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21/May/2020

For many of us our pain is always there – sometimes in the background and at other times it’s very much in the front of our minds. It’s a constant – just like taxes. Even with a pandemic causing so much chaos and uncertainty, our pain persists, it’s always there.

And quite frankly it’s a pain in the arse. It hurts. It’s exhausting. And it’s invisible.

The Australian Institute of Health and Welfare last week released their latest report Chronic pain in Australia. It highlights that 1 in 5 of us lives with chronic pain. So next time you’re standing in a physically distant queue at the shops or taking a walk around the park – consider the fact that 1 in 5 of the people see you around you is also living with pain. It’s a massive problem, but there are things we can all do to manage our pain effectively.

Know your pain and yourself

It’s so important when you live with a chronic condition that you understand it. Learn as much about your condition as you can so that you can take an active role in managing it, including the pain associated with it. For example, what makes your pain better? What makes it worse? Do you tend to overdo things when you’re feeling great and end up paying for it over the next couple of days with increased pain? Or when you’re experiencing a flare and your pain is worse – do you get anxious, and everything becomes negative and too hard?

Knowing these things – really understanding how your pain affects you physically, emotionally and behaviourally – will help you manage your pain and your condition better, even in this time of crazy COVID.

Tackle the big three – exercise, eat, sleep, repeat

I don’t know about you, but I’m finding my exercise, diet and sleep have all taken a hit due to the pandemic and iso. Not being able to get to the gym, changes to work and my normal routine and stress has really impacted how and when I’m eating, sleeping and exercising. And not in a positive way.

This has had a very noticeable effect on my pain levels. If you’re experiencing this too, acknowledging it is the first step to changing things. So I can’t get to the gym – there are other ways to be active. So my routine has changed and as a result so has my diet. I can manage that. Stress and pain is impacting my sleep? I’ve managed that before – I can do it again.

It’s all about finding the right mindset. This is a strange, new normal we’re living in. And it’s going to change and evolve as we continue through 2020. We have no roadmap for what’s been, and what’s to come – so we need to do the best we can to change and adapt to the constantly shifting landscape.

Get help

OK, that all sounded sooooo easy, right?? Nope.

We may be able to change and adapt to some things but there will be times when we need to ask for help. From our family and friends, from our doctor, physio, psychologist. Whether it’s medications or physiotherapy to directly manage the pain, or asking a family member to carry the heavy laundry basket to the clothesline, or talking with a friend about your frustrations – whatever it is, there’s help available. You just need to acknowledge the fact that you need it and reach out. And remember the nurses on our Help Line are just a call or email away.

Use your mind

It’s a powerful tool. You can use it for distraction, mindfulness, relaxation, visualisation and guided imagery. None of these things will take your pain away completely, but they can provide temporary relief while you do a painful task, try to fall asleep, or wait for your pain medication to kick in.

‘P’ yourself – plan, prioritise and pace

We’re often our own worst enemy. We do too much when we’re feeling great, and end up feeling rubbish for hours/days afterwards. Something ‘simple’ we can do to prevent this from happening time and again is to plan, prioritise and pace ourselves. First plan – what do you need to do today? Write it down. Now prioritise. How much of those zillion things do you really need to do? Often things we see as hugely important aren’t. And do you need to do them yourself? Can someone else do it? Now pace yourself. It’s not a race – so be generous with your time, spread your jobs over the day and build in space for rest breaks.

Look after your mental health

Living with persistent pain can sometimes be a roller-coaster of emotions. It’s perfectly natural that from time to time to feel sad, worried, angry, anxious, depressed or frustrated. Add a pandemic, and it’s no wonder many of us are feeling as if our worlds have turned upside down and inside out. It’s important that you acknowledge these feelings. You may want to write in a journal, talk with a family member or close friend or talk with a counsellor or psychologist. Don’t ignore these feelings or keep them bottled up.

Your GP can refer you to a psychologist if needed on a GP Mental Health Management Plan. At the moment because of COVID-19 you can arrange to speak to a psychologist via telehealth (over the phone or a video call).

