild stuff that happens along the way.” – Emma Chase

    7. Stay hydrated and eat well

    Water lubricates and cushions your joints, aids digestion, prevents constipation, keeps your temperature normal and helps maintain your blood pressure. When you’re not getting enough water, your body can’t work as well as it should. So make sure you fill your water bottles before you set out and take time to drink from them.

    Pack healthy snacks like unsalted nuts, pre-cut fruit and veg, trail mix, or cheese and crackers. Check the nutrition panel to ensure they’re not high in fat, sugar or salt.

    Alongside the healthy snacks, you may decide to add a road trip treat (because you’re only human 😉). For my family, that’s always been kool mints or snakes. Yum! 😛

    8. Manage your fatigue

    You may experience fatigue or intense tiredness due to your condition, the effects of some medicines, or lack of sleep. So plan around your fatigue. For example, if you’re generally fatigued most days around 3pm, plan to do your driving before this.

    Your driving ability is compromised when you get tired, or your pain worsens. So don’t drive when you’re feeling foggy or sleepy. Share the driving with others. When you’re not the driver, you can keep the music playing, be the navigator, quiz master, or lolly dispenser. Or just put your head back and rest.

    “You can pack for every occasion, but a good friend
    will always be the best thing you could bring.”- Unknown

    9. Check out aids and gadgets

    There are many aids available to help make driving more comfortable, including:

    • A swivel seat cushion to help you get in and out of the car. You pop it on top of your car seat, sit on it with your body facing out and then swivel your body and legs aroundto face the dashboard.
    • A lumbar back support or a rolled-up towel to support your lower back.
    • A steering wheel cover can help make your steering wheel easier to grip if you have stiff, sore hands.
    • If you find it difficult to twist the petrol cap on or off, try using a petrol cap turner. It’ll make twisting the cap easier.
    • Grab handles and bars can be added to your car to help you get in and out of your car more easily.
    • A seat belt reacher can help reduce arm and shoulder strain when reaching for your seat belt and pulling it across your body.
    • Reversing cameras and parking sensors are available in most new cars and can be added to older ones. They can make parking and reversing easier if you have problems twisting, turning your neck or looking over your shoulder.

    Talk with an occupational therapist for information and advice about what aids or gadgets may be helpful for you.

    10. Use heat and cold treatments

    Applying heat or cold to painful areas before you head out in your car can help relieve your pain. Generally speaking, heat can ease muscle spasms and tension, and cold can reduce swelling. Heat and cold treatments are available in a wide range (e.g. packs, rubs, gels, patches). Some are portable and can be left in your glovebox or bag, so you have them on hand when you need them. Always read the instructions carefully before using them.

    11. And have fun!

    Heading out on a road trip is a time-honoured tradition because it’s fun, gets us out of our bubbles, and leads to new and exciting adventures. So take some time to plan and prepare, and enjoy the journey! 🚗

    “It doesn’t matter how old you get, buying snacks for a road trip should
    always look like an unsupervised 9 year old was given $100.”- Unknown 😁😂

    Contact our free national Help Line

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

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    osteoarthritis-blog.jpg
    Lisa Bywaters
    13/Oct/2022
    Health InformationMSK articles

    Osteoarthritis: It’s not ‘just’ arthritis

    Osteoarthritis is the most common form of arthritis. And because of this, I think it’s often dismissed, and its effects underestimated.

    I mean, how often have you heard people say, ‘it’s just wear and tear’, ‘we’ll all get it eventually’, or my personal favourite ‘it’s just a bit of arthritis’ 😤? These offhand comments trivialise the considerable pain and disability that osteoarthritis (OA) causes many Australians.

    If you have OA or know someone who does, you know it can significantly impact every aspect of life. Symptoms such as persistent pain, fatigue, stiff and swollen joints, weakened muscles, anxiety, depression, and sleep problems can affect a person’s ability to be as involved in social, community and work activities as they might like.

    So, no, it’s not ‘just’ arthritis.

    Let’s look at what it is.

    What is osteoarthritis?

    As we know, OA is the most common form of arthritis. It’s most likely to develop in people over 45, but it can also occur in younger people. It frequently affects weight-bearing joints, such as the knees, hips, feet, and spine. The joints of the hands, including the thumbs, are also commonly affected.

