fatigue - Musculoskeletal Health Australia (MHA)

16/Nov/2023

Or how to manage fatigue

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

But fatigue is different.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

FIRST WRITTEN AND PUBLISHED BY LISA BYWATERS IN OCTOBER 2020

Call our Help Line

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

More to explore

I’m a “spoonie.” Here’s what I wish more people knew about chronic illness
healthline
A great way to describe what it’s like to have limited energy to family and friends who want to understand.
Fatigue
Better Health Channel
Fatigue and arthritis
Arthritis Society (Canada)
Managing fatigue
Versus Arthritis (UK)

Musculoskeletal Health Australia

24/Oct/2023

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

So what can you do?

Avoid using technology in bed. The blue light from laptops, tablets and smartphones suppresses the hormone melatonin, which makes us sleepy at night. So be sure to stop screen use at least one hour before bed.
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.
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.
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.
Try some relaxation techniques. There are as many ways to relax as there are stars in the night sky (well, almost) so there’s bound to be something that suits you. Consider trying mindfulness, visualisation, deep breathing or a warm bath before bed. These techniques will help you become more relaxed and may help you manage your pain better so that when you go to sleep, you sleep well.
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.
Seek help. If pain is constantly keeping you awake at night, talk with your doctor about other things you can do to manage your pain and get some decent sleep.

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

First written and published by Lisa Bywaters in June 2018

Lisa Bywaters

23/Mar/2023

And how to do it right

“Let’s begin by taking a smallish nap or two.” – Winnie the Pooh

Ever had one of those days when you wake up feeling like you need a nap??

Days like that make me want to be just like Winnie the Pooh. He has it all worked out. Lots of honey, good friends and naps. I’m sure my spirit animal is a small, round-ish teddy bear who lives in the Hundred Acre Wood .

However, unlike Pooh Bear, many people with chronic pain crave a nap during the day because of poor sleep quality, not because they’re relaxed and full of honey. Chronic pain and sleep issues often go hand in hand.

In our report: Making the invisible visible: Australians share the impact of musculoskeletal conditions on their lives almost three-quarters (72%) of the people who took part in our survey said their sleep was affected by their condition. One person said: “I sleep very little due to pain, so find myself very tired during the day, which makes it harder to manage the pain.”

So should we follow Pooh’s advice and “when all else fails, take a nap”?

It depends.

Sleeping is a complicated business. There’s so much we still don’t know about it.

However, we do know that sleeping too long or too often during the day can make getting a good night’s sleep even harder. And it can exacerbate your pain and make you feel stiff and sore.

But sometimes, when you’re battling pain and fatigue, a nap is exactly what you need. So what can you do? How do you find the right balance?

Tips for napping

First, listen to your body. You know it better than anyone else. So if you’re exhausted and know you won’t make it through the day, or the commute home without falling asleep, listen to your body and take a nap.

That being said, sleep experts recommend that you:

Limit your nap to 20 minutes or less – aka a power nap. Any longer and your body enters a deeper state of sleep from which it’s harder to wake – and when you do wake, you’ll most likely feel groggy. Limiting your nap to less than 20 minutes reduces this risk, and you’ll wake up feeling rested.

Nap in the early afternoon. After lunch, most of us tend to feel a bit fuzzy and unfocused, but when you combine that with fatigue or sleep problems, it can be tough to keep your eyes open. This is the perfect time to lay your head down for a short time. But avoid late afternoon napping, as this will interfere with your overnight sleep.

Maintain good sleep habits. That means going to sleep at the same time each night and getting up at the same time each morning. This helps your body clock find a rhythm that works best for you. Read our information on sleep to find out more.

Only nap occasionally, not as a daily practice. Experts recommend that you only take a nap when you really need one so it doesn’t start affecting your night time sleeping patterns. An exception is when you’re going through a flare, or you’re unwell, as naps may be required more often to help you recover. But once you’re better, go back to your usual sleep routine.

Set an alarm. This is important because once you’ve nodded off, you’ll need help to wake up, especially if you’re exhausted. But 20 minutes is the sweet spot for napping, and you need to stick to it. So set your alarm.

Find a comfy place to nap – preferably not your bed. If you’re in bed, sleeping longer than planned is far too easy (trust me) 😴. Even with an alarm set, it’s too easy to hit snooze (it’s so comfy and you’re so tired). So nap on the couch, in a supportive armchair or at your desk if you have some supports to keep you comfortable and not put a crick in your neck or back or aggravate your condition.

