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    Lisa Bywaters
    07/Jul/2022
    Health InformationMSK articles

    10 tips for protecting your hands and arms when cycling

    Guest blog by hand therapist Catherine Reid, B.App. Sci, (OT), M.Sci (H&UL rehab), MAHTA (As awarded by the AHTA), CHT

    The advent of COVID has seen many more people riding their bikes, either for exercise or for their daily commute. It’s a great exercise for the heart and lungs and a low-impact exercise for people with musculoskeletal conditions.

    In recognition of the health and environmental benefits of riding a bike, the United Nations declared June 3rd to be World Bicycle Day. Unfortunately, as a hand therapist, I frequently hear patients complain that hand and upper limb pain or weakness limits their ability to ride.

    Hand therapists are experts in rehabilitating the upper limb. We understand anatomy and how it relates to everyday activities. We can help determine what’s causing the problem, if it’s due to an injury, illness or activity, and provide appropriate treatment.

    Some pain experienced when riding a bike may be due to vibration transmitted up through the bike into the arms or due to the prolonged time or force with which the handlebars are gripped.

    If you love to ride but find it a bit painful, here are my top 10 tips for protecting your hands and upper limbs while riding. The best place to start is from the ground up.

    1. Tyres

    If you’ve ever ridden a bike or billy cart with solids tyres rather than rubber, air-filled, pneumatic tyres, you know what a difference a little air and rubber can make!

    Yet even with pneumatic tyres, vibrations or jolting through the handlebars can be painful for people with arthritis or joint injury. Ensuring the tyres on your bike are properly inflated can help reduce stress going up through the arms and into your body. The current thinking in the biking world is that wider tyres with less pressure offer better rolling resistance and comfort.

    Wheels for bikes can also vary in stiffness depending on the design and the material they’re made from, so some are better at absorbing shock than others.

    2. The frame

    If you plan to explore the world and take your bike with you, you need to consider the weight of your bike. Is the weight manageable for you?

    And when choosing a bike rack, one mounted on the back of the car might be an easier option than lifting your bike over your head onto the roof of a car. Lower lifts reduce the strain on sore or stiff shoulders.

    Carbon fibre and titanium bikes are much lighter than traditional steel-framed bikes but come at a cost.

    Another consideration is that the further away your seat is from the handlebars, the more of your weight your arms will be supporting.

    3. Shock absorbers

    The front fork of a bike can have shock absorbers that reduce the force going up into your arms from uneven terrain while keeping the tyres in contact with the ground for better control. They can be easily adjusted to provide more or less bounce.

    4. Stem flexibility

    The stem attaches the handlebars to the bike, and the modern stems have pivots, elastomers and moving parts to provide suspension. They may be as effective at smoothing the force from rough terrain as the fork suspension but may be a cheaper option to retrofit to a bike.

    5. Handlebar shape

    There’s a huge variety of handlebar shapes, which roughly fall into three categories: swept back, drop or flat handlebars. Some of the handlebars offer several different grip positions enabling the rider to vary their grip.

    For example, the drop bars enable the rider to use three different positions

    • the hooks, the part that curves or drops down, taking most of the weight through the hand;
    • the hoods are the rubber covers around the hinges of the levers. For smaller hands, it might be more comfortable holding the levers here, but there’s some loss of strength as the grip is near the hinge and not the end of the lever;
    • the third place you can hold a drop bar is on the top of the bar. This gives the rider a more upright position and places the hands in a palm down position, but this is a less anatomically friendly position for the wrist. Placing hands in a palm down position also puts pressure on the nerves in the palm of the hand, which can cause compression neuropathies such as carpal tunnel syndrome or cyclist’s palsy. Carpal tunnel syndrome affects the thumb side of the hand, while Bicycler’s neuropathy affects the little finger side; both conditions cause numbness and tingling in the hand.

    6. Handlebar rise and sweep

    Handlebar rise is the vertical rise measured from the centre of the bar to the bar end. The handlebar height can be adjusted by raising the stem or by increasing the rise of the handlebars. Increasing the rise changes the body position of the rider to a more upright position, meaning more weight is placed through the saddle, and less weight is placed through the shoulders, wrists and hands. Handlebars can have an upsweep and a backsweep. Sweep is the angle from the stem to the end of the bar either in an upward angle (upsweep) or in a backward angle (backsweep). More upsweep generally places more pressure on the hands, wrist and shoulders, whereas more backsweep places the wrists in a more natural (palms facing) position.

    7. Handlebar material

    The material the handlebars are made of can affect their ability to reduce or dampen the forces going through them. Carbon fibre and aluminium dampen vibrations better; however, steel and titanium flex. A little bit of flex in a handlebar is a good thing as it absorbs some of the force from bumps in the road.

    There’s also a line of handlebars that have a foam-filled core to deaden the vibration through the core.

    8. Grips and tapes

    Larger grips generally distribute the weight more evenly through the hand. There are lots of commercially available grips, and many can be retrofitted to your bike.

    Some change a flat handlebar to provide a vertical grip as well, allowing for a change of hand, wrist and elbow position. This can help reduce hand stiffness and provide rest from pressure on a particular joint or nerve. Tapes can either be gel or cork. The advantage of cork tapes over gel is that they don’t compress over high-pressure areas and are generally more durable.

    9. Gloves

    Gloves offer added protection from blisters and falls and improve grip. Glove fit should be firm so they don’t bunch up and cause pressure areas. They should also fit firmly around the cuff so water can’t leak in when it’s raining.

    Keeping hands warm with waterproof or thermal gloves helps maintain hand dexterity, especially for arthritic hands. Lightweight, breathable summer gloves with wicking ability may be helpful to reduce sweaty palms, which reduce grip.

    Some gloves have padding to reduce vibration, which irritates the nerves of the hand, or silicon tips or open tips to improve touch.

    Gloves can provide skin protection in the case of a fall or protection for mountain bikers with inbuilt carbon fibre inserts to protect the backs of the hands from trees.

    10. Gears and brakes

    Traditionally gears fall into 3 categories:

    • Twist or grip shifters,
    • Trigger shifters, or
    • Shimano Total Integration (STI) brake lever shifters.

    More recently, digital computerised gear mechanisms have been introduced. They require very little resistance to use, but unfortunately, they’re expensive to retrofit to your bike.

    Twist shifters can only be fitted onto straight handlebars and are controlled by rotating the wrist. They’re easier on the fingers and the thumb as wrist motion is used to control the gears. So if you have painful fingers or reduced dexterity, twist gears might be advisable. Twist shifters are known to become stiffer over time, which might put undue strain on the wrist. They also require frequent repositioning of the wrist.

    Trigger shifters generally require little force and can be activated with different fingers. To shift gears, the top lever is moved with the fingers, and the bottom lever is moved with the thumb. The benefit of trigger shifters is that the wrist stays in a neutral position. This is helpful if you have tennis elbow as it reduces strain in the muscles at the elbow joint.

    STI Brake lever shifters are a combination of the gear shifter and the brake lever on the one fitting. This allows the rider to shift gears without moving their hand from the bars. They’re generally found on touring or racing bikes and can be activated while holding the hoods. They require minimal force to use.

    Brakes can either be hydraulic or cable brakes.

    Hydraulic brakes are preferable if you have upper limb problems as they take far less force to use. The back pedal (coaster) brakes are less common these days and are generally found on cruiser bikes or kids bikes. They’re worth considering if you have poor eye-hand coordination or poor hand strength. If the levers are too far out from the bars, people with smaller hands have difficulty reaching their fingers around the brake levers, making it difficult to grip forcefully. This can be adjusted with small rubber inserts placed at the hinge end of the brake lever.

    Getting your bike tailored to meet your specific needs may just require some minor changes to your existing bike. But sometimes, purchasing a new bike can be more cost-effective. Remember, changing any part of your bike will affect your bike’s fit and may affect your bike’s handling. It’s worth getting your existing bike correctly fitted to you before making too many expensive changes.

