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    Musculoskeletal Health Australia
    15/Oct/2024
    Health InformationMSK articles

    I’m walking on sunshine

    “Whooooa, and don’t it feel good!”

    Gotta love the eighties and music from bands like Katrina and the Waves, right?

    And even though we’re no longer in the depths of winter and you can imagine the summer sunshine just around the corner, I’m in Melbourne as I’m writing this and I’m a bit chilly from the quick walk I took round the block. Now back at my desk, I’m certainly feeling brighter than I did 15 minutes ago! Especially with the tune of that song stuck in my head.

    While I was out I couldn’t help but notice how many people were also out for a stroll. It seems that everyone’s rediscovered walking now that  the clouds are parting and the tempreture is set to rise.

    Walking is one of the most positive things to have lingered post the pandemic with people contiuing to put on their walking shoes and hitting the paths. Walking is such a great way to exercise. It costs nothing, it’s suitable for most people, and it gets you out and about.

    It’s a fantastic way to wind down after a long day of work. It can help you relax, especially if you’re feeling stressed or anxious.The fresh air, the exercise, and listening to something interesting – your family, a friend, a podcast or music – it’s a great way to boost your mood.

    If you don’t exercise much, walking might be a good way for you to build up your activity levels – though be sure to talk with your doctor first to get the all-clear. Then start slow.

    Try walking 30 minutes a day on most days of the week and you’ll really notice the health benefits. It can help you manage your pain, lose weight or maintain a healthy weight, it can lift your mood, help you get a good night’s sleep, improve your bone and joint health and increase heart and lung fitness.

    If you can’t walk 30 minutes at a time, break the walking up over your day. Three 10 minute walks, six 5 minute walks…it all adds up.

    And if 30 minutes most days isn’t achievable for you at the moment, set yourself a goal so that it becomes achievable. Think about your daily commitments, your level of fitness, your pain/fatigue levels and all of the other things that affect you day to day. Now create a SMART goal. That’s a goal that is Specific, Measurable, Achievable, Realistic and has a Time-frame that works for you. Read our blog about goal setting for more info.

    Walking tips

    • Wear comfortable, appropriate clothing and shoes. Your shoes should support your feet and have a non-slip sole. Clothes should be loose and/or stretchy enough to allow you to walk without restrictions. And don’t forget a hat on sunny days.
    • Warm up and cool down to prevent injuries or pain. While you might be eager to just get out there it’s important that you take the time to let your muscles and joints warm up. And when you’re close to finishing your walk, take the time to slow it down and give your body the chance to cool down. Don’t forget to incorporate some basic stretches after you’ve warmed up and after you’ve cooled down. Check out these ones from the Arthritis Foundation (USA).
    • Make it social (if you can) – walk with a friend, your family, kids, the dog.
    • Listen to music, audio books, podcasts. Going for a walk by yourself gives you space for some alone time. Listen to something that interests you and relax as you get some exercise.
    • Make walking a part of your regular routine. Go at the same time each day – e.g. before/after work, after lunch.
    • Be mindful while you’re walking. Really take time to be in the moment and experience the walk. How do your feet feel as they connect with the ground? What can you smell? How does the wind feel on your face? This is an opportunity to really connect with what you’re doing and savour every moment.
    • Explore new places. Visit new walking trails, parklands and suburbs. Mixing it up will make your walks more interesting. Comedian and radio host Tony Martin and his partner have spent more than 10 years exploring the streets of Melbourne, with the goal to walk every single street! While your goal doesn’t need to be this challenging, it may inspire you to use google maps or your GPS to discover new and interesting places to walk.
    • Take a water bottle – it can be thirsty work! And depending how far you’re walking, consider taking a small backpack for your water bottle and any other supplies you think may need such as snacks, a map, band aids (just in case) and your phone.
    • Track your walking with a pedometer or fitness activity tracker. This’s a great way to see how you’ve progressed over time. And many of the walking apps allow you to challenge others, so if you can’t physically walk together, you can in spirit.
    • Increase the distance and intensity of your walks over time. To see the health benefits from your walking, you need to push yourself to go further and harder.
    • And if you catch the walking bug (that sounds a little gross but you know what I mean), consider joining a walking or bushwalking group. You’ll meet other people who love walking, explore new places together and get lots of tips and advice to make your walking more enjoyable and challenging.