Be kind

To yourself and to others. It’s an unprecedented, really strange time and we’re all doing the best we can. So be kind to yourself – you’ll experience ups and downs, stumbling blocks, and barriers that get in your way. And some days you’ll need to work really hard just to keep moving. So give yourself a break. And remember 1 in 5 people are living with invisible chronic pain. And even more people are dealing with all kinds of stuff we can’t even imagine. So be kind to the people you encounter. It makes us all feel so much better than the alternative.

More to explore

Our nurse Clare discusses some simple things you can do to manage pain while at home in isolation, including pacing activities, exercise, getting a good night’s sleep and heat and cold packs.

We also have some great blogs to give you more tips and info about managing pain:


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13/May/2020

Thanks to one of our MSK Kids parents who has written this blog for us. They have chosen to remain anonymous. 

When our world changed rapidly at the end of March due to COVID-19 social distancing regulations and remote learning, I was amazed that my child wasn’t freaking out about all the changes taking place. I put it down to her wonderful teachers and the fact that she has dealt with a major event in her life already, a chronic health condition and immunosuppressive treatment. Here are some of the ways my child has had the dress rehearsal to COVID-19, and so have we as parents.

Experienced at social distancing

When you have an immune suppressed child you have already had to cancel play dates, sleepovers and extra-curricular activities. Your child has already stopped sport at some stage, and has probably missed important days at school or with friends. You have already been fearful of every cough and sneeze in the classroom and you know the times of the year when chicken pox cases increase.

We’ve been using hand sanitiser already

Ask any parent who has spent time with a child in hospital, and chances are they know the smell of Microshield® very well (the brand of hand sanitiser in most Australian hospitals). We’ve been used to having good hand washing habits and know the importance of alcohol-based agents to clean hands. You probably already had a decent amount of hand sanitizer at home before COVID-19, as well as alcohol-based wipes (especially if you have to administer subcutaneous injections).

We know and appreciate our healthcare workers

It didn’t take this pandemic for us to appreciate our wonderful healthcare workers. We’ve known this for years through our regular interactions with doctors, nurses and allied health workers. Hopefully everyone else now recognises the importance of good health in our lives and our amazing healthcare workers.


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07/May/2020

In the last couple of weeks pop-up and drive through testing centres for COVID-19 have been appearing in places like shopping centre carparks, town halls and community centres.

Testing in Australia has now been expanded to include anyone with COVID-19 symptoms. At the beginning of the pandemic we were focused on mainly testing people who’d been overseas, on cruise ships or had been in direct contact with someone diagnosed with the virus.

Now focus has moved to community transmission. This is when someone develops COVID-19 for no obvious reasons. They’ve not been overseas or in contact with someone with the virus…that they know about.

Symptoms

As we know some people may have the virus without having obvious or severe symptoms. If they’re out and about they may unwittingly spread this highly infectious virus to others.
That’s why testing is being broadened to anyone who has symptoms such as:

  • fever, chills or sweats
  • cough
  • sore throat
  • shortness of breath
  • runny nose
  • loss of sense of smell.

For more information about symptoms and to see if you or someone you care for may have the virus, use the healthdirect Coronavirus (COVID-19) Symptom Checker. Answer a few simple questions to find out if you need to seek medical help or be tested. Or call the National Coronavirus Helpline on 1800 020 080, 24 hours a day, seven days a week.

It’s important to be aware that there are currently some slight differences in the testing criteria for states and territories.

For example Victoria has started a two week testing blitz. As well as people with symptoms, some people can be tested even if they don’t have symptoms. This includes people with chronic conditions, Aboriginal and Torres Strait Islanders and people who can’t work from home (including healthcare workers, police, construction workers).

Visit your state/territory health website for information about testing criteria relevant to where you live or call the National Coronavirus Helpline on 1800 020 080.

So what are the tests and how do they work?