    If changing your bike isn’t helping, then you need to see a hand therapist to evaluate the cause of the pain and, if needed, provide upper limb exercises, treatments or supportive splints to enable you to keep riding. A hand therapist in your local area can be found on the Australian Hand Therapy website.

    Our guest blogger Catherine Reid is an occupational therapist with a Master of Science in Hand and Upper Limb Rehabilitation. She’s a full member of the Australian Hand Therapy Association and works in her private practice Western District Hand Therapy, in Warrnambool, Victoria.

    Contact our free national Help Line

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

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    Musculoskeletal Health Australia
    07/Jul/2022
    Health InformationMHA Blogs

    What is axial spondyloarthritis?

    It’s definitely a mouthful, but what is axial spondyloarthritis?

    Axial spondyloarthritis (axSpA) is the umbrella term for two different types of inflammatory arthritis that affect the spine: ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA)

    Ankylosing spondylitis (AS) affects the spine and the joints that connect the lower spine to the pelvis (sacroiliac joints). These changes are visible on x-ray.

    In non-radiographic axial spondyloarthritis (nr-axSpA), these changes aren’t yet visible on an x-ray but may be seen on an MRI. For some people, nr-axSpA will never progress to the stage where joint changes are seen on x-ray. For others, these changes will eventually be seen on an x-ray, and their diagnosis will be changed to AS.

    These conditions cause pain, stiffness and reduced mobility in your spine. They can also cause symptoms including inflammation of tendons and ligaments, inflammatory bowel disease, psoriasis and inflammation of the eye.

    The good news is that axSpA can be treated effectively with medicine and self-care.

    Q. What are the signs that I may have axial spondyloarthritis?
    A. The signs or symptoms of axial spondyloarthritis vary from person to person. The most common symptoms are pain and stiffness in the back, often the lower back and into the buttocks that:

    • comes on gradually over weeks or months
    • is worse in the second half of the night and wakes you up
    • is worse first thing in the morning, with early morning stiffness that lasts 30 minutes or more
    • is worse after rest and feels better after activity and exercise
    • has been present for 3 months or more
    • may involve pain deep in the buttock that can swap from one side to the other over time, especially in the early stages (doctors call this ‘alternating buttock pain’).

    Other symptoms can include:

    • fatigue (extreme tiredness)
    • inflammation and pain in tendons (which connect muscles to bones) and ligaments (which connect bones to each other), which you may feel as pain in the front of your chest, back of your heel or underneath your foot
    • arthritis in one or more of your peripheral joints – such as the joints in your hands, feet, arms or legs
    • inflammation in your eye (uveitis)
    • inflammatory bowel disease
    • psoriasis
    • feeling feverish and having night sweats
    • losing your appetite and losing weight.

    Symptoms may change from day to day. At times your symptoms (e.g. pain, fatigue, inflammation) can become more intense. This is a flare. Flares are unpredictable and can seem to come out of nowhere.

    Q. What causes axial spondyloarthritis?
    A. Axial spondyloarthritis is an autoimmune disease. That means it occurs as a result of a faulty immune system.

    Instead of identifying foreign bodies (e.g. bacteria, viruses) and attacking them to keep you healthy, your immune system mistakenly targets healthy tissue in and around your joints, causing inflammation and pain.

    We don’t know why this happens. Genes are thought to play a role. You’re more likely to get axSpA if you have a history of it in your family. Most people with axSpA have the gene called HLA-B27; however, this gene can also be found in people who don’t have axSpA.

    Since this gene doesn’t automatically lead to the development of axSpA, other factors are thought to be involved.

    We used to think axSpA affected more men than women, but recent research suggests men and women are affected relatively equally.

    Q. How do I know if I have axial spondyloarthritis?
    A. If you have ongoing back pain and stiffness or other symptoms of axSpA, it’s essential that you see your GP. Getting a diagnosis as soon as possible means that treatment can start quickly. This will give you the best possible outcomes.

    No one test can diagnose axSpA, 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 to assess joint tenderness, flexibility, and stiffness.
    • Blood tests to check for inflammation associated with axSpA.
    • Genetic testing to look for the HLA-B27 gene, which is present in most people with axSpA.
    • Scans such as an x-ray and MRI (magnetic resonance imaging) to look for joint inflammation and damage.

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

    Q. How is axial spondyloarthritis treated?
    A. Your rheumatologist will recommend and prescribe medicines for your axSpA.

    The two main types of medicines used to treat axSpA and help manage its symptoms are NSAIDs and targeted therapies:

    • Non-steroidal anti-inflammatory drugs (NSAIDs) are nearly always used as the first medicine to treat the pain, inflammation and stiffness of axSpA unless there’s a reason that you can’t take them. Research shows that NSAIDs are very effective in managing symptoms of axSpA. Some people may need to take them regularly, while others will only take them as needed. This will depend on your symptoms and how you respond to the NSAID. Your rheumatologist will talk with you about how often you should take NSAIDs and the long-term benefits and risks of using them. There are many different types and brands; some are available over-the-counter, while others are only available on prescription.
    • Targeted therapies are medicines that ‘target’ specific proteins in the immune system that produce inflammation. They include biological disease-modifying anti-rheumatic drugs (biologics), biosimilars and targeted synthetic disease-modifying anti-rheumatic drugs. These targeted treatments have dramatically improved the quality of life for people with axSpA who need more than NSAIDs to manage their condition. They work to control your immune system in a targeted way, slowing down the attack on your spine and joints. Your rheumatologist will talk to you about using these medicines if you need more than NSAIDs to manage your axSpA or you’re unable to take NSAIDs.

    Q. What can I do to control my symptoms?
    A. As well as taking your medicines as prescribed, there are things you can do.

    • Learn about your condition. Understanding axSpA allows you to make informed decisions about your healthcare and actively manage it.
    • Exercise regularly. This is the most important thing you can do to help manage your axSpA. Exercise can improve symptoms including stiffness, pain, fatigue, breathing capacity and posture. It helps increase your flexibility and range of movement, so it’s easier to do many everyday tasks. As soon as possible after receiving your diagnosis, you should ideally begin a personalised exercise program developed by a physio or exercise physiologist (EP) and aim to do some exercise every day. Being active is also essential for your overall health and wellbeing. It helps keep your muscles, bones and joints strong so that you can keep moving. It reduces your risk of developing other conditions such as heart disease, osteoporosis, diabetes and some forms of cancer. It boosts your mood, benefits your mental health, helps with weight control and improves sleep.
    • Manage your weight. Being overweight or obese increases inflammation throughout your body. This inflammation affects not only your joints but also blood vessels and insulin levels. This can increase your risk of chronic health conditions such as heart disease and diabetes. Losing weight is an important thing you can do to reduce your risk of these conditions and to reduce your axSpA symptoms. Being overweight or obese also limits the effectiveness of some medicines used to treat axSpA. Losing weight can be challenging, so if you need to lose weight or advice on healthy eating, talk with your doctor or dietitian.
    • Learn ways to manage your pain. Pain is the most common symptom of axSpA, so learning to manage it effectively is crucial. Read our A-Z guide for managing pain for more information.
    • Work closely with your healthcare team. The best way to live well with axSpA is by working closely with the people in your healthcare team (e.g. GP, rheumatologist, physio). Keep them informed about how you’re doing and if you’ve experienced any changes in your symptoms or tried new medicines, complementary therapies, supplements or other treatments.
    • Use aids and equipment. Supports such as long-handled shoehorns, reachers and canes can reduce joint strain and make life easier, especially if your condition has reduced your flexibility and mobility. 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.
    • Sleep well. Not getting enough quality sleep can worsen your symptoms; however, getting a good night’s sleep when you have axSpA and chronic pain can be difficult. If you’re having problems sleeping, talk with your doctor about ways you can address this.
    • Manage 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.
    • Practise mindfulness. Regularly practising mindfulness meditation can improve your mood, relieve stress, improve sleep, improve mental health and reduce pain.
    • Eat a healthy, balanced diet. While there’s no specific diet for axSpA, it’s important to have a healthy, balanced diet to maintain general health and prevent weight gain and other health problems, such as diabetes and heart disease.
    • Quit smoking. Smoking cigarettes is not only bad for your general health but also negatively affects your bone health and increases inflammation.
    • Seek support from others. You might find it helpful to contact Ankylosing Spondylitis Australia or the Ankylosing Spondylitis Group of Victoria and speak to others who have axSpA and know what you’re going through.