    Contact our free national Helpline

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

    More to explore

    This isn’t an exhaustive list, but just some of the sites that provide useful info about different walks and trails in Australia.

    CONTINUE READING
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    Musculoskeletal Health Australia
    02/Oct/2024
    Health InformationMSK articles

    Can I avoid getting arthritis?

    We get asked this question a lot! But unfortunately, it’s not a simple ‘yes’ or ‘no’ answer.

    Arthritis is a general term used to describe over 150 different conditions. The more accurate name for them is musculoskeletal conditions, as they affect the muscles, bones and/or joints.

    They include osteoarthritis, back pain, rheumatoid arthritis, fibromyalgia, gout, polymyalgia rheumatica, lupus, osteoporosis and ankylosing spondylitis.

    Around 7 million Australians live with a musculoskeletal condition, including kids. So can you avoid becoming one of them?

    Maybe? Not really? It depends? 🙄

    Because there are many different types of musculoskeletal conditions, the answer depends on various factors.

    For conditions like rheumatoid arthritis, juvenile arthritis, ankylosing spondylitis, and lupus, we don’t really know their cause. Without knowing the cause, it’s hard to prevent something from occurring.

    What we do know is that they’re autoimmune conditions. That means they occur due to a malfunctioning immune system. Instead of attacking germs and other foreign bodies, the immune system targets joints and healthy tissue, causing ongoing inflammation and pain. We don’t know why this happens, but scientists believe that a complex mix of genes and environmental factors is involved.

    At this stage, we can’t change a person’s genetics to prevent them from developing an autoimmune type of arthritis, or conditions like osteoporosis and Paget’s disease, which are also linked to genetics. Many musculoskeletal conditions also become more common as you get older and are more common in women.

    Other health issues, such as diabetes, kidney disease, coeliac disease, and even other musculoskeletal conditions 😫, can also increase your risk of developing a musculoskeletal condition. For example, chronic kidney disease can increase your chance of developing gout, and rheumatoid arthritis increases your risk of developing osteoporosis and fibromyalgia.

    So that’s the bad news.

    The good news is there are things you can do to reduce your risk of developing a musculoskeletal condition. Or, if you develop one, reduce its impact and severity.

    Maintain a healthy weight

    Excess body weight puts more pressure on your joints and increases the stress on cartilage, especially in weight-bearing joints like your hips, knees, and back. For every kilo of excess weight you carry, an additional load of 4kgs is put on your knee joints.

    In addition to putting added stress on joints, fat releases molecules that increase inflammation throughout your body, including your joints. Being at a healthy weight reduces this risk.

    Being overweight or obese is strongly linked to developing osteoarthritis (OA), most often in the knees. Hand OA is also more common in people who are overweight.

    Back pain and inflammatory conditions such as gout, rheumatoid arthritis, and psoriatic arthritis have also been linked to being overweight.

    If you have a musculoskeletal condition, maintaining a healthy weight, or losing weight if you’re overweight, can decrease your pain, allow you to become more active, and decrease your risk of developing other health problems like heart disease and diabetes.

    Quit smoking

    As well as the obvious links to cancer and lung disease, smoking’s linked to back pain, neck pain, rheumatoid arthritis and osteoporosis. Smoking also causes fatigue and slower healing, which can make pain worse. And it can make some medications less effective.

    So quitting smoking has many health benefits. Within weeks of quitting, you’ll breathe easier and have more energy, making it easier to exercise and do your day-to-day activities. Find out more about the impact of smoking and ways to quit for good.