Turn off your TV, radio, computer etc. Put on an eye mask and/or earplugs if you need to block out light or noise. If your phone is your alarm, set it to airplane mode so you only get the alarm and nothing else. Because if you’re going to nap and enjoy the benefits, you need to block out all other distractions.

When you wake up, take some time to stretch or do some gentle exercises to help you loosen up. After being still for a while, your muscles and joints may become stiff and painful. So take a little time to get yourself going again. And drink a glass of water to rehydrate.

Talk with your doctor if you find you need a nap every day. It may indicate that your musculoskeletal condition, medicines or another health condition is interfering with your sleep or causing drowsiness. Together you can explore these possibilities so that you can come up with a plan to get it under control.

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

Getting a good night’s sleep
Musculoskeletal Australia
How to sleep well despite chronic pain
Pathways
Nanna naps
Sleep Health Foundation
Napping
Sleep Health Foundation
Painsomnia
Musculoskeletal Australia
When coffee isn’t enough: Or how to manage fatigue
Musculoskeletal Australia

Lisa Bywaters

13/Oct/2022

Tips to help you sweep away winter

Spring is such a wonderful time of year 😊🌼. The mornings are becoming lighter, the weather’s improving, and the smell of spring blossoms is in the air. So take a moment to breathe it in – you’ll definitely feel a lift in your mood (unless you have allergies – sorry about that 🤧).

It’s also the perfect time to do a bit of spring cleaning; of your home, office, garden or garage. Especially if, like me, you open the blinds on a sunny day and the sunlight highlights every dust bunny, dirty surface, and pet hair tumbleweed 😮.

But cleaning and reorganising can take a toll when you live with a musculoskeletal condition, chronic pain, and fatigue. So we’ve got some tips to help you clean without overdoing it.

Planning, prioritising and pacing

First, make a plan. You can’t do everything at once. So write down all of the things you want to do.

Now prioritise the jobs. What’s most important? And when you consider this, remember your home doesn’t need to be a glossy magazine or Pinterest version of ‘perfect’. That takes a lot of styling, filters, and constant effort. It just needs to be your version of ‘perfect’ – comfortable and cosy for you and whoever you live with.

And finally, pacing. Take your time when you tackle your cleaning. Break it into smaller tasks. For example, don’t try to organise and clean your entire bedroom cupboard in one go. Go small. Deal with your shoes one day; the next day, you can focus on the things stored on shelves, and so on. Make it achievable and realistic for you and how you’re feeling.

Take breaks

We’re often tempted to get as much done as possible while we’re feeling good or motivated. But you need to take breaks so that you don’t overdo it. Otherwise, before you know it, your back’s sore, you can’t move your neck, and exhaustion hits you like a sledgehammer.

Set an alert on your phone to prevent this from happening. Give yourself a specific time to work and take a break when the alert chimes. Do some stretches, drink water, go outside for some air and vitamin D, or have a healthy snack if you’re hungry.

And if you find yourself getting tired, or starting to ache before the alert goes off, listen to your body readjust your timing, and take an earlier break.

Taking regular breaks, rather than pushing through, will leave you feeling much better at the end of your cleaning session.

Get the right tools for the jobs

Lightweight brooms, mops and vacuums make life much easier, especially if you have stairs or a large space to clean. Upright or robotic vacuums can be helpful as you don’t need to bend over a lot, especially when compared with barrel vacs. Just be aware of where the robots are so you don’t trip over them 😐!

Use an upright dustpan to sweep up crumbs, fluff and other debris from the floor. They require minimal bending, which is great if you have a sore back or get dizzy when you bend over.

Long-handled dusters can help you reach high places, especially if stretching or reaching your arms above your head is painful. If you don’t have one, you can attach your duster to a piece of dowel or a ruler to give you the extra length. Or even better, get someone else to do the dusting!

And don’t forget to use your reacher, grabber or other pick-up tools if you have one. They’re not just handy for retrieving something you’ve dropped but also for cleaning. You can pick up stray toys, socks and other items from the floor and retrieve light objects from high shelves.

Choose your battles

If you need to vacuum but aren’t up to doing your entire home, don’t. Just do the high-traffic areas. Or a high-traffic area. If your bathroom needs cleaning, do the high-use areas. Your shower screen doesn’t need to sparkle, but you do need clean towels and a clean sink.

Let the cleaning products do the hard work

Have you ever read the instructions on your cleaning products? Or do you just spray and wipe away? I’m definitely guilty of that! But many cleaning products need time to work on the grunge and grime. Then you can wipe it and the dirt away with far less effort. It’s also good to know that you don’t need separate multipurpose, kitchen and bathroom sprays. Choice has tested many of these products and found that they basically work the same. So you can save your money and cupboard space and just buy one.