    Q. Are there any complications I should be aware of?
    A. Some people living with axSpA develop an eye problem called uveitis, which causes a painful red eye with blurred vision and sensitivity to light.

    If you develop eye symptoms, you’ll need to quickly get your eye checked and treated by an ophthalmologist. Treatment is usually with prescription eye drops, which reduce the chance of permanent eye damage.

    By understanding this risk and knowing what signs to be alert for, you can reduce the risk of damage to your eyes.
    Ask your GP or rheumatologist what you should do if you develop any eye symptoms.

    Q. What about surgery?
    A. Most people with axSpA can manage their condition using a combination of exercise, medicines and self-care.

    However, surgery may be considered in some cases if treatments haven’t provided relief from symptoms or if you have a spinal fracture or dislocation. Surgery that may be considered includes:

    • hip arthroplasty (replacement) surgery if you have severe and persistent hip pain
    • cervical fusion, where bones in the cervical (upper) spine are fused together to treat a fracture or dislocation
    • wedge osteotomy removes a wedge-shaped piece of bone from a vertebra to allow the spine to be realigned.

    If your doctor thinks surgery might be an option, they’ll refer you to an orthopaedic surgeon. Together, you can discuss the benefits and risks of surgery and decide if it’s right for you. If you’re unsure about surgery or don’t feel comfortable with the information from the surgeon, ask your doctor to refer you to another surgeon for a second opinion.

    Contact our free national Help Line

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

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    Lisa Bywaters
    16/Jun/2022
    Health InformationMSK articles

    Healthy meals on a budget

    Times are tough; there’s no denying that. The rising costs of everything (hello, $10 iceberg lettuce 😭) are putting the household budget under significant pressure. And this is causing many of us to feel anxious.

    But we can do many practical things to relieve some of this stress. Let’s start in the kitchen with our tips for enjoying tasty, healthy meals and snacks that won’t cost an arm and a leg.

    Make a meal plan – and stick to it

    Before hitting the shops, plan your meals and snacks for the week. Check the fridge and pantry to see what ingredients you already have, and write a list of those you need. Writing a list is essential because, even if you’re not in pain or dealing with brain fog, it’s easy to forget things, buy the wrong quantities or items you don’t need in the heat of the moment. (Step away from the chips Lisa 😁). And if, like me, you hate shopping and really want to avoid crowds and germs, getting the shopping done quickly and efficiently is a must. With the steep price of petrol, it also makes sense to keep the trips to the shops to a minimum. So plan, plan, plan! Eatforhealth.gov.au has some helpful information on meal planning, including sample mean plans. There are also lots of meal planning apps you can download from Google Play or the App Store. They conveniently place your meal plan and shopping list on your phone, so no more forgotten shopping lists!

    Read the nutrition panel

    It’s a good habit to get into so you can track the amount of energy (kilojoules), fat, salt, sugar etc., in your foods. It’s also helpful when comparing different brands of the same product.

    Swap some meat dishes for vegetarian or vegan meals

    Research has found that vegan and vegetarian diets cost less than a diet that includes meat. You don’t have to go all-out vego; simply swap some of your meat dishes for plant-based meals. They’re tasty, healthy and cheap. Healthy vegetarian protein sources include tofu, chickpeas, beans, quinoa, lentils, eggs and nuts. If you need help, there are many websites with interesting and tasty vegetarian and vegan recipes.

    Note: You’ve probably noticed the multitude of plant-based ‘meats’ crowding the shelves in your supermarket, often alongside actual meat products. They’ve been developed to look and taste like meat and can be a good alternative to meat, especially if your family aren’t keen on giving tofu a go 😉! Just make sure you read the nutritional panel carefully before buying these products, as some have high levels of salt, saturated fat and other additives. The Cleveland Clinic has an interesting article to help you know what to look for when buying faux meats.

    Choose generic, home brand and no-name products

    They’re generally cheaper and are often exactly the same as the name brand, just without the fancy packaging.

    Prepare some meals in advance

    When you’ve got some free time, make extra meals that you can freeze and use when necessary. That way, when you’re exhausted, having a flare, or just can’t be bothered cooking, you’ll have some meals you know are healthy. And you won’t have to resort to takeaway foods or store-bought frozen meals, which can be costly and are often high in fat, salt and/or sugar.

    Buy local and in-season fruit and veg

    They’re generally more nutritious, fresher and more cost-effective. The Australian Farmers’ Markets Association has a tool to help you find your local farmers’ market, and Sustainable Table has a handy seasonal produce guide.

    Buy so-called ‘ugly’ produce

    These fruits and vegetables are cheaper and taste fine. Who cares if your carrot has two ‘legs’ or your apple has a spot? At the end of the day, they’re perfectly healthy and packed with all the usual nutrients. They just don’t look shiny and new, but who does these days 😉? You can get imperfect produce at many supermarkets and food subscription services.

    Read the unit price when comparing products

    This will enable you to see the price difference regardless of brand or quantity, and you can work out which provides the best value for money. Unit pricing works by using a standard measurement across all products of the same type.

    So, for example, if you compared yoghurt A with yoghurt B:

    • yoghurt A costs $6.40 for 1kg, so its unit price is $0.64 per 100g
    • yoghurt B costs $2.30 for 200g, so its unit price is $1.15 per 100g.

    That makes yoghurt A cheaper per 100g.

    Fortunately, you don’t have to do the mental gymnastics to work this out for yourself. The unit price is generally provided on the shelf label and online. Phew! Shopping is hard enough!

    Grow your own

    Over the past few years, many of us have discovered the joy of gardening. So why not grow some of your own produce? Whether on a small scale with a few pots of herbs on your balcony or larger scale vegie patch and fruit trees in your backyard, you can experience the pleasure and reap the rewards of growing some of your own foods. Nothing tastes sweeter than the food you’ve nurtured, grown and picked yourself 💚.

    Use frozen and canned fruit and vegetables

    They’re still healthy and usually cheaper than produce that’s not in season. They’ll also keep longer. Just make sure you read the ingredients list and nutrition panel. Canned foods may have added salt or sugar. So for vegies, look for ‘no added salt’ on the label, and choose fruits in natural juice with no added sugar rather than canned in syrup.

    Shop around and do your research

    Just because you’ve always shopped at a particular place doesn’t mean you always have to shop there. Visit the local farmer’s markets, keep an eye on catalogues and join online groups with other savvy shoppers. That way, you’ll always know who’s providing the best value for money for your groceries.

    Buy in bulk items you use regularly and have a long shelf life

    This includes things like rice, dried/canned legumes and pasta. And the best time to buy them is when they’re on sale. But please don’t go crazy and start hoarding or buying too much 😐. Bulk buying to save money is different to the panic buying we’ve seen during the pandemic. If we all shop for only the things we need, there’ll be plenty for everyone.

    Reduce your kitchen waste

    Shopping with a list will help, and only buy what you need. Take note of the foods you often throw out because they’ve become a mysterious, furry blob in your fridge. Avoid buying that item, or buy less of it when you shop. Look for ways to use food that’s becoming slightly less than fresh but is still good. Soups are a great way to use the last of the vegies in your fridge crisper. Visit the Foodwise website for tips to help you reduce waste.