    Stay active and exercise regularly

    Regular exercise is vital for overall good health and keeps you fit, independent and mobile. Being active helps keep your muscles, bones and joints strong so that you can keep moving. It reduces your risk of developing other conditions such as osteoporosis, heart disease, diabetes and some forms of cancer. It boosts your mood, benefits your mental health, helps with weight control and improves sleep.

    Having strong muscles is also essential to reduce your risk of falls.

    Look after your mental health

    Mental health conditions can increase the likelihood of developing some musculoskeletal conditions. For example, people with depression are at greater risk of developing chronic back pain. And living with a painful musculoskeletal condition can have a significant impact on mental health.

    If you’re living with anxiety, depression, or another mental health condition and feel that you’re not coping well, it’s important to seek help as soon as possible. This will ensure you don’t prolong your illness and worsen your symptoms. It becomes harder and harder to climb out of a depressive episode the longer you wait. Similarly, the longer you put off seeking help for anxiety, the more anxious you may become about taking that first step.

    There are many different types of treatment options available for mental health conditions. The important thing is to find the right treatment and health professional that works for you. With the proper treatment and support, they can be managed effectively.

    Get enough calcium and vitamin D

    Calcium and vitamin D are essential to building strong, dense bones when you’re young and keeping them strong and healthy as you age.

    Getting enough calcium each day will reduce your risk of bone loss, low bone density, and osteoporosis.

    Calcium is found in many foods, including dairy foods, sardines and salmon, almonds, tofu, baked beans, and green leafy vegetables.

    Vitamin D is also essential for strong bones, muscles and overall health. The sun is the best natural source of vitamin D, but it can be found in some foods.
    If you’re unable to get enough calcium or vitamin D through your diet or safe sun exposure, talk about calcium and/or vitamin D supplements with your doctor.

    Protect your joints

    Joint injuries increase your risk of getting OA. People who’ve injured a joint, perhaps while playing a sport, are more likely to eventually develop arthritis in that joint. So it’s important to protect against injury by:

    • maintaining good muscle strength
    • warming up and cooling down whenever you exercise or play sport
    • using larger, stronger joints or parts of the body for activities, for example, carrying heavy shopping bags on your forearms, rather than the small joints in your fingers
    • using proper technique when exercising, for example, when using weights at the gym or when playing sports, especially those that involve repetitive motions such as tennis or golf
    • maintaining a healthy weight
    • avoiding staying in one position for extended periods
    • seeking medical care quickly if you injure a joint.

    Drink alcohol in moderation

    Excessive alcohol consumption contributes to bone loss and weakened bones, increasing your risk of osteoporosis. For people with gout, drinking too much alcohol, especially beer, can increase your risk of a painful attack.

    It can also affect your sleep, interact with medicines, and affect your mental health. To find out more about the risks of drinking too much alcohol and how you can reduce your alcohol intake, read ‘Should I take a break from booze?’.

    Manage stress

    While stress on its own is unlikely to cause someone to develop a musculoskeletal condition, chronic stress or a stressful event may be a contributing factor, especially with conditions such as fibromyalgia and back pain.

    It can also cause issues with sleep, mood, increase pain, and make you more prone to flares if you have a musculoskeletal condition. It can then become a cycle of stress, poor sleep, pain and more stress. And this can be a difficult cycle to break.

    But there are things you can do to deal with stress. Try relaxation techniques such as meditation, breathing exercises and visualisation, and avoid caffeine, alcohol and cigarettes.

    Talk to someone – whether it’s a family member, friend or mental health professional, about what’s stressing you out so you can deal with it.

    Talk with your doctor

    If you’ve been experiencing joint or muscle pain, it’s important that you discuss your symptoms with your doctor. Getting a diagnosis as soon as possible means that treatment can start quickly, reducing the risk of joint damage and other complications.

    Final word

    While at this moment in time, we can’t absolutely 100% prevent ourselves from getting a musculoskeletal condition, the good news is that early diagnosis and treatment will give you the best outcomes.

