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Written by Mikayla O’Neill
In the age of smartphones and social media, accessing nutrition information has never been easier. Platforms like Instagram and TikTok offer a wide range of content related to health and diet. However, this ease of access can also lead to misinformation. Not all online advice is evidence-based or tailored to the Australian context, and it’s crucial to approach social media content with a critical eye.

When browsing nutrition online, especially in relation to musculoskeletal health, I always:

  • Ensure the advice is provided by a qualified professional, such as a registered dietitian or accredited nutritionist.
  • Seek out content created by Australian professionals, as dietary guidelines and food availability can differ between countries.
  • Remain cautious of exaggerated claims or so-called “miracle” foods that promise instant results.

Although there aren’t too many accounts on both Instagram and TikTok from Australia about musculoskeletal health and nutrition, some stood out to me when researching this article.

Several Australian-based dietitians and nutritionists on social media share practical, evidence-based advice through short videos, infographics, and interactive Q&A sessions. Some accounts I enjoy are:

  • @savvydietetics (Instagram & TikTok) – Nutrition support for invisible illnesses
  • @dietitian – Focus on Hypermobility, EDS, POTS, and MCAS
  • @trust_nutrition_NZ – Arthritis-focused dietary strategies
  • @rigoni.dietitian – Nutrition for chronic disease management
  • @anca_vereen – Specialising in fibromyalgia and chronic disease
  • @idealnutrition_ (Instagram & TikTok) – A team offering support for a range of musculoskeletal conditions
  • @kic.app (Instagram & TikTok)– a paid app for your smartphone for all things wellness. Kic App provides a meal section of the app that provides over 800 recipes that are easy and affordable. All meals are from two accredited Dietitians.

Staying informed and making mindful choices can empower you to take charge of your health and manage musculoskeletal conditions more effectively. Social media platforms like Instagram and TikTok—apps many of us use daily—can be great sources of practical, easy-to-digest information, especially when it comes to nutrition.

I’ve found these accounts to be especially helpful, and I hope you do too! If you know of any great accounts that aren’t listed here, I’d love to hear from you—feel free to reach out and share!


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Written by: Dr Erin Clarke & Hailey Donnelly                                                                 
Nutrition plays an important role in managing and preventing musculoskeletal conditions, particularly osteoarthritisosteoporosis, frailty and sarcopenia. Importantly, while there are many non-modifiable factors that impact musculoskeletal health, diet is a key modifiable risk factor that people can manipulate to help reach their weight and health goals.

Key nutrients that are important to consider for musculoskeletal health include vitamin D, calcium, and protein. Vitamin D and calcium work together to support musculoskeletal health. The primary source of vitamin D is from sunlight, and can be hard to reach recommendations through diet alone. Calcium is readily available in dairy products and can also be found in almonds, tofu and fish with bones. A meta-analysis of observational studies showed that total dairy intake was protective against osteoporosis and hip fractures. While it is known that vitamin D and calcium are important for musculoskeletal health, there are no definitive results that vitamin D or calcium supplementation promote musculoskeletal health, therefore, a food-first approach is recommended.

Dietary protein intake is important for maintaining skeletal muscle structure. Protein is found in meats, fish, dairy products, legumes, nuts and seeds. A recent meta-analysis of 16 randomised controlled trials and 13 cohort studies identified that higher protein intakes, compared to lower protein intakes, resulted in a 16% reduction in hip fractures. Interestingly, there was no significant difference if protein sources were plant or animal-based.

The Mediterranean diet focuses on the inclusion of fruits, vegetables, nuts, wholegrains, legumes, and extra virgin olive oil, and encourages a higher intake of fish and poultry over red meat. A systematic review has shown the Mediterranean diet is beneficial for musculoskeletal health as it reduces hip fracture risk, with olive oil aiding in the prevention of frailty, and fruits and vegetables protecting against frailty, sarcopenia and functional disability. Moreover, high-quality protein from lean meat and fish, promoted in the Mediterranean diet, also aid in the prevention of sarcopenia, frailty and osteoporosis. Whilst the Mediterranean diet has demonstrated effectiveness in the prevention of musculoskeletal conditions, evidence suggests it can also improve bone mineral density, muscle mass, lower extremity function, mobility and walking speed. Therefore, the Mediterranean diet could be considered as a dietary pattern to support musculoskeletal health.

Osteoarthritis, obesity and sarcopenia are pro-inflammatory conditions that affect musculoskeletal health. Diet can play a role in modulating inflammation in the body. Unhealthy diets, i.e. those high in saturated fats, processed foods, sugar and refined grains, have been referred to as a pro-inflammatory diet and shown to be associated with an increased risk of fractures and low bone mineral density. Healthy diets that are rich in fruits, vegetables, wholegrains, lean proteins and unsaturated fat have been shown to have anti-inflammatory effects. Anti-inflammatory diets have been shown to reduce osteoarthritis progression and pain. Although anti-inflammatory diets, such as the Mediterranean diet, have positive effects on muscle mass and function, few studies examined the relationship with sarcopenia; therefore, more evidence is required for the relationship between diet and sarcopenia. While anti-inflammatory diets could be considered, weight loss interventions also show promise in improving inflammation, with research showing small to moderate improvements in pain, disability and weight loss in those with osteoarthritis.

