MSK articles - Musculoskeletal Health Australia (MHA)

16/Jun/2022

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.

More to explore

Check out our recipes page
The recipes have been created by our volunteers including an Accredited Practising Dietitian, a Master of Dietetics student and a Registered Clinical Nutritionist.
100 budget family meals under $5 a serve
Australia’s Best Recipes
50 healthy dinners on a budget
Taste
Budget recipes
Jamie Oliver
Easy wins: imperfect produce – the perfect solution to food waste
The Guardian
Four tips to cut grocery costs while prices skyrocket
Money
Fruit and veggie price hikes are hurting household budgets. Experts say shopping seasonally could save you money
ABC
How to save money on groceries
Canstar
How to save money on groceries: the best value fresh produce in Australia this May
The Guardian

Lisa Bywaters

16/Jun/2022

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

More to explore

10 ways to make lifestyle changes easy
Center for Healthy Eating and Activity Research, UC San Diego School of Medicine
Changing your habits for better health
National Institute of Diabetes and Digestive and Kidney Diseases
Creating healthy habits
healthdirect
Small changes for a big impact on your health
Brigham Health Hub

Lisa Bywaters

25/May/2022

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

More to explore

Temporomandibular disorders
MSD Manual Consumer Version
Temporomandibular joint (TMJ) anatomy and disc displacement animation
Alila Medical Media (video)
Temporomandibular joint (TMJ) disorders
Cleveland Clinic
Temporo-mandibular joint (TMJ)
The Royal Victorian Eye and Ear Hospital
Temporomandibular joint dysfunction
healthdirect
TMD (temporomandibular disorders)
National Institute of Dental and Craniofacial Research
TMJ disorders
Mayo Clinic
Why do I grind my teeth and clench my jaw? And what can I do about it?
The Conversation

Reference

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

Lisa Bywaters

25/May/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

Medicare telehealth services – Consumer information
Australian Government
Telehealth
Australian Digital Health Agency

Lisa Bywaters

04/May/2022

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:

increasing age
a past injury, trauma or surgery involving the joint
osteoarthritis
family history of the condition
having conditions such as haemochromatosis and hyperparathyroidism.

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

More to explore

Acute CPP crystal arthritis (pseudogout)
Versus Arthritis
Gout
Versus Arthritis
Gout and pseudogout
Safer Care Victoria
Gout or pseudogout
Arthritis Foundation
Gout
Arthritis Society
Patient education: Calcium pyrophosphate crystal deposition (CPPD) disease (Beyond the Basics)
UpToDate
Patient education: Gout (Beyond the Basics)
UpToDate
Pseudogout
Arthritis Society
What is pseudogout, and how does it differ from gout?
Medical News Today

Lisa Bywaters

04/May/2022

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:

8 May – World Axial Spondyloarthritis Day
10 May – World Lupus Day
12 May – International Fibromyalgia Awareness Day
20 May – World Autoimmune Arthritis Day.

October also has its fair share:

12 October – World Arthritis Day
20 October – World Osteoporosis Day
31 October – Rattle Ya’ Bones Day.

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

More to explore 😉

World Sword Swallowers Day (26 Feb)
World Storytelling Day (20 Mar)
World Party Day (3 Apr)
World Juggling Day (18 Jun)
International Kissing Day (6 Jul)
International Talk Like a Pirate Day – 19 Sep
International Coffee Day (1 Oct).

Lisa Bywaters

13/Apr/2022

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

More to explore

23 ways to revamp your night-time routine
HealthLine
Bedtime routines for adults
Sleep Foundation
Getting a good night’s sleep
Musculoskeletal Australia
How to build the perfect wind-down routine
Sleepstation
How to create a bedtime routine for way better sleep
TechRadar
How to design a better bedtime routine
Sleep.org
How to sleep like a baby as an adult: Steal the bedtime routine of a toddler
Inc
Science says having a regular bedtime is healthy for adults, too
healthline
Sleep problems as a risk factor for chronic conditions
Australian Institute of Health and Welfare

Reference

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

Lisa Bywaters

24/Mar/2022

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

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

Managing your pain: An A-Z guide
Musculoskeletal Australia
Osteoarthritis (OA) of the hip
Versus Arthritis
Osteoarthritis of the hip
American Academy of Orthopaedic Surgeons
Osteoarthritis of the hip
Arthritis Foundation

Reference

* Osteoarthritis, AIHW, 2020.