    Treatments for many of these conditions have come a long way in recent years, and most people live busy, active lives with musculoskeletal conditions. 😊

    More to explore

    CONTINUE READING
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    Musculoskeletal Health Australia
    23/Jul/2024
    Health Information

    WalkingBack to Health

    WalkingBack to Health 

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

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

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

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

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

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

    For further information on WalkBack click HERE 

    Contact our free national Helpline

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

    Read more

     

    CONTINUE READING
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    Musculoskeletal Health Australia
    18/Jul/2024
    Health InformationMSK articles

    Seven things you should know about self-care

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

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

    So what is self-care?

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

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

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

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

    Let’s explore them.

    Pillar 1. Knowledge and health literacy

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

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

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

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

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

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

    And never be afraid to ask questions.

    Pillar 2. Mental wellbeing, self-awareness and agency

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

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

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

    Pillar 3. Physical activity

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

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

    Pillar 4. Healthy eating

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

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

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

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

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

    Pillar 5. Risk avoidance or mitigation

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

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

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

    Pillar 6. Good hygiene

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

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

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

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

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

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

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

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

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

    Contact our free national Helpline

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

    More to explore

    References

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

    CONTINUE READING
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    Musculoskeletal Health Australia
    27/Jun/2024
    Health InformationMSK articles

    Painsomnia

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

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

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

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

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

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

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

    Call our Helpline

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

    More to explore

    CONTINUE READING
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    Musculoskeletal Health Australia
    13/Jan/2024
    Health InformationMSK articles

    Make a splash with water exercise

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

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

    Just add water!

    There are so many benefits to exercising in warm water:

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

    What is water exercise?

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

    There are different ways you can exercise in water

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

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

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

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

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

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

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

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

    What if you can’t swim?

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

    Tips for exercising in warm water

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

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

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

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

    Call our Helpline

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

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    Karla Wignall
    12/Dec/2023
    MSK articlesMSK Kids Blogs

    What to expect when taking your child to a physio

    Our child has seen so many specialists and now they have been told to go to a kid’s physio. Are you thinking how will a physio help? Or how will this be any different to any other appointments we have? What do I tell my child they will be doing with them?

    I am Nicole Pates, a Titled Paediatric Physiotherapist and director of Western Kids Health, a paediatric clinic in Perth Western Australia. I have been a Paediatric physio for over 13 years and these are the things I would like you to know about seeing a paediatric physio.

    Children and teenagers, as we all know, are different from adults. Not just physically, but in all of their systems. Their brain is growing and their understanding of their body and how it works is constantly changing. Add into that school, friends and puberty and well, it can be a lot. Let alone managing chronic pain and fatigue on top of this. This is why it is important to work together with a physiotherapist who is experienced in working with kids and teens, who understands growth and development. You can search for a Titled or Specialist Paediatric Physiotherapist, who has undertaken extra study or experience in paediatrics, on the Australian Physio website https://choose.physio/find-a-physio

    For families of children with persistent pain and / or fatigue, finding the right help can be tricky.  You can find a practitioner experienced in working in paediatric pain on the Australian Pain Society website  https://www.apsoc.org.au/Home/wcontent2/60

    Once you have chosen a physiotherapist you will be *hopefully* be on your way to an appointment. You may be required to fill out some questionnaires or forms, prior to your initial appointment, depending on your reason for visiting the physiotherapist.

    Typically, an initial appointment for children with chronic musculoskeletal / rheumatological conditions will be an hour or potentially more. For some families at Western Kids Health, we might sit down for 2 hours with not just physio but also OT and psychology. I encourage you to contact your chosen clinic to find out more about the first appointment. It is important to dress in clothes that are comfortable to move in and take a water bottle if needed.

    Your physiotherapist may ask lots of questions in the first appointment. Not just about your child’s condition, symptoms, history, current team and limitations but also about their strengths, likes and future goals. Your physio will then watch how your child moves and plays, particularly the things they are having trouble with.