    Getting takeaway

    Let’s face it, there’ll be times when you really, really want takeaway food. It’s quick, easy and delicious 😋. As long as it’s an occasional thing and you eat it in moderation, it shouldn’t have too great an impact on your health or wallet. Here are some tips from Health and Wellbeing Queensland to help you make the healthiest choices when it comes to takeaway food.

    Finally, don’t shop when you’re hungry

    It’s an easy way to end up with lots of things in your trolley that weren’t on your shopping list. This can blow your budget and plans for healthy eating right out of the water. So shop after you’ve eaten or munch on some fruit or handful of nuts before you even consider walking into the bright lights and air-conditioned aisles of your local shopping centre. Your budget will thank you for it.

    Contact our free national Help Line

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

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    Lisa Bywaters
    16/Jun/2022
    Health InformationMSK articles

    Want to make healthy changes in your life? Start small.

    January 1, the traditional date many of us resolve to make healthy changes in our lives, has come and gone. Exercise more regularly, add new recipes to the repertoire, meditate in the evenings … sound familiar? And many of us gave it a red hot go.

    But as often happens when life gets in the way (or the continuing saga of the pandemic keeps on rolling 🤦), our goals can take a hit.

    If you still want to make these changes but haven’t had much success so far, you may want to rethink your approach.

    ‘Start small’; ‘slow and steady wins the race’; ‘small changes eventually add up to huge results’. These clichés are plastered over Pinterest and motivational boards for a reason. When we start small or break our goals into smaller tasks or actions, they’re less overwhelming and more achievable.

    Here are some tips to help you make small but deliberate changes that can have a big impact on your physical and mental health and wellbeing 😊.

    First – take the time to reflect on what YOU want to achieve.

    Now write it down. Try to be as clear as possible.

    Next, consider using the SMART framework. It can help you achieve your goals by helping you clarify your ideas and focus your efforts. SMART stands for:

    Specific. What are you trying to do? Losing weight isn’t a specific goal. But committing to a healthy eating plan and regular exercise with the aim to lose 10kg in 8 weeks is.

    Measurable. You need to be able to measure your progress so that you know when/if you’ve achieved your goal. With the weight loss example, we’ve specified how we’ll go about losing weight and included a measurable target, i.e. 10kg in 8 weeks.

    Achievable. The goal needs to be achievable for you. It should challenge you but still be attainable.

    Realistic. You need to be realistic, and your goal needs to be doable – for you and your circumstances. For example, if you’re currently under a lot of stress and not sleeping well, it can be more challenging to lose weight. Aiming to lose weight over a longer period might be a better option. Take the time to think about what’s realistic for you now. By doing this, you’re not setting yourself up to fail.

    Timeframe. The goal needs to have an end date that you’re working towards. This gives you the motivation to push yourself further.

    Don’t feel that you have to change everything at once. Say you’ve decided you want to improve your health and fitness. You’ve identified that you need to lose weight, exercise more regularly, quit smoking, start meditating, get more sleep, reduce your alcohol intake and drink more water. That’s a lot!

    And it’s not like you’re trying to do these things in a vacuum – you also have work/study, family life, social life and – oh yeah – managing a chronic condition or two.

    So instead, start with what you’d like to achieve most – e.g. exercising more – and work on that for a week or two. Then include other elements, e.g. talking with your doctor about safe weight loss options. When you feel like you’re making progress there, move on to other things, such as quitting smoking or reducing alcohol.

    You’ll still be making a change but in a more achievable, less overwhelming way. And remember that any healthy changes you make will impact other areas you want to improve; e.g. reducing alcohol will aid weight loss and help you sleep better, as will exercising regularly.

    Be mindful and focus…on your eating, exercise, time with family, hobbies, etc. We often move through life at breakneck speed and rarely pay attention to the small details. But these things and moments in time add meaning and colour to our lives. So take the time to savour your meals, notice how your body moves and supports you when you exercise, what it feels like to be with your family, or the enjoyment you get from your hobbies. These are small but important things you can practice every day.

    Eat when you’re hungry, not when you’re tired, emotional or bored. Working from home and pandemic stress has led many of us to eat things, or at times, we usually wouldn’t. Before you eat something, take time to reflect on whether you’re hungry or not. And if you’re not hungry, what’s making you reach for that food? If you’re hungry, and it’s between meals, do you have healthy snacks close at hand? Will a glass of water help fill you up? Or do you need to look at your meals and whether they provide the nutrients you need to get you through to your next meal without hunger setting in? If you’re not sure how to make healthy changes to your diet, talk with your doctor and/or a dietitian.

    Put the devices away for a while and detox from digital. Our preoccupation with our phones, TVs, computers, gaming consoles etc., can get in the way of being present in the moment. And when it comes down to it, how many cat videos, memes, or news stories do we really need to see 😹? Our devices can be a trap, and it’s easy to lose an hour or two before you know it. This could be time spent reading with your kids, cooking a delicious meal or relaxing so you can sleep well. So put them away for a bit and enjoy life offline.

    Incorporate the outdoors. Go for a walk in the park or another green space, take deep breaths and inhale the cool, crisp air. Not only will this get you moving, but there are many other health benefits associated with getting outdoors. They include reducing stress, lowering blood pressure, improving your mood and clearing your mind. However, be careful in these wet, wintery months of potentially slippery paths, rug up against the cold and wear appropriate shoes.

    You can also use pot plants to bring the outdoors in and enjoy the health benefits. Just be sure to check that they’re not toxic for you, your family or your furry housemates.

    Put some physical distance between yourself and your phone. Many of us constantly check our phones to see what the latest beep, blip or alert was for. And most of the time, it wasn’t for anything important. It takes you out of the moment and shifts your focus and concentration. The next thing you know, you’ve zoned out on conversations or started doom-scrolling. So give yourself some space.

    Another benefit is that having your phone in a place you need to get up to access it can add quite a bit of incidental exercise to your day. For example, if you use your phone as your morning alarm, moving it away from your immediate bedside area means you’ll have to get up to turn it off. This also means you’ll be less likely to hit snooze countless times 😉.

    Make it achievable. Whether you’ve decided to use the SMART framework or not, always make sure the goals you’re setting are achievable; otherwise, it can be disheartening if you don’t reach your target. For example, say you want to drink more water but only manage a glass of water a day at the moment. Trying to immediately go from a glass to the ‘magic’ 2 litres a day will be challenging. So don’t go straight for the big guns; ease your way in and increase your quantity over time.

    Take time to make decisions. We’re often quick to say yes when family and friends invite us to dinner or a party, or a colleague asks to collaborate on a project. But try to slow your reaction. A night out or working together on a project might sound great at the time, but take a moment to consider it properly. What’s your schedule like? How are you feeling? Are you able to add another thing to your calendar? Instead of an immediate yes, try saying, “That sounds great; I’ll let you know once I check my schedule”, or “I’ve got a big week ahead, so I’ll have to get back to you”.

    Taking control of your time at the outset is better than falling in a heap after over-committing. And those who know you will understand that this is essential to self-care and managing a chronic condition.

    Slow and steady wins the race. Do you get to the end of the week and find that you have piles of laundry, too many unread emails and a garden full of weeds? It’s exhausting to even think about! A good practice is to break these jobs into smaller tasks and deal with them methodically during your week. Set aside some time to do these mundane chores each day. It’s up to you how long you spend on this – but having some dedicated time to deal with it means it’s less likely to overwhelm you by the end of the week. Leaving you with more time for the fun stuff! 🕺

    Enlist help. There’s lots of help available if you need it. Family, housemates and friends can help you get things done around the home – on a regular or occasional basis. Then there are the professional cleaning/gardening/meal services you can have on standby if you need some backup. You can also talk with your doctor about accessing healthcare services if you need help developing things like a safe exercise program or a healthy eating plan. All you need to do is reach out.

    Write it down. How often do you think, “I’ll remember that”, and completely forget it moments later 😣? The name of a TV series someone recommended, a new recipe, the date of your healthcare appointments 😑. It’s so frustrating! But having a foggy brain, persistent pain, sleeplessness, busy lives, and pandemic-brain can make us lose track or forget things. So write it down. On your phone, notepad, fridge … whatever works for you.