    While it was once thought to be an inevitable part of ageing, resulting from a lifetime of wear and tear on joints, we now know it’s a complex condition and may occur due to many factors.

    Osteoarthritis and your joints osteoarthritis

    To understand how OA affects your body, it’s helpful to know a little about your joints.

    Joints are places where bones meet. Bones, muscles, ligaments and tendons work together so you can twist, bend and move about.

    Covering the ends of your bones is a thin layer of tissue called cartilage. It provides a slippery cushion that absorbs shocks, helps your joints move smoothly and prevents bones from rubbing against each other.

    Around most of your joints is a tough capsule that holds your bones in place. The inside of the capsule is lined with synovial membrane, which produces synovial fluid. This fluid lubricates and nourishes the cartilage and other structures in the joint.

    With OA, the cartilage becomes brittle and breaks down. Some pieces of cartilage may even break away and float in the synovial fluid. Because the cartilage no longer has a smooth surface, the joint becomes stiff and painful to move.

    Eventually, the cartilage can break down so much that it no longer cushions the two bones. Your body tries to repair this damage by creating extra bone. These are bone spurs (or osteophytes). Bone spurs don’t always cause symptoms but can sometimes cause pain and restrict joint movement.

    OA causes and risk factors

    Many things can increase your chances of developing OA, including:

    • your age – people over 45 are more at risk
    • being overweight or obese
    • your genetics – the genes you inherit can play a role in developing OA
    • other conditions – such as rheumatoid arthritis and gout, can cause damage to your joints and lead to OA
    • gender – 3 in 5 people who have OA are women
    • repetitive movements associated with your job or occupation (e.g. constant kneeling, squatting, lifting heavy loads)
    • significant injury, surgery, damage or overuse of a joint.

    Signs and symptoms

    The symptoms of OA can vary from person to person. Some of the more common symptoms include:

    • joint pain, stiffness and swelling (inflammation)
    • grinding, rubbing or crunching sensation (crepitus)
    • muscle weakness.

    These symptoms can sometimes worsen, especially when you feel stressed, upset, overdo things, or don’t get enough sleep. This is called a flare or flare-up.

    Diagnosing OA

    If you’ve been experiencing joint pain, it’s essential you discuss your symptoms with your doctor. Getting a diagnosis as soon as possible means that treatment can start quickly. This will give you the best possible outcomes.

    To diagnose your condition, your doctor will do some exams or tests. They may include:

    • Your medical history. Your doctor will ask you about your symptoms, family history and other health issues.
    • Physical examination. Your doctor will look for swelling in and around the joint and test your joint’s range of movement. They’ll also feel and listen for grinding, rubbing or creaking in the joint.

    Imaging (e.g. x-rays, ultrasound or MRI) and blood tests aren’t routinely used to diagnose OA. However, they may sometimes be needed if there’s uncertainty around your diagnosis.

    Treating OA

    There’s no cure for osteoarthritis; however, your symptoms can be effectively managed with exercise, weight management, medicines, and self-care.

    Exercise

    Because of the old ‘wear and tear’ myth, many people are worried that exercising joints with OA will cause more joint damage. But regular exercise can actually help reduce some of your symptoms (e.g. pain, stiffness) and improve your joint mobility and strength. It will also move synovial fluid through the joint, providing essential nutrients and removing waste.

    Exercises that move your joints through their range of movement will also help maintain joint flexibility; this is often lost due to OA. Strengthening the muscles around your joints is also important. The stronger they are, the more weight they can take. This will help support and protect your joints.

    An exercise program that promotes muscle strength, joint flexibility, improved balance and coordination, and general fitness will give you the best results. Start exercising slowly and gradually increase the time and intensity of your exercise sessions over weeks and months. A physiotherapist or exercise physiologist can help you work out an exercise program that’s right for you.

    Weight management

    Being overweight or obese increases your risk of developing OA and the severity of your condition. The additional weight also increases pressure on your joints, especially your weight-bearing joints (e.g. hips, knees, feet), which is likely to cause further pain and damage.

    The amount of overall fat you carry is also significant because fat releases molecules that contribute to low but persistent levels of inflammation across your whole body. This, in turn, increases the level of inflammation in the joints affected by OA.