    We love watching kids move and figuring out the different reasons as to why they might be having trouble or moving differently.

    Being able to identify the activities that trigger your child’s symptoms, understanding their experience and watching how your child moves will enable your physio to work with you to formulate a plan. This plan should be collaborative and based around your child’s goals such as getting back to school, sport or hobbies. Having pain or fatigue can be so annoying and make moving and doing things difficult. But with chronic conditions, waiting for the pain or fatigue to go away before you get back into things can be an endless waiting game. Your physio will help you get back into doing things in a way that is meaningful, fun and supported.

    Your physio may also provide education around:

    • Symptoms such as pain and fatigue and potential triggers / aggravators
    • Strategies on how to bring awareness to and strategies to minimise triggers and aggravators
    • Why your child may be experiencing pain.
    • How best support your child and their pain journey through supportive language in a progressive mindset

    Your physio will also work hard to understand where your child’s physical function is at present and work out a plan to build on their activity level, strength, balance, movement control and most importantly, function over time. Your physio will support your child (and you!) with a plan for flare ups or set backs.

    Other team members who your physio may recommend supporting you are

    • An Occupational Therapist, who assists your child to minimise the impact symptoms may have on sleep, school and relationships
    • A Dietician to understand your child’s nutrition needs whilst they are growing and create plans to support and meet these needs
    • A Psychologist to build coping skills and resilience and manage mental health symptoms such as low mood, stress or anxiety. This is important as often these symptoms are contributing to or exacerbating your child’s ability to engage in the physical rehab.

    At Western Kids Health we run specialised groups in conjunction with the Arthritis & Osteoporosis Association of WA, including group hydrotherapy and strength and conditioning classes.

    Hydrotherapy and physical conditioning for children with conditions like Juvenile Idiopathic Arthritis is safe and effective. Building strength through range is essential to keep your joints healthy. Your physio will work with you to help your child understand their body’s reactions and sensations as they try new activities. This will help your child build their capacity and understanding of body awareness. Your physio will help explore what movements and types of exercise work best for your child’s body, and most importantly making it fun!

    You should see improvements over time with the right support and if you aren’t seeing those improvements, or your child isn’t reaching their goals, please discuss this with your therapy team.

    Contact our free national Help Line

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

    More to explore

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    Lisa Bywaters
    16/Nov/2023
    Health InformationMSK articles

    When coffee isn’t enough

    Or how to manage fatigue

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

    But fatigue is different.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    FIRST WRITTEN AND PUBLISHED BY LISA BYWATERS IN OCTOBER  2020

    Call our Help Line

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

    More to explore

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    Lisa Bywaters
    21/Jun/2023
    Health InformationMSK articles

    Exercising for bone health

    We all know regular exercise is essential for good health. It can improve the fitness of your heart and lungs, sleep quality, energy levels and mental wellbeing. And it can reduce your risk of developing conditions such as diabetes.

    Exercise is also vital for the health of your bones.

    Like muscle, bone is living tissue that responds to exercise by becoming stronger. People who exercise regularly have stronger bones and higher bone density than those who don’t. This reduces the risk of developing osteoporosis.

    Exercise also increases your balance, coordination and flexibility, which improves your ability to prevent trips and falls. DYK, falls are Australia’s largest contributor to injuries that require a stay in hospital and are a leading cause of injury deaths? More than half of the hospitalisations were due to broken bones (fractures).(1)

    Bones need exercise.

    To understand why exercise is important for bone health, it helps to know how bones work.

    Throughout your life, your bones are constantly changing. This is called ‘remodelling’. Bone cells called osteoblasts build new bone, while other bone cells (osteoclasts) break down and remove old bone. This process is controlled by hormones such as calcitonin, parathyroid hormone, oestrogen (in women), testosterone (in men), and vitamin D.

    From birth to about 25, you build more bone than you lose. Your bones are not only getting bigger as you grow, but they’re also developing their density. This determines how strong they are.