Beware of dust and toxic smells

Many people with musculoskeletal and other chronic conditions are sensitive to chemicals, strong smells and/or dust. Some alternatives to the usual cleaning products include bi-carb soda, vinegar, tea tree oil, lemon juice and water. Many websites provide details for making your own cleaning products. There’s also a large range of more natural and plant-based cleaning products you can buy online and from the supermarket.

As far as dust goes, dusters often just move it from your surfaces to the air around you. Use a slightly damp cloth over surfaces to remove dust, and rinse it frequently. Or use an electrostatic duster that attracts and holds onto the dust.

Recycle old socks

I’ve recently discovered that old socks are perfect for many cleaning jobs around the house. You can put one on your hand and wipe down furniture, clean skirting boards, shutters, blinds, ceiling fans and even your indoor plants. When you’ve finished, you can remove the sock from your hand by pulling it off inside-out, and the dust and grime stay off your hand.

You can also put some potpourri or lavender into a sock, tie or sew the end shut, and stick it in the back of your closet, drawers, and other closed-up spaces you want to freshen up. 😊🌸🌻🌼🌷

Use your dishwasher for more than dishes

Did you know you can clean plastic toys, thongs, metal keys, exhaust covers, scrubbing brushes, and even dog toys in your dishwasher? Check out this article: Can you wash it in the dishwasher? The big list of things you can and can’t wash in the dishwasher from Choice for more info.

Consider reorganising your pantry, laundry or kitchen

These are the areas we use a lot. And they often have heavy things we use regularly – e.g. packets of rice, canned goods, pots and pans, detergents and cleaning products. Put these heavy items at waist level (if you have the space) so you aren’t constantly bending or stretching to access them. Check out Pinterest for ideas and inspo.

Get some wheels

A basket of wet washing or a bucket full of water can be really heavy. Instead, use a laundry trolley or a mop bucket with wheels.

Repackage it

We often buy cleaning products in bulk as it tends to be cheaper. But that can end up being several kilos or litres. So when you buy a big box or bottle of cleaning products, put a quantity into smaller, easier-to-use containers. You can top them up when you need to. And make sure you label the new containers clearly.

Alternate your cleaning activities

If you’ve spent some time doing physically tiring cleaning, take a break and do something more passive, like sitting at your desk and cleaning out your email inbox or reviewing receipts for your tax return. Or take a break and read a book or do some guided imagery. Then when/if you feel up to more physical work, you can go back to it. The important thing is you’ve given your body a chance to rest.

Get the family involved

This is obvious, but often such a drama that many of us just end up doing the chores ourselves 😑. But that’s not sustainable. Also, as everyone contributes to the mess, everyone needs to contribute to the cleaning. Read ‘How to divide chores around the home and get kids involved’ from RACV for some tips.

De-clutter

When we have a build-up of clutter and everyday things invading our space, they can become a trip hazard. Here are some ways to tackle the mess.

Make a plan and start small.
Organise the clutter by putting ‘like’ things together. For example, in your linen cupboard, put all your towels together in one group, bedsheets in another etc.
Decide what you want to keep and what’s just taking up valuable space. Then you need to decide what to do with the things you no longer want. So donate, give away, sell, and repurpose what you can. Or if it’s damaged/worn out/soiled/beyond repair, recycle or throw it away.

Hire someone

This isn’t an option for everyone or for every time, but there might be occasions you decide it’s worth the cost. Consider hiring a local handyperson/business to help with your lawns/gardening or cleaning your carpets, curtains or blinds.

Distract yourself with music, podcasts and audiobooks

This can make the cleaning more enjoyable. Just be mindful of the passing time, so you don’t get distracted and overdo things 😉.

Give your medicine cabinet a spring clean too

Get rid of out-of-date or unnecessary items. But don’t throw medications in the bin – take them to your local pharmacy for disposal.

Things don’t have to be perfect…

So give yourself a break. As a clean freak, I constantly struggle with this. But listening to your body and doing things that are realistic for you is more important than some idea of perfection that’s unsustainable (or unattainable). Accept that and just enjoy being in your home 😊.