    Focus on your breathing. Most of us take breathing for granted. It’s just an unconscious thing we do. But your breathing can become shallow if you’re in pain or anxious. However, you can reduce your pain and anxiety by focusing on breathing more deeply. Deep breathing increases feelings of calmness and relaxation and improves your focus and concentration.

    Making changes to improve your health and wellbeing is admirable, but it can be challenging. That’s why starting small, building on your progress and asking for help are important. Talk with your family, doctor or the nurses on our Help Line for information and support. Because you can do this … one step at a time.

    Contact our free national Help Line

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

    More to explore

    CONTINUE READING
    jaw-pain.jpg
    Lisa Bywaters
    25/May/2022
    Health InformationMSK articles

    What causes jaw pain?

    Did you know the joints in your jaw are the most frequently used joints in your body? They’re constantly on the move as you talk, chew, cry, swallow, sing, smile and yawn.

    Unfortunately, these joints can also be the source of pain and discomfort.

    Let’s explore the anatomy of your jaw to better understand what can cause pain in these joints.

    Lightly place your fingers on your face, between your nose and mouth, and spread them across your cheeks. This is the upper part of your jaw, called the maxilla. It holds your top row of teeth.

    Now place your fingers on your cheeks in front of and just below your ears. This is the lower part of your jaw or the mandible. It holds your bottom row of teeth.

    Open your mouth. You’ll feel the temporomandibular joints (TMJ) working. The rounded ends of your lower jaw (condyles) glide along the joint socket of the temporal bone. Close your mouth, and you’ll feel the condyles slide back to their original position.

    The temporomandibular joints connect your lower jaw to your skull. Inside the joint, between the two bone surfaces of your skull and jaw, is a disc of cartilage. It provides a slippery cushion that helps the joints move smoothly, absorbs shocks and prevents the bones from rubbing against each other. Muscles attached to and surrounding the joints control their position and movement, and enable your jaw to move up and down, side to side, and forward and back.

    Temporomandibular joint disorders (TMD) are conditions that affect the bones, joints, and muscles responsible for jaw movement. They’re the most common causes of jaw pain.

    What causes temporomandibular joint disorders?

    A number of different things can cause temporomandibular joint disorders, including:

    • teeth grinding or clenching (known as bruxism)
    • musculoskeletal conditions (e.g. fibromyalgia, rheumatoid arthritis and osteoarthritis)
    • movement or dislocation of the disc
    • stress, tension, anxiety, depression
    • jaw injury
    • dental problems (e.g. uneven bite, ill-fitting dentures).

    Who gets temporomandibular joint disorders?

    TMDs are common, affecting up to 60–70% of the population, especially adults aged 20–40 years. Women are at least four times as likely to have a TMD.(1)

    Many TMDs last only a short time and go away on their own. However, in some cases, they can become chronic or long-lasting.

    What are the symptoms?

    The most common symptom of TMDs is pain in and around the jaw, ear and temple, especially when eating. Other symptoms may include:

    • clicking, popping or grinding (crepitus) when you move your jaw
    • headache
    • earache
    • difficulty opening and closing your mouth or a ‘locking’ jaw.

    How are they diagnosed?

    If you’re experiencing pain in the jaw or other symptoms that are causing you problems, you should see your doctor or dentist. They’re usually able to diagnose a TMD by:

    • taking your medical history – where the pain is, when it started, what makes it worse, and any other symptoms you have, and
    • doing a physical examination – observing as you open and close your mouth, feeling your jaw, listening for clicking and other noises.

    Sometimes they may need scans (e.g. x-rays, or CT (computed tomography scans) if the history and exam weren’t conclusive or there’s uncertainty around your diagnosis.

    Treatment

    Many people with a TMD find that their symptoms go away without treatment.

    However, others require a treatment approach that involves a combination of self-care and medical care.

    Self-care

    There are simple and effective things you can do to ease the pain and other symptoms of TMDs.

    • Use heat or cold packs. Cold helps reduce swelling and pain, while heat can relax your jaw muscles. Always wrap the pack in a cloth so it doesn’t touch your skin directly.
    • Try some gentle stretches, exercises and massage. They help relieve muscle tension and pain in your face, jaw and neck.
    • Eat soft foods, cut your food into smaller pieces and take your time eating. This will rest your temporomandibular joints and reduce the amount of work they need to do.
    • Avoid eating gum, or foods that are tough or chewy, as they require lots of repetitive chewing.
    • Avoid extreme jaw movements (e.g. wide yawning, yelling).
    • Relax your jaw. This is something you’ll need to make a conscious effort to do because most of the time, we’re not aware that we’re clenching our jaw. It can be helpful while you’re getting in the habit of doing this to set an alarm or alert to remind you to do it.
    • Do some relaxation techniques for the whole body. If you’re feeling stressed or anxious, this can aggravate your TMD. You can do many things to relax your body and mind, including going for a walk, getting a massage, listening to music, and practising mindfulness.
    Medical care

    Not everyone will need medical treatment to ease their symptoms. But some of the treatments used are:

    • Medicines to relieve pain and inflammation and to relax muscles.
    • Wearing a mouth guard while sleeping to prevent tooth grinding. Your dentist can fit you for one.
    • Treating underlying conditions, such as dental problems, musculoskeletal conditions or mental health issues.

    Surgery is rarely needed to treat TMDs.

    Contact our free national Help Line

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

    More to explore

    Reference

    (1) Lomas, J. et al, 2018. Temporomandibular dysfunction. Australian Journal of General Practice, 47(4), pp.212-215.

    CONTINUE READING
    telehealth-consultation.jpg
    Lisa Bywaters
    25/May/2022
    Health InformationMSK articles

    Telehealth 2022

    In March 2020, at the beginning of the pandemic, the Federal Government made telehealth available for all Australians. This enabled us to access our general practitioner (GP) and other healthcare providers from the comfort – and safety – of our homes.

    As of 1 January 2022, many telehealth services became a permanent and ongoing part of Medicare.

    Eligible patients will continue to have access to GP, specialist, nursing, mental health care, midwifery and allied health services via telehealth where the healthcare provider believes it’s appropriate.

    It’s important to note that telehealth consultations will not take the place of face-to-face consultations. They’re just another option that may be convenient, and yet another example of the hybrid world we now live in 😉.

    What is telehealth?

    Simply put, telehealth enables you to consult with your healthcare provider over the phone or through a video platform (e.g. Zoom, Skype, FaceTime). Your healthcare provider may specify which platform you need to use.

    Depending on your available technology and how comfortable you are using it, you might have a conversation over your phone with your doctor (like any other phone call), or interact face-to-face via the video platform.

    If you’re only comfortable talking on your phone, that’s ok. You don’t have to download apps and learn how to use them, especially if this makes you anxious. You can choose to see your healthcare provider in person or consult over the phone if appropriate.

    But if you’re interested, video platforms are easy to use. And they allow your healthcare provider to see you and assess you visually. This obviously gives them a lot more information about you and your health. The platforms and technology just take a little practice 😊.

    However, a change that did come into place in January 2022 means that for initial and complex specialist consultations, face-to-face and video services are required. Telephone consultations are only available for subsequent and minor consultations. This is because you and your specialist will have a better quality consultation face-to-face or via video than you could over the phone. This is essential for your first consultation or if your situation is complex and can’t be managed effectively and safely over the phone.

    Why would I choose telehealth over face-to-face consultations?

    You may choose telehealth over face-to-face consultations if you’re feeling unwell or fatigued, and going in person would make you feel worse. Or, you may not be able to take time off work to go to an appointment, but you do have a quiet space at work where you can have a private telehealth consultation during a break. Or, you may live in regional or remote parts of the country and accessing a healthcare provider via telehealth is more convenient and timely.