First, it’s important to note that all tests for COVID-19 are performed by health professionals. You may have seen information about home tests on social media. In Australia it’s illegal for anyone to sell a home testing kit and claim that you can test yourself for COVID-19. Supply of these kits is also prohibited under the Therapeutic Goods (Excluded Purposes) Specification 2010. Testing for COVID-19 is complicated and requires the specialised knowledge and training of health professionals. As well as the actual testing and interpretation of results, they’re also able to give you expert information and support. So if you see these home tests advertised, ignore them.

The main test currently used for COVID-19 is a swab test.

A swab (similar to a long cotton bud) is inserted into your nose or back of your throat to collect fluid and cells. Once the sample has been collected it’s sent to a lab for testing.

At the lab, technicians will look for genetic material from the virus. They will then send the result to the health professional who took the sample. This usually takes between 1-3 days. You’ll be contacted with the results – whether you have the virus or not.

The swab test can only tell you if you have an ongoing infection, it can’t tell if you’ve had COVID-19 in the past.

While this test is considered to be very accurate, especially in a laboratory setting, there can be errors. People may be told they aren’t infected when they are. This is called a false negative. It can happen if a sample hasn’t been taken correctly or if the virus hasn’t replicated in your body to a level that can be detected. There’s also the possibility of a false positive, when a person has been told they have the virus, but they don’t. This can happen if the sample becomes contaminated in the lab. However these are not common occurances.

Another test that may be used in some situations looks for antibodies in your blood. If you have the virus, your body will create antibodies to fight it. The blood test will look for this. However it takes time for your body to create antibodies, so you may have already recovered from the virus before antibodies appear. So this test can’t tell you if you still have the virus, or when you may have had it – only that you have had it.

Testing as we go forward

As well as testing for COVID-19 in people who have symptoms or suspect they may have the virus, testing may begin to be carried out on the community at random.

Called sentinel testing or sentinel surveillance this mode of testing will look for cases of COVID-19 in people that aren’t displaying symptoms.

It’s likely that sentinel testing will be happening in the near future as we begin to relax restrictions. We just have to wait to hear from the Federal Government as to how and when it’ll happen.

For more info, read What is sentinel surveillance and how might it help in the fight against coronavirus? 

Contact our free national Help Line

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


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22/Jan/2020

Written by Steve Edwards, MSc(Oxon), MSc(Edinb), BSc(Pod)

“A cortisone injection? You want to stick a needle in my sore foot?”

Your health care clinician has suggested you have a cortisone injection into your foot. As with any medical procedure, both of you are best advised to discuss the benefits and risks before proceeding. It helps to know what cortisone is, what it does, and why it’s been offered to you.

Cortisone is an anti-inflammatory medication that’s often used to treat musculoskeletal conditions. It’s a synthetic version of cortisol, a hormone that naturally occurs in your body. Injected into the affected area, cortisone can lower inflammation and pain, remove fluid, and thin scar tissue or adhesions. So if your clinician diagnoses a musculoskeletal condition affecting your foot or ankle – such as arthritis, bursitis, neuroma, or tendinitis – a cortisone injection is commonly raised as an effective treatment option.

Cortisone injections also contain a local anaesthetic. For certain conditions an injection can be painful, so the anaesthetic may be injected separately before the cortisone to block this pain.

The clinician may or may not use ultrasound technology to guide the injection. For pain relief in the foot or ankle, research finds no statistically-significant difference between procedures conducted with or without ultrasound. Interestingly, trials on cadavers injected with dyed cortisone show how it rapidly spreads from the injection-point to adjacent tissue, indicating that pinpoint accuracy is not key to effectiveness.

There are several types of cortisone. In most cases the clinician will administer a long-duration cortisone, taking effect within 1-3 weeks, with benefits lasting between 1-9 months, depending on the condition and its severity. There’s a clinical consensus that no more than 3 injections should be administered to the same body-part within a 12-month period, though there’s no research literature to clearly support this belief.

After the injection, you can quickly return to most activities. The clinician may recommend you avoid strenuous physical exertion such as gym workouts or running for a few days, so the cortisone isn’t displaced from the target tissue.