Call our Help Line

More to explore

15 cleaning games that make even the most boring chores fun
Mumtastic
20 helpful tips for cleaning and organising when you’re chronically ill
Fed Up with Fatigue
26 ‘hacks’ that can make cleaning easier if you have a chronic illness
The Mighty
Day by day: Cleaning with a chronic illness
Waking Up Amy
How to get rid of pet hair at home: Handy tips on how to keep the hairy onslaught to a minimum.
Choice
Spring clean checklist: Your room-by-room checklist for preparing your home for the warmer months
Choice

Lisa Bywaters

10/Sep/2020

If you live with a musculoskeletal condition, chances are you’ve had a flare at some stage. Your body turns up the dial on your pain-o-meter and wow…that hurts. As well as increased pain you may experience increased joint stiffness, inflammation and fatigue. As a result everyday activities – getting out of bed, showering, looking after the kids, working, cooking – become much more difficult.

Flares are frustrating and painful. You don’t always know why they happen – and sometimes they seem to come out of the blue. How long they last is also uncertain and can in part depend on how you deal with them.

What causes a flare?

Flares can be caused or triggered by a number of things including:

stress
changes in medications
overdoing it physically
changes in weather
poor sleep
illness, infection or injury.

Knowing the triggers that cause you to have a flare can help you be prepared and take control.

Your flare plan

Be prepared

Talk with your doctor about the things you can do to manage a flare when one occurs. This may include pain relieving medications to help you get through the worst of it, as well as self-management strategies, including rest, gentle exercise and the use of heat and cold. You may also need to adjust your medications, or alter the dosage during a flare.
Have a plan in place for how you’ll deal with your commitments when you’re in the middle of a flare – family, work, home life, social activities. Can you alter your work hours, work from home, get your family to help out with chores?
Manage your stress. Many people find they’re more prone to flares when they’re stressed. Unfortunately we’re living through a particularly stressful time at the moment. But there are things you can do to deal with stress. Try relaxation techniques such as meditation, breathing exercises and visualisation, avoid caffeine, alcohol and cigarettes. And talk to someone – whether it’s a family member, friend or a mental health professional. Talk through what’s stressing you out so you can deal with it, and hopefully avoid a flare.
Don’t overdo things. We’ve all done it. Countless times. We’re feeling great so we decide to go for the extra-long walk. Or clean the house from top to bottom. Or weed the entire garden. Afterwards we’re proud of our achievements…until we wake up and can’t move. And we tell ourselves never again. But we really need to follow through with the ‘never again’. So when you’re feeling great, pace yourself. Go for the walk – but don’t go too far, or stop for a coffee break and a rest. Do the cleaning or gardening – just don’t get carried away, and get help from others. By managing your activities, energy levels and pain, you can hopefully prevent a flare from occurring.

Take control

Even when you do all you can to prevent a flare, you can still have one. Some flares we can predict, but sometimes they seem to happen for no reason at all. Or they may be triggered by things we can’t control – such as changes in weather or changes to meds. So you need a plan for dealing with them in the moment.

Over-the-counter and/or prescription medications may help you manage the pain and inflammation of a flare. As we mentioned earlier, discussing this with your doctor before you have a flare means that you can act quickly as soon as a flare strikes. You’ll have the medications you need, when you need them. But if you haven’t had the opportunity to have this discussion, now’s the time. Make an appointment as soon as possible. Don’t try to soldier on. This will only make life miserable, and can potentially make your flare last longer and cause more damage.
Write down what you were doing before the flare. It might seem like it came out of the blue, but there may be triggers you aren’t aware of. Tracking your activities, sleep patterns, stressors, diet and even the weather each time you have a flare may help you identify potential triggers. This will help you reduce your risk of future flares.
Prioritise your tasks and activities. You still need to be able to get through your day and commitments, so you need to prioritise what’s most important. You may not be able to do everything if you’re in a lot of pain or you simply can’t focus because you’re so tired. So be realistic – what really, seriously needs to be done? Only do those things. You can get to the other things when you’re feeling better.
Pull out all of your pain management strategies. Use heat or cold packs, get a massage, go for a walk, distract yourself…use all the things you know help you manage your pain.
Rest when your body needs it – but not for too long. Going to bed and being inactive during a flare can make your pain and fatigue worse. Continue to exercise, but at a lesser intensity than usual. It’s important you listen to your body.
Use aids and other gadgets when your joints are painful and swollen. Aids include splints, walking sticks, jar openers, tap turners and pick-up reachers. They’ll help protect your joints, and reduce some of the pain you feel when doing everyday tasks. Check out our online shop to view some of the items we have available to make life easier.
Get a good night’s sleep. Not enough sleep or poor quality sleep has a negative effect on our mood, our physical wellbeing, pain levels and our energy. It can also trigger a flare. Unfortunately it’s easy to say ‘get a good night’s sleep’ but it’s often hard to do when you’re in a lot of pain. The good news is there are lots of things you can do to improve your sleep. Find out more.
Track your flares. Keep an accurate record of when you had a flare (or flares). Also note down the symptoms you experienced and rate them. For example if you have increased fatigue, how would you rate it compared to the fatigue you feel when you’re not having a flare? Do this with all of the symptoms you experience. All of this information is valuable to help you and your doctor understand how your condition is progressing, if it’s being well managed or if your treatment plan is providing the best results.
See your doctor. If your flare is lasting longer than usual, your symptoms are much worse, you’re experiencing unusual symptoms or you’re having more frequent flares, go and see your doctor or specialist. You may need your medications to be adjusted. Or you may need an assessment of your current treatments to see if there’s an alternative that will help you gain control over your condition.