Lisa Bywaters

24/Mar/2022

We have a long and complex relationship with opioids. Humans have been actively growing poppies and enjoying their medicinal benefits since at least 3,400 B.C. The Sumerians referred to it as Hul Gil or the ‘joy plant’.

However, we now know that while these medicines can provide significant pain relief when used appropriately, they can also cause great harm.

Did you know that every day in Australia, nearly 150 people are hospitalised, and 3 people die due to issues related to opioid use? (1)

That’s why in 2020, the Australian Government made changes to how we use and access opioids.

What are opioids?

Opioids are pain-relieving medicines that come in various formulations, dosages and strengths. They include tramadol, codeine, morphine, oxycodone and fentanyl.

There are two groups of opioids:

opiates – created using the milky substance found inside the pods of the opium poppy, and
synthetic or man-made opiods – created in a laboratory using chemicals.

Opioids can be taken as tablets, injections or patches on the skin.

How do they work?

Opioids attach to opioid receptors in the nervous system and slow down the messages between the body and brain, including pain messages. This dulls your perception of pain – it’s not gone, nor is the cause of the pain. It’s simply been dampened so that you can function with less discomfort. They also cause the brain to release the hormone dopamine, making you feel happy or relaxed.

However, opioids can also slow your heart rate and breathing.

Opioids are used to treat severe pain associated with cancer or acute pain, for example following surgery.

They’ve also been used for many years to help people with severe, persistent non-cancer pain, like the pain associated with musculoskeletal conditions.

However, extensive research now shows that opioids don’t provide ‘clinically important improvement in pain or function compared with other treatments’ for most people with persistent pain or chronic pain.(2) This research, combined with our knowledge of the serious side effects of opioid medicines, particularly with long-term use, mean that these medicines should be used with caution.

Side effects

All medicines have side effects, so it’s important to know what they are. Side effects of opioids include sleepiness, constipation and nausea. More serious side effects include shallow breathing, slowed heart rate and loss of consciousness. These serious side effects may be due to too many opioid medicines being taken (an overdose). This can be life-threatening, so you need to ensure that you know when and how to take your medicines to prevent an accidental overdose.

Addiction is also a possible side effect of opioids.

Opioids, when taken long-term, can also make you feel more pain. This is called opioid-induced hyperalgesia. It happens because opioids make the brain and nerves more sensitive to pain.

Tolerance, dependence and withdrawal

Your body adapts to opioids when you use them long-term. This is called tolerance. To get the same pain relief, you need to increase the dosage. However, it’s not safe or sustainable to continue to increase the dosage of opioid medicines because of the serious risk of harm associated with their long-term, high-dosage use.

Dependence is when your body requires a specific dose of the medicine to avoid withdrawal symptoms when the dose is reduced or stopped. Symptoms of withdrawal can include: disturbed sleep, hot and cold flushes, sweating, feeling anxious or irritable, cravings for opioids, nausea, vomiting, diarrhoea, lack of appetite and tremors.(3) You’re more likely to experience withdrawal symptoms if you’ve been taking opioids for a long time and/or taking high doses.

Your doctor will slowly reduce your dosage to lessen your risk of withdrawal symptoms. This is called tapering.

Using opioids safely

Because of the risks associated with their use, opioids aren’t a first-line treatment for managing pain associated with musculoskeletal conditions. Instead, your doctor may suggest strategies such as exercise, maintaining a healthy weight, cognitive behavioural therapy (CBT), heat and cold packs, distraction, and short-term use of medicines such as paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs).

If you are prescribed opioids, it’s important that you:

take them as prescribed
don’t drink alcohol while you’re taking them
don’t change the dosage or stop taking them without discussing this with your doctor – you may need to reduce your dosage gradually
talk with your doctor about other medicines or supplements you’re taking – some may not be able to be used at the same time you’re taking opioids
let your doctor know about any side effects you experience
discuss other options you can use to help manage your pain with your doctor – for example, gentle exercise, CBT, heat and cold.

While using opioid medicines, you should also monitor whether or not they’re working for you. If you’re still experiencing severe pain that’s affecting your quality of life and ability to do daily activities, discuss this with your doctor. Together you can look at alternative treatment options.

Finally – it’s important to understand that opioids reduce our perception of pain. They don’t ‘kill it’, because there’s no such thing as a ‘pain killer’. Medicines and other strategies such as heat and cold, exercise, distraction and CBT can help you reduce pain to levels that enable you to live a healthy and happy life.