    From about 25 to 50, your bones break down and rebuild at about the same rate. They’re in a state of balance. This is when you’ve achieved your ‘peak bone mass’. Your bones are at their strongest.

    After about 50, you break down more bone than you rebuild. While this means everyone will experience some bone loss as they age, it doesn’t mean everyone will develop osteoporosis.

    Women commonly experience a period of rapid bone loss after menopause. This is due to a drop in oestrogen levels. It’s estimated that the average woman loses up to 10% of her bone mass in the first five years after menopause.(2)

    For good bone health, exercise is vital for everyone – from the very young to the very old.

    A combination of different exercises is best for bone health.

    Different exercises challenge and strengthen your bones and muscles in different ways, so you should include the following in your exercise plan:

    Weight-bearing exercises or activities where your body carries its own weight. These exercises put stress on your bones, making them stronger and denser. It also strengthens the muscles around your bones, providing support and reducing the risk of fractures. Weight-bearing exercises include brisk walking, climbing stairs, tennis, and netball.

    High-impact exercises such as jogging, running, jumping, and skipping rope. They’re also weight-bearing exercises, but they place greater stress on the bones of the spine and legs as your feet hit the ground. This can provide more bone-strengthening benefits; however, these exercises aren’t suitable for everyone.

    Resistance training, also known as strength training, uses resistance or weights to strengthen your muscles by working them harder than you do in everyday life. The strong muscle contractions required to move a heavy weight place stress on the bone where the muscle attaches. When bone feels this strain repeatedly, it responds by becoming stronger. Resistance training uses equipment like free weights (e.g. dumbbells), gym machines, elastic resistance bands or your body weight (e.g. push-ups, squats).

    Balance and flexibility exercises such as tai chi and yoga improve balance and mobility and can reduce your risk of falling. This is important for preventing fractures.

    Before beginning an exercise program, speak with your health professional. Not all types of exercise are suitable for everyone. This is especially important if you have other health conditions, including osteoporosis. A physiotherapist or exercise physiologist can assist you with a safe exercise program that targets your specific needs and reduces your risk of injury.

    Exercise must be regular and ongoing.

    You need to exercise regularly to have a significant benefit, so you should choose activities you enjoy. This will make it easier to exercise consistently.

    Australian physical activity and exercise guidelines recommend that all adults be active most days, preferably every day, for 30 minutes or more. This includes at least two sessions of strength training every week. However, when you’re just beginning, this can seem daunting.

    That’s why it’s good to know you don’t have to do all your exercise in one session. For example, a 30-minute brisk walk can be broken up across your day into shorter, more achievable sessions, such as three 10-minute or six 5-minute walks.

    You can do other things to make exercise a regular, ongoing activity.

    Exercise with a group or a partner. This can improve your motivation to exercise and provides an opportunity for socialising with others.

    Exercise SMART and set goals. A clear goal can motivate you to stay on track with your exercise program. But they must be realistic and specific to your abilities, needs, and health issuehttps://muscha.org/goals/s. So, ensure your goal is SMART – Specific, Measurable, Achievable, Realistic and has a Timeframe.

    For example, a good SMART goal for resistance training for stronger bones and muscles could be: “I will perform resistance exercises, such as lifting weights or using resistance bands, for 30 minutes, twice a week, for the next three months.”

    This goal is Specific (focuses on resistance training), Measurable (30 minutes, twice a week), Achievable (realistic for most people), Relevant (aimed at improving bone and muscle strength), and has a Timeframe (three months).

    Constantly evaluate your goals, adjust them as needed and reward yourself for your successes.

    Add variety. Vary where you exercise and the type of exercise you do. Include recreational activities such as bushwalking or dancing. This will help keep your mind fresh and your motivation high. Find activities that are enjoyable to you so that you’ll be motivated to continue doing them.

    Exercise within your capabilities. Often, people drop out of exercise programs because they exercise at a level beyond their current capabilities. Ensuring your exercise program suits your current abilities will decrease your risk of injury and increase your enjoyment and motivation to continue your exercise program.