Some of the suggestions listed here are easy, however others involve a bit of thought, as well as input from others. But taking the time to work out a plan that works for you will help you manage your flares better, and with less disruption to your life.

Call our Help Line

More to explore

Flares and JIA: What you should know
Arthritis Foundation (USA)
How to look after your hair when you’re having a flare
Arthur’s Place (UK)
How to manage rheumatoid arthritis flares
Johns Hopkins Arthritis Center, 19 February 2019
Newly identified cell type may help predict, treat rheumatoid arthritis flares
Science, 17 July 2020
Tips for managing an arthritis flare
Arthritis Foundation (USA)
What an AS flare is like
AnkylosingSpondylitis.net

Lisa Bywaters

07/May/2020

Hands up if you’re feeling tired at the moment? Or if you’re too weary to raise your hand, just a brief nod will do it. It seems like we’re a nation of tired people at the moment (?).

Why is this? We’re not going out like we used to, to the movies, restaurants, family gatherings, to see friends, sports events, or take the kids to all of their extra-curricular activities. We should be swimming in time and feeling relaxed and rested, right?

Ah, no.

We’re stressed

Stop me if you’ve heard this before but we’re going through unprecedented times. This pandemic is causing massive disruptions to our lives, our families, our work and our routines. This constant uncertainty causes us to feel stressed. All the time.

When we’re stressed our bodies release adrenaline. It’s so we can react to a crisis, the old ’fight or flight’ response. But when the stress is constant, as many of us are feeling at the moment, this has an effect on our health – including making us feel physically and mentally tired.

There are lots of things you can do to manage stress. By understanding what’s causing your stress, you can start to manage it. This may include things like developing a new routine (and sticking to it), exercising, talking with your family about how you’re feeling, finding ways to relax, making sure you’re eating a healthy diet and drinking enough water, getting a good night’s sleep and avoiding excessive use of alcohol and other drugs.

We’re staying indoors more

Because of restrictions we’re staying inside our homes more. So we’re not getting exposed to as much sunlight as we normally would. A lack of sunlight causes the brain to produce more of the hormone melatonin, which makes us sleepy.

To deal with this, schedule time every day to go outside for a walk or stroll in your yard, open your blinds or curtains as soon as you get up and expose yourself to as much sunlight as you can. It’ll help you feel more awake and improve your mood. Just think how much better you feel after being stuck indoors when you get out into the sun. It makes you feel so much more energetic and alive! So this one’s a no brainer. We just have to make time to do it.

We’re sleeping less (or more) than usual

Let’s face it, since this all started our usual everyday routines have been shot to pieces. Work, home life, family, socialising, shopping – it’s all so different at the moment. When you add stress to the mix, our sleep is often affected.

You may find you’re sleeping less than usual because you’re working long hours to catch up on work after spending the day home schooling the kids, or you’re watching more TV and spending more hours online, or stress is causing you to feel more pain and you’re having issues sleeping through the night.

Or you may be sleeping more – trying to rid yourself of this constant feeling of tiredness, or because you’re bored, or because it’s cold outside and you’re feeling cosy and warm indoors, or because you’re feeling sad. Not enough sleep, too much sleep and poor quality sleep will all increase how tired you feel.

That’s why it’s important that you stick to a sleep schedule – even on the weekends. Get out of bed in the morning and go to bed at night, at the same time every day. Your body needs this regularity for your internal clock to function properly, and to help you fall asleep and wake up more easily and feeling more refreshed.

And if you’re regularly finding it difficult to sleep or get out of bed because you’re feeling really sad or down, it’s a really good idea to talk with someone about this, whether it’s family, a close friend or your doctor. Please don’t ignore this.