    It’s also your only option if you have COVID and you’re self-isolating. We still need to restrict the spread of the virus.

    And remember, it’s not an either/or situation. Face-to-face and telehealth consultations will continue alongside each other – with both having their merits.

    What are the costs?

    During the initial phase of the COVID telehealth rollout, all telehealth consultations were bulk-billed. This was to keep us at home and reduce the spread of the virus.

    However, with most of the population now vaccinated and living in ‘COVID-normal’ times, you can’t assume that telehealth consultations will be bulk-billed. So when you’re making your appointment, ask if it will be bulk-billed or if you have to pay a consultation fee.

    The video platforms are free to download and use.

    Eligibility

    As with the rules when telehealth was first introduced in 2020, you still need to have an existing relationship with your GP to meet eligibility requirements. That means you must have had a face-to-face consultation with the same GP or another practitioner at the same practice in the 12-months before a telehealth consultation.

    It’s not always easy

    As many of us have discovered over the last couple of years, as we’ve been working, schooling and just trying to entertain ourselves at home, there are always teething issues. The two biggest issues are technology and time.

    Technology – it can make our lives easier and more entertaining, but sometimes it seems like it just makes things more complicated. Like when you’re tired, anxious, frustrated, unwell or in pain, everything, including technology, seems against you, and nothing seems to work 😑. Often this is because we find it difficult to focus or concentrate; after all, we’re tired, anxious, frustrated, unwell or in pain. Other times it may be because there’s a big demand on the system. Everyone is trying to get online for one reason or another, which may cause slower internet speeds.

    Time – as with any appointment, there can be issues with time. Your healthcare provider may be running late because of tech issues, other patients have needed more time, there’s been a medical emergency, or because they’re human and have lives and families too, and things can get in the way. Or you may be running late for similar reasons. We all need to be patient and give people a little leeway as we navigate this new ‘normal’ we find ourselves in.

    But we can make it easier

    We’ve identified these potential issues not to freak you out but to prepare you. Honestly, they may not happen at all. But there are things you can do to prepare for your telehealth consultation that will make things easier for everyone.

    Be patient – if your doctor is running late, if your internet is slow, if your appointment is rescheduled due to an emergency, be patient. This can be hard to do when you’re unwell or in pain. But becoming impatient won’t change the situation and will only make you feel worse – physically and emotionally. Make a cuppa, read a book, do a crossword puzzle, talk with your partner/cat/dog/kids – distract yourself while you wait.

    However, if you have chest pain, difficulty breathing, or a medical emergency, call 000 immediately. Don’t wait for your telehealth appointment.

    Be prepared – before your appointment, make a list of the things you want to discuss with your doctor. Put them in order from the most important to the least. That way, you won’t finish your consultation and then kick yourself for not asking X. Also – be aware that your appointment may end earlier than you anticipate if there’s a tech issue or an emergency. So lead with your most pressing questions or concerns, and if you have time, follow with the less important ones.

    Be kind – Our healthcare providers are doing the best they can, often under stressful, trying circumstances. During this crisis, they’re our frontline, so please be kind to them. And be kind to yourself. You’re learning new technology or new ways to do things and just trying to stay sane during an insane time – recognise that you’re also doing the best you can. So hang in there.

    Talk with someone who cares

    Call the National MSK Help Line – our nurses are available weekdays from 9am to 5pm on 1800 263 265, or you can email helpline@msk.org.au. They can help you with info and support about musculoskeletal conditions, managing pain, treatments, accessing services, and much more.

    More to explore

    CONTINUE READING
    Crystals.jpg
    Lisa Bywaters
    04/May/2022
    Health InformationMSK articles

    Crystal arthritis

    Did you know that some forms of arthritis are caused by crystals forming inside a joint?

    Two of these conditions are gout and acute calcium pyrophosphate (CPP) crystal arthritis. CPP is a mouthful (!), but you may have heard of its old name, pseudogout, which means ‘false gout’.

    So what are these conditions? And how do they affect people?

    Let’s start with gout.

    Gout is a common and painful form of inflammatory arthritis. It involves sudden flares of extreme joint pain, swelling and redness. It most often affects the big toe, but it can affect any joint, including your wrists, ankles, knees, elbows, and fingers.

    Gout occurs more frequently and develops earlier in men, often between 30 and 45 years. Women are more at risk of developing gout after menopause. It affects both men and women equally over 65.

    Gout occurs when uric acid builds up in your blood, causing needle-shaped crystals to form inside a joint.

    Some things increase your risk of developing gout. They include:

    • being overweight or obese
    • having conditions such as high blood pressure, chronic kidney disease, diabetes and heart disease
    • drinking too much alcohol (especially beer)
    • eating a diet high in purines such as meat, sweetbreads, offal, shellfish, and fructose
    • using diuretics
    • becoming dehydrated
    • crash dieting, fasting or overeating.

    Acute calcium pyrophosphate (CPP) crystal arthritis also involves sudden and painful flares of extreme joint pain, swelling and redness. This condition most often affects the knees and wrists but can affect other joints and tendons.

    CPP affects both men and women, most commonly over age 60.

    It occurs when calcium pyrophosphate crystals form in the joint cartilage. They may also be found in the joint lining and the joint fluid. Unlike the needle-shaped crystals in gout, these crystals are rod-shaped with blunt ends. It’s not clear why the crystals form, but they increase in number as people get older.

    Some things increase your risk of developing CPP. They include:

    Diagnosing crystal arthritis

    Many conditions can cause joint pain and swelling, so your doctor will talk with you about your symptoms and medical history and examine the affected joint. If they suspect you have gout or CPP, they will take scans of the joint.

    They may also remove a fluid sample from your joint. This fluid is examined under a microscope for the presence of crystals or anything else that may be causing the pain and inflammation. This is the most definitive test for crystal arthritis and indicates whether uric acid crystals or calcium pyrophosphate crystals are present.

    Treatment

    The first step in treating gout and CPP is to control the pain and inflammation. This may involve medicines, cold packs, and resting the joint.

    Your doctor will consider your medical history and other health issues when deciding which medicines are most appropriate and safe for you to use.

    The most common medicine used to control pain and inflammation during a gout or CPP flare is a non-steroidal anti-inflammatory (NSAID). Another common medicine used to treat gout is colchicine. Corticosteroids (or steroids) can also be very effective.

    In the case of gout, once the flare is under control, your doctor may prescribe medicines that lower uric acid levels in your blood. This will depend on things such as:

    • how often you have flares
    • if you’ve developed tophi (hard, uric acid deposits under the skin) or kidney stones
    • other health conditions you may have (e.g. kidney disease).

    For both conditions, treating any underlying conditions is also important to prevent future flares.

    Self-care

    As well as taking your medicines as prescribed, you can reduce the pain and swelling of a flare by using an ice pack on the painful joint for short periods. You should also protect and rest the joint.

    Other things you can do to prevent future flares:

    • Take any medicines as prescribed.
    • Lose weight if you’re overweight or obese. This needs to be done carefully and gradually, as crash diets or fasting can cause a flare for people with gout. Your doctor and/or a dietitian can support you in this.
    • Drink water regularly, as becoming dehydrated can increase your risk of a flare for both conditions.
    • Drink alcohol in moderation and avoid binge drinking.
    • Eat a healthy, balanced diet. If you have gout, avoid or eat in moderation foods high in purines. Talk with a dietitian for more information. There is no link between CPP flares and diet. Although the crystals are calcium pyrophosphate, there’s no evidence having a calcium-rich diet triggers a CPP flare. In fact, everyone should ensure they get enough calcium in their diet to reduce their risk of developing osteoporosis.
    • Exercise regularly.
    • Work closely with your doctor to prevent further flares and actively manage your condition.

    Contact our free national Help Line

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

    More to explore

     

     

    CONTINUE READING
    awareness-ribbons.jpg
    Lisa Bywaters
    04/May/2022
    Health InformationMSK articles

    Awareness Days

    It seems like every time you look at your socials, open a newspaper or listen to the radio, another awareness day, week or month is being promoted.