Contact our free national Help Line

More to explore

Managing your pain: An A-Z guide
Musculoskeletal Australia
More changes to opioid access
Musculoskeletal Australia
Opioid medicines and chronic non-cancer pain
NPS MedicineWise
Patient guide to managing pain and opioid medicines
Choosing Wisely Australia
Prescription opioids: Information for consumers, patients and carers
Therapeutic Goods Administration
Prescription opioids: What changes are being made and why
Therapeutic Goods Administration
What are opioids?
Alcohol and Drug Foundation

References

Prescription opioids: What changes are being made and why
Therapeutic Goods Administration
Prescription opioids: Information for consumers, patients and carers
Therapeutic Goods Administration
Opioid withdrawal symptoms
Healthdirect

Lisa Bywaters

24/Mar/2022

Do you get to the end of your day and wonder where all your time went? Between work, family commitments, random phone calls, catching up with friends, walking the dog, feeding the cat and endlessly scrolling through socials, your day has flown by, your to-do list has barely been touched, and you still need to scrounge up something for dinner?

If this sounds familiar, I’m right there with you 🙃. Adjusting to our ‘new normal’ is taking a bit of getting used to. Finding the right balance between work and home life, commuting to the office (or moving from my couch to my desk 😉) is challenging. And my routine, once the foundation of my day, is in tatters and needs some help.

Why do we need routine?

When so much is out of our control, developing a morning routine can help you gain some control so you can do the things you need to do in your day. This boosts your confidence, makes you feel more positive and reduces feelings of stress.

Having a morning routine allows you to plan and prioritise activities so that if things go pear-shaped – as they sometimes do – your most important activities have (hopefully) been accomplished. And having a regular routine means you’re less likely to forget something, which is especially helpful if you’re feeling a bit ‘foggy’.

So how can you create (or update) your morning routine?

First, let’s start with the foundation of your morning routine – getting a good night’s sleep. We all know what it’s like when we haven’t slept well. We drag ourselves through the day, bleary-eyed and unfocused. But we also know that getting a good night’s sleep can sometimes be tough when you live with a musculoskeletal condition and persistent pain. Fortunately, there are many things you can do to improve your sleep quality and quantity, and wake up feeling refreshed. Read our article on sleep for info and tips.

The next step is planning. For your morning routine to be effective and have a positive flow-on effect for the rest of your day, you need to be prepared and have a plan. This may include:

Getting things ready the night before. Do whatever you can at the end of your day so that your mornings are less hectic. For example, check the weather and decide what you want to wear the following day; prep healthy breakfasts/lunches/snacks so you can just grab them as you head out the door in the morning.
Make a list of the things you need to do in the day and prioritise them to know what absolutely needs to be done. Include appointments, exercise, work/school/family/social commitments and recreation.

Now it’s time to get moving.

When the alarm goes off, it’s tempting to hit the snooze button, but resist the urge! Endlessly hitting snooze will make you lose valuable time, and it could also affect your health. Find out how.
Build extra time into your morning routine in case you wake up feeling blah. The extra time will also make you feel less rushed and stressed.
Do some gentle stretches while in bed to warm up and loosen stiff muscles and joints.
Have a warm shower for the same reason. It’ll also help clear your head and wake you up fully.
Sit down and eat a healthy breakfast and drink some water.
Take your medications (if required).
Do some exercise. Take your dog for a walk, do some yoga, hit the gym, go for a swim. Whatever exercise you enjoy and you’re committed to doing, do it. Not only will it help you manage your condition and health overall, exercising in the morning improves your concentration, energy levels and mood.
Do something nice for yourself. Try mindfulness meditation, deep breathing, practising gratitude, listening to upbeat music, hug your partner/kids/pet. Choose something that makes you happy and puts a smile on your face as you start a new day.
Review your day ahead so you know what to expect, what you need to do, what things to take with you etc.
Set up alerts or alarms on your phone or computer to help you stay on track with your day.

Making your routine stick

Once you’ve established your routine, you need to be consistent and stick to it. That way, it’ll become second nature.

And be flexible. Sticking to your morning routine as often as possible is great, but you’ll also need to learn to be flexible if something unexpected happens.

When it’s all said and done, routines may sound boring, but they’re a great way to stay on top of your commitments and get to the end of the day feeling accomplished and relaxed. So if you struggle to achieve all of the things you set out to do each day, why not try a couple of these strategies to see if they can help? You’ve got nothing to lose and so much to gain.