We’re exercising less

Many of us are finding we’re exercising less because we don’t have access to our warm water exercise classes, tai chi, gyms and exercise groups. Not getting enough exercise can make you feel sluggish and tired. If this continues for some time, we start to get out of shape and feel less inclined to exercise. So it’s really important to make exercise – whether it’s online videos and apps, walking, dusting off your old exercise DVDs, or dancing around the living room – an essential part of your everyday routine. And get the family involved. Everyone needs to be exercising and staying active for our physical and mental wellbeing. If you’re home alone, use a video app to call a friend and exercise together. You’ll find you’ll feel more energised and happier when you’re exercising regularly.

We live with chronic conditions

Apart from all of above affecting how tired we’re feeling, we live with chronic musculoskeletal conditions and other health issues. These often cause us to feel fatigued. Many of our medications and living with chronic pain can also make us feel excessively tired. When you add a pandemic on top of that, the unique issues you’re facing – how the virus may affect you, worry about being more at risk, how to safely access your healthcare team, navigating telehealth – it can heighten you’re feelings of fatigue.

Many of the things we’ve looked at – such as establishing a routine, getting adequate sleep, eating well, exercising and staying connected with your family, friends and work colleagues will help you with some of these issues.

You can also get help from your GP and from the nurses on our Help Line. Contact a peer support group or go online and connect with others dealing with similar things. Even just talking with others who know exactly how you’re feeling can help you feel less isolated.

We may need to talk with our doctor

Finally if you’re concerned that your tiredness is due to more than just the reasons listed above, it might be worth talking with your doctor about it. Your tiredness may be caused by other things like vitamin deficiency (for example iron and vitamin D), side effects of your medications, feeling sad, anxious or depressed or it may indicate another health issue. So make an appointment to discuss it with your doctor – either in person or via a telehealth consultation.

Contact our free national Help Line

If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain 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

Managing fatigue
Versus Arthritis(UK)
No wonder isolation’s so tiring. All those extra, tiny decisions are taxing our brains
The Conversation, 1 May 2020
Why am I so exhausted? How to combat the unexpected side effects of coronavirus isolation
7News, 9 April 2020
Here is why you might be feeling tired while on lockdown
The Conversation, 7 April 2020
5 ways to wipe out winter tiredness
NHS (UK)
Does your self-care plan need some TLC?
Musculoskeletal Australia
Getting a good night’s sleep
Musculoskeletal Australia

Photo by Tracey Hocking on Unsplash

Lisa Bywaters

30/Apr/2020

Have you noticed how many more people seem to be out and about – in the shops, on the road, walking in the park? And even though restrictions haven’t changed yet, many seem to have become a bit more relaxed when it comes to their activities and physical distancing?

While many of you have self-isolated in the past because of your musculoskeletal condition or other health reasons, what we’re all experiencing now is unprecedented. And for it to go on this long, with only a glimmer of light at the end of the tunnel, it’s no wonder we’re all going a little stir crazy.

There may be many reasons for this:

In Australia we’ve done exceptionally well at flattening the curve. But that means most of us don’t know anyone affected by COVID-19. So the virus doesn’t seem quite real to a lot of us.
We started iso thinking it was a chance to do the odds jobs, hobbies, reading, Marie Kondo-ing your space etc. And we’ve either done all of those things, or we’ve realised there was a reason we didn’t do them in the first place – we don’t want to! So now we’re getting a bit bored.
Decisions are being made that affect our lives, our families, our work and finances. And most of the time we have no say in these decisions. So we feel out of control.
The reality of home schooling, the chaos of everyone working from home, the isolation of being cooped up in your house alone, the constant internet and tech issues, fighting for space, the endless baking of banana bread…we’re over it.
We’re social beings, but we’re having to make do with virtual almost everything. But phone and video calls can’t compete with or replace the face-to-face connections with our family and loved ones. We want and miss our physical interactions.
All of the restrictions are a bit confusing – especially since every state/territory has their own specific set. So we’re confused, and a little jealous of the areas that are slowly easing restrictions.
We just want things to return to normal.

But we really need to adhere to the restrictions in our state/territory.