    Challenge yourself. Increase the intensity of your exercise as your fitness improves. It’ll make your exercise more interesting and also has greater health benefits.

    Stop if you have pain. Don’t continue exercising if you experience pain or severe discomfort. Talk with your fitness professional for advice to ensure you’re not doing an exercise incorrectly.

    Bone health doesn’t happen in a vacuum.

    As well as exercise, you need to also to eat a nutritious diet with calcium-rich foods, get sufficient sun exposure for vitamin D, take medicines or supplements as prescribed by your doctor, quit smoking, and moderate your use of alcohol, caffeine, and salt intake, as they can impact bone density.

    Contact our free national Help Line

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

    More to explore

    References

    (1) Falls. Australian Institute of Health and Welfare.
    (2) Osteoporosis, Australasian Menopause Society

    CONTINUE READING
    dodgy-knee.jpg
    Lisa Bywaters
    18/May/2023
    Health InformationMSK articles

    Got dodgy knees? Find out what helps.

    Do you have osteoarthritis in your knees? Does the pain sometimes interfere with your ability to be as quick or mobile as you’d like? If so, you’re not alone – it’s a big club!

    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 because it’s so common and causes lots of pain and distress, we’re all looking for effective treatments to manage the pain and keep moving.

    The good news is there’s strong evidence about the most effective treatments for knee OA, those that aren’t effective, and those that don’t have enough evidence to support their use.

    And yet, a recent study has shown an increasing number of people with OA are investigating some less effective treatments such as stem cells, platelet-rich plasma, and Botulinum toxin.

    There are likely many reasons for this.

    We’ve become much more familiar with searching online for information during the pandemic.

    Information about the effectiveness (or not) of treatments isn’t always translated for consumers. And unfortunately, to access much of this information, you need access to journals and databases that are often behind a paywall.

    Another problem is that it’s easy for anyone to create a video, blog, or social media post about the latest and greatest treatment without using current evidence. Their reasons for doing so can be many – from sharing personal experiences in the hopes of helping others to purely commercial gain. This info is everywhere online, easily accessible and often looks legitimate.

    So you need to weigh any information carefully, be cautious and discuss your options with your doctor.

    Here’s a snapshot of what we know works (or doesn’t) for knee OA

    Staying active and exercising regularly

    You had to know this was coming 😉. Research has repeatedly shown that exercise is key in managing knee OA (and other musculoskeletal conditions). A tailored exercise program developed by a physiotherapist or exercise physiologist can help reduce knee pain and improve knee function. 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.

    Managing your weight

    Being overweight or obese is directly related to the risk of developing knee OA. It’s also 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. But weight loss can be a long process for many people. And it’s challenging, especially when pain affects your ability to be as active as you’d like. However, it’s good to know that any weight loss can reduce your pain and increase your ability to exercise. So making small, achievable changes to your eating and exercise habits can bring big results. If you’d like to lose weight to improve your symptoms, your doctor and/or dietitian can assist you in losing weight safely.

    Dealing with stress and your emotions

    It’s natural to feel stress, anxiety and frustration when living with chronic pain. However, if you’re always fearful or worried about it, it can worsen your pain. That’s because pain isn’t just a physical sensation – it also involves your perceptions, feelings and thoughts.

    The worse you think your pain will be, the worse it can feel. It can affect your sleep, and you become less active. These feelings, thoughts and behaviours can become a vicious cycle.

    Talking with a family member, close friend, or a health professional about how you’re feeling can get it out in the open so you can start dealing with these feelings and hopefully break this cycle.

    Strategies like breathing exercises, cognitive behavioural therapy (CBT), meditation, heat, and gentle activities like tai chi, walking, swimming, and cycling can also help you control your stress and anxiety.

    What about medicines?

    No medicine can affect the underlying disease process of OA. Still, combined with self-care and lifestyle changes, medicines may provide temporary pain relief and help you stay active.