    Just this week, to name a few, we have World Asthma Day (3 May), International Day of the Midwife (5 May) and International No Diet Day (6 May). Oh, and let’s not forget Star Wars Day (4 May), as in May the force (fourth) be with you. 😂

    In fact, as far as musculoskeletal conditions go, May is chock-full of awareness days:

    October also has its fair share:

    And we have World Young Rheumatic Diseases Day (WORDDay) on 18 March.

    So what’s the point of all of these days and the countless others that get shared around?

    Awareness raising

    In our 2020 national consumer survey, a common issue raised by many respondents was the lack of awareness of musculoskeletal conditions and the impact they have on people’s lives. It’s one of the reasons we named the subsequent report Making the Invisible Visible because, for the most part, these conditions have no visible signs to indicate the pain and suffering they cause. Or the tremendous effect they have on daily lives, finances, the ability to work and study, be social, exercise, have a family, travel, be intimate, and so much more.

    Rattle Ya’ Bones Day came about as a vehicle for us to promote these issues, educate the public about them and lift the stature of musculoskeletal conditions. It also provides the opportunity to dispel many myths surrounding arthritis, back pain and other musculoskeletal conditions.

    Promoting specific conditions

    There are over 150 different musculoskeletal conditions, so it can be easy to get lost in the mix. Specific condition awareness days allow conditions like lupus, juvenile arthritis and fibromyalgia to shine and get the awareness they deserve.

    Sharing personal stories

    An important aspect of awareness days is sharing the voices of people living with the condition or health issue. These stories, experiences, and perspectives provide the broader community with insight into their lives. And that’s a powerful way to make people care.

    Connecting people

    When you live with a painful condition, it can be an isolating experience. If you don’t know anyone else with your condition, it can be even more isolating. Awareness days can provide an opportunity to connect with others online and at events.

    And for those newly diagnosed who may be feeling a bit lost, these awareness days can help people find a community of people who understand what they’re going through.

    Showing support

    You can show your support for people living with specific conditions by sharing information about the awareness day, donating, volunteering, and so much more. Even liking a post and sharing it with your network goes a long way to supporting a cause and the people whose lives are affected. It’s a chance to say “this matters” and let others know it matters. And hopefully they’ll learn about it and care too.

    Seeking change

    In our survey, many people expressed their frustrations and difficulties they faced living with musculoskeletal conditions and the shortcomings in the systems that should support them. By raising awareness of these issues, we can lobby for change.

    Raising funds

    Many awareness days also have a fundraising component to them. This may be for anything from providing services to supporting research.

    Having fun

    Whether it’s a serious awareness raising campaign or just a weird and wacky day that exists on its own (I’m looking at you, International Goof Off Day 😁), adding fun elements encourages people to get involved. And let’s face it, the world can be a grim place at times, so any extra fun we can cram into our days provides some necessary silliness.

    Save the date! Rattle Ya’ Bones Day – 31 October 2022

    Keep an eye on our socials and MSK News for information about this year’s Rattle Ya’ Bones Day (RYBD). RYBD aims to raise awareness of the impact of muscle, bone and joint conditions on the lives of those who live with them. You can help us do that. So stay tuned!

    Contact our free national Help Line

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

    More to explore 😉

     

    CONTINUE READING
    relaxing-with-dog.jpg
    Lisa Bywaters
    13/Apr/2022
    Health InformationMSK articles

    Bedtime routines – not just for kids

    Do you get to the end of your busy, tiring day, drag yourself to bed and then have trouble falling asleep? Or staying asleep?

    If so, you’re not alone. It’s a common problem, especially for people with musculoskeletal conditions or chronic pain. The Australian Institute of Health and Welfare (AIHW) reports that about two-thirds of Australians aged 18 and over with chronic conditions such as arthritis, diabetes and mental health issues report at least 1 sleep difficulty or problem.(1)  And so while it’s probably no surprise to you that poor sleep affects your pain levels and quality of life, did you know it can put you at risk of developing other chronic conditions, including high blood pressure, diabetes and heart disease? (2)

    That’s why it’s important to develop a healthy and consistent bedtime routine that allows your body and mind time to wind down and relax so that you can sleep well.

    What are the elements of a bedtime routine?

    First, a good bedtime routine needs time. Rushing is counterproductive and can lead to more stress and anxiety right before you hop into bed. So give yourself enough time, at least 30 minutes each night. Also, allow time for your new routine to stick. We’re creatures of habit, but when we create new routines, we have to give them time to become second nature.

    Next, your bedtime routine should involve things that you enjoy, help calm your body and mind, and let your body know it’s time for sleep.

    Here are some suggestions for things you might include in your routine:

    • Set a time for going to bed, and stick to it as much as possible. When you have a consistent sleep schedule, your body naturally adjusts and begins to feel tired at the right time each day, making it easier to fall asleep.
    • Don’t use technology during your wind-down time. It’s easy to lose track of time while reading emails, checking social media or watching the latest TV series. The next thing you know, you’re still awake at midnight. So put the technology away.
    • Write it down and get it out of your head. Put pen to paper and write down your worries, concerns, and things you need to do the next day. Basically, anything playing on your mind and interfering with your ability to relax and sleep. Don’t do this right before you hop into bed, as they’ll still be on your mind. Instead, do it a few hours before bedtime, and then put it away.
    • Avoid caffeine, alcohol, nicotine and big meals close to bedtime. They can affect your ability to fall asleep and the quality of your sleep. Instead, drink water, herbal tea or non-caffeinated drinks. And if you’re hungry, eat a light snack, for example, a piece of fruit, some yoghurt or a small handful of nuts.
    • Adjust the temperature. Your body’s core temperature needs to drop a few degrees for you to fall asleep. So for your bedroom temperature, it’s best to aim for cooler (but not cold) rather than warm. A helpful tip from the American Academy of Sleep Medicine is to think of your bedroom as a cave: it should be cool, quiet, and dark.
    • Have a warm shower or bath an hour or two before bed. This is also about achieving optimum body temperature for good sleep. The shower or bath will initially warm your body, but then as the water evaporates from your skin, you’ll quickly cool down. The warm water also stimulates blood flow from your core to your hands and feet, lowering your body temperature.
    • Don’t forget your teeth! While it doesn’t directly relate to sleep quality, it’s part of the winding down process at the end of your day.
    • Take your regular medicines (if required).
    • Avoid strenuous exercise before bedtime. It raises your temperature and heart rate, making it difficult to fall asleep. Instead, save these kinds of activities for your morning or afternoon.
    • Do something you enjoy – for example, read a book, listen to music, talk to your partner/kids/pet. These enjoyable activities create a feeling of calm. They can also improve your mood and help you manage stress and anxiety.
    • Try other ways to relax – such as gentle yoga, meditation, stretching, deep breathing and progressive muscle relaxation.
    • Have sex! Research suggests that having sex improves sleep, whether you’re alone or with a partner. Orgasm releases several hormones, including oxytocin, which when elevated as a result of sexual intercourse improves sleep quality. Cuddling may also help you fall asleep, as it can make you feel calm and comforted.
    • Prep for the next day. Take the stress out of your morning routine by doing some prep the night before. Sort out your lunch, outfit, kid’s homework etc, so you can go to bed feeling confident your morning will start well.

    These simple suggestions to help you wind down at the end of your day can help you relax and sleep better. And in the end, we all want to sleep well and feel as refreshed as possible when we wake up. So why not give some of these things a go? You’ve got nothing to lose and so much to gain.

    Contact our free national Help Line

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

    More to explore

    Reference

    (1-2) Sleep problems as a risk factor for chronic conditions 
    Australian Institute of Health and Welfare (AIHW)

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    hip-pain.jpg
    Lisa Bywaters
    24/Mar/2022
    Health InformationMSK articles

    Osteoarthritis of the hip

    Osteoarthritis (OA) is the most common type of arthritis, affecting 1 in 11 Australians.* It can develop in any joint but commonly occurs in weight-bearing joints like your knees and hips.