It’s hard. But we’re up for the challenge. So when you start getting a bit itchy or grumpy or frustrated, here are some things you can do:

Remember why we’re doing this. Think of the health system and the frontline workers and essential services. Think of the vulnerable in our society (which may indeed be you or someone you care about).
Remember there are outliers. People have become very seriously ill or have died from this virus for reasons we don’t understand. There are still so many unknowns when it comes to COVID-19 – so not following the advice from our health officials will put you and others at risk.
Check the restrictions relevant to you. Visit the website of your state/territory health department so you know what you need to be doing.
Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
Stick to your routine. Get up at the same time each day. Exercise regularly. Eat healthy meals. Plan time for fun and creative things you can do in and around your home.
Connect with others. Yes, we’re getting sick of our phones and computers (who thought they’d ever say that ??) but they’re the safest way for us to connect with the people important to us. So do it. Pick up the phone or get on your computer and make a call. Talk about anything other than the virus. Reminisce about fun times, silly things you’ve done together, jokes you’ve heard. It’s a great way to give yourself a lift when you’re feeling down. Contact the people you know are on their own and may be struggling. See how they’re doing and if you can help in any way. I know I keep saying it, but we really are in this together.
Set yourself a challenge or goal. It may involve looking after your health – e.g. exercising 30 minutes a day 5 days a week – or getting your finances in order, or starting an evening book club with the kids, or scheduling time each day to meditate/read/listen to music/relax, or plant a vegie garden, or doing that 3,000 piece jigsaw…Think of something you really want to do. Not the things you thought of at the start of iso, but something that seems more relevant to you 2 months into isolation – and set yourself the challenge to do that. If you encounter obstacles, that’s fine. Look for ways to manage them and move on.
Ignore the social media posts from the people who seem to be achieving amazing things during iso. You know the ones…they’ve learned a language, repainted their house, started a successful online business and written a book – all while working full time and home schooling 5 children under the age of 5. What a load of rubbish. Remember we generally use social media to present ourselves in the best light – it’s not always an accurate representation of what’s really happening. So take these posts with a grain of salt, or stop following them all together. It’s pointless comparing your situation with someone else’s. And it can make you feel stressed or inadequate, so try not to do it. You’re doing the best you can – so be kind to yourself.
Remember this will end.

Contact our free national Help Line

Lisa Bywaters

31/Jan/2020

If you live with persistent pain, then you’ve probably had many nights when sleep has eluded you. You’ve tossed and turned, gotten up, watched TV, checked your phone, gone back to bed, and then tossed some more.

Pain, muscle tension, anxiety and other factors can interfere with your ability to get to sleep, stay asleep and the quality of your sleep. And sadly, not getting enough good quality sleep can affect your pain levels, your muscle tension and your anxiety levels.

It’s like a colossal feedback loop that’s spiraling out of control and you can’t break free. OK, that was a little dramatic, but I’m also a little tired and cranky 🙁

The good news is there are many things you can do to break this cycle and get back to having a good night’s sleep.

Try not to put too much pressure on yourself to go to sleep. This leads to anxiety and stress if you don’t fall asleep quickly. Feeling anxious or stressed will affect your ability to sleep. 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.
Develop a sleep routine. Try to go to bed and get up at the same time each day.
Try some relaxation techniques. Consider mindfulness, visualisation, deep breathing or a warm bath before bed. These techniques will help you become more relaxed and may help you manage your pain better so that you go to sleep, and sleep well.
Write it down. Thoughts, worries and anxiety can prevent good sleep. Don’t take them to bed. Write them down and then put them away. You can deal with them tomorrow.
Be active during the day. As well as the many other benefits of regular exercise, it will help you fall asleep and stay asleep longer.
Keep a sleep journal. This will help you and your doctor work out what may be causing your sleep problems because it tracks the things that may affect your sleep. Make sure to write down things like the time you went to bed, the time you got up the next morning, how easily (or not) you fell asleep, how many times you woke up and for how long, things that woke you up (full bladder, outside noise, anxiety, pain etc).
Keep a water bottle by your bedside so that you don’t have to get up if you wake up thirsty in the middle of the night.
Avoid caffeine and alcohol for several hours before going to bed.
Don’t look at the clock. Constantly checking the time can make you anxious and anxiety makes it hard to sleep. Try removing your clock from the bedside, or cover it up at night.
Avoid using technology in bed. The blue light from laptops and tablets suppresses the hormone (melatonin) that makes us sleepy at night, so be sure to stop screen use at least one hour before bed.
Light. Is your room dark enough to allow you to sleep well? If not, look at solutions such as window coverings or a dim switch on your alarm clock. You might also try using an eye mask.
Noise. If you have no control over the noise in your environment (e.g. a barking dog, loud party, your partner’s snoring), ear plugs may be an option. Or playing soothing, gentle music softly in the background can also be helpful at cancelling out other noises.
Clear your bedroom of clutter. Researchers have found a link between being surrounded by lots of “stuff” and your ability to fall asleep quickly and easily.
Seek help. If pain is constantly keeping you awake at night, discuss it with your doctor for information and advice.