As for risk-factors, there’s been research into whether the injection may risk tearing tendons in the target area. There’s no recorded case of this in human trials, though it has occurred in trials on dogs and horses. There were cases of more general tissue damage recorded in early trials on American gridiron players, but various factors could have produced this result – the needle used, the amount of fluid injected, and the subjects receiving multiple injections within a short period.

No medical procedure has a 100-percent success rate, but a single cortisone injection administered by a trained clinician is both safe and effective in providing medium-term pain relief. Side effects are minimal, and the benefit to your musculoskeletal condition is potentially vast. And for some foot-specific conditions – such as a neuroma (pinched nerve), or plantar fasciitis (heel pain due to scar tissue) – a cortisone injection can often be a cure.

Our guest blogger

Steven Edwards is a trainee foot and ankle surgeon with the Australasian College of Podiatric Surgeons. He also teaches pharmacology and foot surgery to undergraduate podiatry students at La Trobe University.


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02/Aug/2018

Gathering your all-star support team

Written by Amanda Sobey

Attempting to take control of your chronic condition can at times be a daunting and uncertain challenge. Ensuring you have a strong team around you to help tackle each milestone, step by step, can make it feel achievable.

So who might be in your personal support team?

Health professionals

Depending on your individual needs, your team may be made up of a variety of health professionals. These could include your GP, rheumatology nurse, specialist, pharmacist, physiotherapist, rehabilitation practitioner, occupational therapist, nutritionist or dietitian, physiotherapist, remedial massage therapist, acupuncturist, health coach, counsellor, podiatrist, or your exercise physiologist. Share your goals with your health practitioner up front to maximise the limited time in your appointments and so they can help you progress.

Your personal cheer squad

Surrounding yourself with people who lift you up and encourage you to take charge of your condition can be empowering.

Family and friends

Let them know how they can help you and keep them in the loop as you go along. Let them celebrate the small wins with you. Examples could be receiving positive results of reduced inflammation from your latest blood test, that you managed to walk around the block comfortably, or that you had a pain-free night’s sleep. They might be able to help you hang out that load of washing or put a home cooked meal in your fridge. They can provide a second pair of ears when you need to off-load, question information you’ve been given or accompany you to your next medical appointment. They can also be great companions for a belly laugh, keeping active and getting out of the house!

Peer support group contacts

Being able to connect with people who are going through the same challenges can mean the world. This might be through online social networks or contacts you’ve made at meetups. Group members will be at various stages of their conditions. Some will be newly diagnosed, others may be long-time chronic illness warriors. They’ll be happy to share their experiences and provide insight based on what has helped them.

Studying?

Consider letting your teacher or course convenor know about your condition, so that they can provide assistance if you need to ask for an extension, or are unable to attend a class. It’s also worth finding out about other support services available at the school or university you are studying with.

In the workplace

If you feel comfortable, let your employer or HR Manager know about your condition so that they can provide flexibility, if and when you need it. They’ll be appreciative of any information you can share with them about your condition, so they know how best to help.

On the road to wellness

With the right support around you, taking control of your chronic condition can feel even more possible. Keep your care team in the loop, share your highs and lows and be sure to celebrate each milestone on your wellness journey.

Our guest blogger

Amanda Sobey is a co-founder of Young Adults with Arthritis+ (YAWA+), an online peer support network for young adults in Australia aged 18-35 with arthritis and related chronic conditions. Amanda was diagnosed with rheumatoid arthritis at age 22 and is passionate about raising awareness and helping others on their wellness journey.

For more information please visit the following links:

Facebook: www.facebook.com/yawaplus
Twitter: www.twitter.com/yawaplus
Instagram: www.instagram.com/youngadultswitharthritisplus


musculoskeletal health australia

Musculoskeletal Health Australia (or MHA) is the consumer organisation working with, and advocating on behalf of, people with arthritis, osteoporosis, back pain, gout and over 150 other musculoskeletal conditions.

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