    Your hip joint hip joint osteoarthritis

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

    Your hips are one of the largest joints in the body. They’re called ball and socket joints. That’s because the head of your thigh bone (femur) is shaped like a ball that fits inside a rounded socket (acetabulum) in your pelvis.

    The ends of your bones are covered in a thin layer of cartilage that acts like a slippery cushion absorbing shock and helping your joints move smoothly.

    With OA, the cartilage becomes brittle and breaks down. Because the cartilage no longer has a smooth, even 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. This causes pain, stiffness and swelling.

    Symptoms

    The symptoms of hip osteoarthritis usually happen gradually and vary from person to person. They may include:

    • pain in the hip joint
    • pain in your groin or thigh that radiates to your buttocks or your knee
    • stiffness and/or swelling of the hip joint
    • grinding, creaking or crunching sound when moving the hip
    • it may feel like your hip ‘locks’ or ‘sticks’ during periods of activity
    • reduced range of movement.

    Causes

    Many factors can increase your risk of developing osteoarthritis of the hip, including:

    • age – OA occurs more often in people over 45
    • being overweight or obese – extra weight on your hips can increase strain and may lead to premature or increased joint damage
    • gender – 3 in 5 people who develop OA are female*
    • family history of OA
    • joint damage – for example, from a sports injury or a car accident
    • joint abnormalities – for example, developmental dysplasia of the hip, a condition that affects the hip joint in babies and young children.

    Diagnosis

    If you’re experiencing pain or stiffness in or around your hip, it’s important that you discuss your symptoms with your doctor. Getting a diagnosis as soon as possible means that treatment can start quickly. Early treatment will give you the best possible outcomes.

    To diagnose your condition, your doctor will:

    • take your medical history – this will include finding out about your symptoms, how long you’ve had them, what makes them better or worse
    • physically examine your hip.

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

    Treatment

    There’s no cure for hip OA, but it can be managed effectively using exercise, weight management, medicines, self-management and in some cases, surgery.

    Exercise

    Exercise is one of the most important strategies for managing OA. A tailored exercise program developed by a physiotherapist or exercise physiologist can help reduce your hip pain and improve your hip function. Evidence suggests that while no one particular type of exercise is better than another, a combination of certain exercises is likely to be the most effective.

    These exercises include:

    • strength training specifically targeting your legs
    • aerobic exercise – these are exercises that get you moving and increases your heart rate (e.g. brisk walking, cycling, swimming) and will help improve the health of your heart and lungs (cardiovascular system)
    • balance training
    • exercises that move your joint through its full range (range of motion exercises).

    When choosing an exercise for yourself, think about what you enjoy and what you’re likely to keep doing. The best results occur when you exercise at least three times per week.

    If pain prevents you from exercising, you may find that warm water exercise is a good starting point. Warm water pools offer the comfort of warmth and the buoyancy of the water to ease the load on your joints. For those able, cycling is a good option for non-weight-bearing exercise.

    Weight management

    Being overweight or obese increases the risk of developing hip OA. It’s also highly likely to speed up how quickly your OA develops or progresses. Evidence shows a relationship between weight loss and relief of symptoms such as pain and stiffness; even a small amount of weight loss can help. If you’d like to lose weight to improve your symptoms, your doctor and/or a dietitian can assist you in losing weight safely.

    Medicines

    For some people, medicines are an important part of managing their OA. Tablets, creams, gels or injections may help to reduce pain and improve function.

    There are a variety of medicines used in the management of hip OA. Each comes with varying degrees of evidence to support them. These include:

    Non-steroidal anti-inflammatory medicines or NSAIDs (e.g. Nurofen, Celebrex, Voltaren)
    NSAIDs are available over-the-counter and with a prescription, depending on their dosage and any other ingredients. They may be taken by mouth (orally) as a tablet or capsule or applied directly to the skin (topical) in the form of gels and rubs.

    Oral NSAIDs are considered the preferred first-line drug treatment for OA and have been shown to reduce pain and symptoms in hip OA.

    Although there’s no solid evidence either for or against topical NSAIDs, it may be worth giving them a short trial to see if they help.

    It’s important to note that NSAIDs are designed to be taken at low doses for short periods. Always talk to your doctor before starting NSAIDs as they can cause harmful side effects, especially in older people.

    Paracetamol (e.g. Panadol, Panamax)
    Research has shown that paracetamol provides only low-level pain relief and, in some cases, no pain relief at all compared to a placebo in hip OA. However, some people do report that it helps reduce or take the edge off their pain so that they can be more active. If you can’t take NSAIDs they may also be an option. Before using paracetamol, talk with your GP to see if it’s appropriate for you.

    Corticosteroid injections
    If you have persistent hip pain and haven’t had relief from oral medicines or other treatments (e.g. exercise, weight loss), your doctor may suggest a corticosteroid (steroid) injection. Corticosteroid injections into the hip joint can provide short-term pain relief for some people with hip OA. However, the duration of pain relief can vary from a few days to a few weeks, and the number of injections you can have is limited due to potential harm. It’s important that you discuss the benefits and risks of steroid injections with your doctor to have all the information you need to make an informed decision.

    Opioids
    Opioids are powerful pain-relieving medicines. They’re effective at reducing acute pain (or the pain resulting from an injury or surgery), but evidence shows 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 hip OA.

    Glucosamine and chondroitin
    Studies have found that there’s no benefit from taking glucosamine for osteoarthritis. The Australian Rheumatology Association and the Royal Australian College of General Practitioners recommend against taking glucosamine.

    Glucosamine supplements are usually made of shellfish, so if you have a shellfish allergy, don’t use glucosamine. Glucosamine can also affect your blood sugar levels and may adversely affect diabetic, cholesterol, chemotherapy and blood-thinning medicines.

    Much like glucosamine, the effects of chondroitin are unclear. Some studies have found an impact, while others did not. Speak with your doctor before trying glucosamine or chondroitin.

    Stem cell injections
    Currently, there’s no evidence to support the use of stem cell injections in the treatment of hip OA despite it being commercially available. The International Society for Stem Cell Research and the Australian Rheumatology Association does not support the use of stem cell injections for osteoarthritis. It’s recommended that stem cell administration should only take place under a rigorously designed clinical study that prioritises individual health and safety.

    Self-management

    There are many things you can do to manage your OA:

    • Learn about your condition – knowing as much as possible about your OA means that you can make informed decisions about your healthcare and play an active role in managing your condition.
    • Learn a range of strategies to manage your pain – such as heat and cold, muscle relaxation, meditation, visualisation and massage. For more tips on managing pain, check out our online book Managing your pain – an A-Z Guide.
    • See a physio – a physiotherapist can provide you with techniques to improve movement and reduce pain. This can include designing an individualised exercise program tailored to your needs and offering advice on ways you can modify your daily activities.
    • Talk to an OT – an occupational therapist can advise on pacing yourself and managing fatigue, as well as how to modify daily activities both at home and work to reduce strain and pain on your joints.
    • Grab a gadget – things such as walking aids, long-handled shoehorns and long-handled reachers can reduce joint strain and movements that cause you pain. An OT can give you advice on aids and equipment to suit you. You can also check out some aids available in our online shop.

    Surgery

    For some people with hip OA, when all non-surgical treatment options have failed, and hip pain and reduced hip function impact their quality of life, surgery may be an option. In this case, your doctor may refer you to an orthopaedic surgeon to discuss your options.

    A total joint replacement of the hip is the most common type of surgery for hip OA. It can provide significant pain relief and improved function. However, it’s important to remember that a total hip replacement is major surgery and requires you to commit to months of rehabilitation.

    Contact our free national Help Line

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

    Download this information sheet (PDF).

    More to explore

    Reference

    * Osteoarthritis, AIHW, 2020.

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