More to explore

Read our more detailed page on sleep.

Lisa Bywaters

01/Feb/2019

We all get tired. We overdo things and feel physically exhausted. It happens to us all.

But something that most of us living with a chronic, painful condition experience, and that can be hard for others to really understand, is fatigue.

Fatigue’s that almost overwhelming physical and mental tiredness. It may be caused by lack of sleep, your medications, depression, your actual condition (e.g. rheumatoid arthritis) or just the very fact of living with persistent pain.

Fatigue can make everyday activities seem too hard, and can get in the way of you doing the things you enjoy. The good news is there’re many things you can do to manage fatigue.

They include:

Exercise and being active – while this may sound like the last thing you should do when you’re feeling fatigued, exercise can 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.
Frankie says relax – listening to music, reading a book, taking a warm bubble bath, meditating, deep breathing, visualisation, gardening, going for a walk…they’re just some of the ways you can relax. By using relaxation techniques, you can reduce stress and anxiety (which can make you feel fatigued), and feel more energised.
Eating a well-balanced diet – this 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.
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 things 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.
Get a good night’s sleep – it 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.
Talk with your doctor about your meds – sometimes fatigue can be caused by medications you’re taking to manage another health condition. If you think your medications are causing your fatigue, talk with your doctor about alternatives that may be available.

So that’s fatigue…it can be difficult to live with, but there are ways you can learn to manage it. Tell us how you manage. Share your tips for managing fatigue.

Lisa Bywaters

26/May/2018

Make your life easier with aids, equipment and other gadgets

Do you find that at times you struggle with everyday tasks?

When you have a musculoskeletal condition, simple things like pulling on your shoes, opening jars, combing your hair or sitting for long periods can sometimes become difficult and painful.

The good news is there are a variety of aids, gadgets and other equipment available to help you manage. They can also help reduce stress on your muscles and joints, save energy, prevent fatigue and basically make your life easier.

There are gadgets that can help you with everything from cooking, cleaning, getting dressed, driving, gardening, using technology and working.

Some things – e.g. kitchen utensils or gardening tools with thick handles that are easier to hold– can be found in many of the stores we already shop at.

Other items need to be bought from specialty stores or pharmacies. Or you may be able to modify objects that you already own – e.g. if you have sore hands, foam tubing can be used to create an easier grip on your pens.

Because there are so many options, it’s helpful to speak with an occupational therapist (OT) to get specific information and advice.

OTs work in the public and private sectors. You can access them through public and private hospitals, community health centres, independent living centres and private practice.

As well as helping you with aids and equipment, OTs can help you learn better ways to do everyday activities to help you:

protect your joints
reduce the pain caused by doing certain activities
save energy.

They can also provide advice about pacing your day and activities so you can achieve a balance between activity and rest.

The important thing to keep in mind is that there are many aids and gadgets available that can make your life easier. You don’t have to struggle.

Talk with an OT today.

You can also contact our National Arthritis and Back Pain+ Help Line on 1800 263 265 and speak with a nurse for information about living well with a musculoskeletal condition. We’re here to help!

Or how to manage fatigue

Call our Help Line

More to explore

So what can you do?

And how to do it right

Tips for napping

Contact our free national Help Line

More to explore

Tips to help you sweep away winter

Planning, prioritising and pacing

Take breaks

Get the right tools for the jobs

Choose your battles

Let the cleaning products do the hard work

Beware of dust and toxic smells

Recycle old socks

Use your dishwasher for more than dishes

Consider reorganising your pantry, laundry or kitchen

Get some wheels

Repackage it

Alternate your cleaning activities

Get the family involved

De-clutter

Hire someone

Distract yourself with music, podcasts and audiobooks

Give your medicine cabinet a spring clean too

Things don’t have to be perfect…

Call our Help Line

More to explore

What causes a flare?

Your flare plan

Be prepared

Take control

Call our Help Line

More to explore

We’re stressed

We’re staying indoors more

We’re sleeping less (or more) than usual

We’re exercising less

We live with chronic conditions

We may need to talk with our doctor

Contact our free national Help Line

More to explore

Contact our free national Help Line

More to explore

Make your life easier with aids, equipment and other gadgets

Useful Links

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