    For these reasons, maintaining a healthy weight is essential if you have OA. Your doctor or dietitian can advise you on safe weight-loss strategies if you need to lose weight.

    Weight loss can be a long process for many people. It’s challenging, especially when pain affects your ability to be as active as you’d like. But it’s good to know that any weight loss can reduce your pain and increase your ability to exercise. So making small, achievable changes to your eating and exercise habits can bring big results. It just takes time, commitment, and support.

    Medicines

    No medicines can affect the underlying disease process of OA, but combined with exercise, weight management, and self-care, medicines may provide temporary pain relief and help you stay active.

    The most commonly used medicines for OA are:

    • Non-steroidal anti-inflammatory medicines or NSAIDs (e.g. ibuprofen). These medicines are available over-the-counter and with a prescription, depending on their dosage and other ingredients. They come in tablet/capsule form (oral NSAIDs) or as a gel or rub applied directly to the skin (topical). It’s important to note that oral NSAIDs are designed to be taken at low doses for short periods. Always talk with your doctor before starting NSAIDs, as they can have side effects.
    • Paracetamol. Research has shown that paracetamol provides only low-level pain relief for osteoarthritis. However, some people report that it helps reduce their pain so they can be more active. For this reason, it’s worth discussing a trial of paracetamol with your GP to see if it‘s appropriate for you.
    • Corticosteroid (steroid) injections may be helpful for people who haven’t found relief from other treatments (e.g. exercise, weight loss) or other medicines. Corticosteroid injections into a joint can provide short-term pain relief; however, the number of injections you can have each year is limited due to potential harm.

    Note: Opioids are powerful pain-relieving medicines that effectively reduce acute pain (or the pain resulting from an injury or surgery). In the past, they were prescribed to treat pain associated with conditions like osteoarthritis; however, there’s strong evidence that they have little effect on OA pain. Opioids also have many potentially serious side effects. That’s why they’re not recommended in the management of OA. Read the Choosing Wisely Australia resource ‘5 Questions to ask about using opioids for back pain or osteoarthritis’ for more info.

    Self-care

    There are many other things you can do to reduce the impact of your symptoms, including:

    • Learning about your condition. Understanding OA and how it affects you means you can make informed decisions about your healthcare and actively manage it.
    • Learning ways to manage your pain. Pain is the most common symptom of osteoarthritis, so it’s crucial to learn to manage it effectively. Read our A-Z guide for managing pain for more information.
    • Working closely with your healthcare team. The best way to live well with OA is by working closely with the people in your healthcare team (e.g. GP, physio) and keeping them informed about how you’re doing and alerting them to any changes.
    • Protecting your joints. Supports such as walking aids, specialised cooking utensils, ergonomic computer equipment and long-handled shoehorns can reduce joint strain and make life easier. An occupational therapist can advise you on aids, equipment and home modifications. You can also check out our range of aids in our online shop.
    • Taping, knee braces and orthotics may be helpful if you have OA in your knees or feet. A physiotherapist or podiatrist can advise you on these.
    • Improving sleep quality. Not getting enough quality sleep can worsen your symptoms; however, getting a good night’s sleep when you have osteoarthritis and chronic pain can be challenging. If you’re having problems sleeping, talk with your doctor about ways you can address this.
    • Managing stress. Stress can also aggravate your symptoms, so learning to deal with stress is extremely helpful. Things you can do to manage stress include planning your day and setting priorities, using relaxation techniques such as going for a walk, getting a massage or listening to music, and, where possible, avoiding people and situations that cause you stress.
    • Eating a healthy, balanced diet. While there’s no specific diet for OA, it’s important to have a healthy, balanced diet to maintain general health and prevent weight gain and other medical problems, such as diabetes and heart disease.

    Surgery

    In most cases, surgery isn’t required for people with osteoarthritis. However, surgery may be an option if all non-surgical treatment options have been unsuccessful and you’re still experiencing significant pain and loss of function.

    The most common surgery for osteoarthritis is a joint replacement. When considering surgery, you should be informed about what it involves, the rehabilitation process, and its potential benefits and risks.

    Note: An arthroscopy isn’t recommended to treat knee OA. Evidence shows it’s not effective in improving OA knee pain or function.

    Contact our free national Help Line

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

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