    There are a variety of medicines used in the management of knee OA, and each comes with varying degrees of evidence to support their use. They may be taken by mouth as a tablet or capsule (orally), applied directly to the skin in the form of gels and rubs (topical), or injected into the joint (intra-articular). Discuss the benefits and risks with your doctor if you’re interested in the following medicines.

    Non-steroidal anti-inflammatory medicines or NSAIDs (e.g. Nurofen, Celebrex, Voltaren). Depending on the dosage and other ingredients, NSAIDs are available over-the-counter or with a prescription. Oral NSAIDs are the preferred first-line drug treatment for OA and have been shown to reduce pain and symptoms in knee OA.

    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 compared to a placebo in knee OA. However, some people report that it helps reduce their pain so 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.

    Some medicines aren’t effective

    Other medicines have been used for OA in the past that we now know aren’t effective and may have harmful side effects.

    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 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 knee OA.

    Capsaicin. Capsaicin is the active ingredient in chilli peppers – it makes them ‘hot’. Capsaicin in creams and lotions has been used to help reduce OA pain, and some people report beneficial effects. However, evidence for its effectiveness in knee OA is low, and it’s generally not recommended. It also has side effects when applied, such as a burning sensation, which can take several uses to wear off.

    Glucosamine and chondroitin. Studies have found no benefit from taking glucosamine and/or chondroitin for osteoarthritis.

    The pointy end of the stick – intra-articular injections

    Intra-articular injections are given directly into the knee joint. They include steroids, platelet-rich plasma, stem cells, hyaluronic acid and Botulinum toxin. Let’s look at them a bit more closely.

    Corticosteroid injections. If you have persistent knee 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. 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. There’s also emerging evidence that long-term use of these injections may cause OA to worsen in the affected joint.

    Hyaluronic acid injections. The benefits of hyaluronic acid joint injections (also known as viscosupplementation or hyaluronan injections) are uncertain. Research findings have been inconsistent, and although some people find the treatment helpful, it can be expensive and isn’t generally recommended. The Australian Rheumatology Association states, “emerging evidence indicates that the effect of hyaluronic acid could be smaller than previously reported.”

    Platelet-rich plasma (PRP) injections. Platelets are small cell fragments in the blood that help form blood clots to slow or stop bleeding and help wounds heal. PRP is a concentrated version of a person’s platelets injected into the affected joint. An Australian clinical trial led by researchers at the University of Melbourne, University of Sydney and Monash University has found that PRP was no better than a placebo at reducing symptoms in people with knee OA.

    Stem cell injections. Despite being commercially available, there’s no evidence for using stem cell injections in treating knee OA. The International Society for Stem Cell Research and the Australian Rheumatology Association do not support using stem cell injections for osteoarthritis.

    Botulinum toxin injections. The American College of Rheumatology/Arthritis Foundation Guidelines states that the small number of trials that have looked at the use of botulinum toxin in knee and hip OA ”suggest a lack of efficacy”.(1)

    What about surgery?

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

    A total joint replacement of the knee is the most common type of surgery for knee OA. However, having an artificial knee means there will still be some limitations. An artificial knee won’t have the same sideways movement as a natural knee. It won’t bend fully, so getting down and up from kneeling is more likely to be challenging.

    Arthroscopy is a surgical technique that involves the insertion of small surgical instruments, including a camera, into the knee. This allows the surgeon to examine the inside of the joint and cut, shave and remove material from the inside of the knee joint. “The Australian Government and most orthopaedic surgeons recommend against using arthroscopy for osteoarthritis of the knee. Research shows that doing an arthroscopy for this condition isn’t effective. Arthroscopy should only be used for knee OA if other treatments fail, such as losing weight, exercising and taking pain relievers.” (2)

    Contact our free national Help Line

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

    More to explore

    References

    (1) Kolasinski, S.L., et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis & Rheumatology (2020).
    (2) Arthroscopy, Healthdirect

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