For personalised nutrition advice that can support individuals to prevent and manage their musculoskeletal health, or guidance on appropriate weight management, refer to a dietitian. Find a Dietitian

References:

  1. https://pubmed.ncbi.nlm.nih.gov/36278278/
  2. https://www.mdpi.com/2673-396X/6/1/10#:~:text=A%20balanced%20diet%20and%20regular,for%20preventing%20falls%20and%20fractures.
  3. https://www.tandfonline.com/doi/abs/10.1080/10408398.2019.1590800
  4. https://www.mdpi.com/2673-396X/6/1/10#B57-endocrines-06-00010
  5. https://pmc.ncbi.nlm.nih.gov/articles/PMC10092134/
  6. https://pubmed.ncbi.nlm.nih.gov/28686536/
  7. Mediterranean diet | Dietitians Australia
  8. Nutrition and Physical Activity in Musculoskeletal Health
  9. Nutritional strategies to optimise musculoskeletal health for fall and fracture prevention: Looking beyond calcium, vitamin D and protein – ScienceDirect
  10. Mediterranean Diet and Musculoskeletal-Functional Outcomes in Community-Dwelling Older People: A Systematic Review and Meta-Analysis – ScienceDirect
  11. https://www.mdpi.com/2072-6643/15/10/2405
  12. https://www.sciencedirect.com/science/article/pii/S216183132200388X
  13. https://pubmed.ncbi.nlm.nih.gov/36904104/
  14. Effectiveness of Weight-Loss Interventions for Reducing Pain and Disability in People With Common Musculoskeletal Disorders: A Systematic Review With Meta-Analysis | Journal of Orthopaedic & Sports Physical Therapy
  15. Find a Dietitian

Bio – Dr Erin Clarke

Dr Erin Clarke is an early career researcher in School of Health Sciences at The University of Newcastle. In addition, she maintains her role as an active clinician as an Accredited Practising Dietitian. She completed her Bachelor of Nutrition and Dietetics (Honours Class I) in 2016 and a PhD in Nutrition and Dietetics in 2021.

Dr Clarke’s research expertise includes dietary assessment, which harnesses technology, dietary biomarkers the relationship between diet quality and health. Her interest areas include the relationship between diet and heart health, diabetes, and chronic health conditions. Since graduating, she has expanded her research to focus more on precision and personalised nutrition, including investigating the interplay between diet and genetics, and the dietary metabolome.

 Bio – Hailey Donnelly

Hailey is a PhD candidate in the School of Health Sciences at The University of Newcastle and is an Accredited Practising Dietitian working in the local community health service. She completed her Bachelor of Nutrition and Dietetics (Honours Class I) in 2021. Hailey’s expertise and interest areas include diabetes, diabetes-related complications and the role of nutrition in prevention and management of chronic disease.


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Meet Isabella Fitzgibbon…as an eleven-year-old, Isabella was diagnosed with slipped capital femoral epiphysis (SCFE) of her left hip, a condition where the growth plate in the hip breaks, causing the femur to slip out of place.

As a kid, I never stopped moving. I was always running, climbing, and playing sports with my siblings. But at eleven, while kicking the footy around, I felt a sharp pain in my left leg. I limped home, saw the GP and physio, and was told it was just a muscle strain. But as the pain worsened over six weeks, I was sent for X-rays—and that’s when I got my diagnosis of SCFE.

Due to the blood supply of the femur being compromised, I was rushed to the hospital for surgery, which consisted of bilateral screws to my hips and crutches with no-weight bearing on my left leg for twelve months.

Despite this, sport remained my passion. Thanks to my older brothers, cricket became my game. By eighteen, I’d signed my first professional county cricket contract in Ireland, followed by two seasons in England. But then the pain returned AND my hip started ‘clicking’. Tests revealed severe osteoarthritis, a labral tear, femoroacetabular impingement, and hip dysplasia—all in my left hip. By 22, I was undergoing my third hip surgery.

They say the third time’s a charm. Unfortunately, that wasn’t to be the case. The surgery didn’t work. Within months, the pain and clicking were back. I’ve since seen specialists across Australia and New Zealand, all agreeing that I’ll eventually need a total hip replacement. The catch? You can only have a maximum of three in your lifetime, each lasting around fifteen years. So, for now, I’ve been advised to wait as long as possible and ‘manage’ my pain.

When it became clear I couldn’t keep playing cricket, I pivoted. I completed my Diploma in Sports and Remedial Massage, determined to stay in the game in some way. That led me to my dream job (at the time) —working as a Sports Therapist with the NRL. It was the perfect balance: I still got my professional sports fix, stayed part of a team, and worked closely with athletes. But just two years in, the physical demands of the job took their toll on my hip, and once again I had to step away from doing something I loved.

Whilst sport had always been my passion, I knew I wanted to make a difference. My interest in the health space and my lived experience could be the way that I would achieve this. Currently, I’m studying Health Promotion at Monash University and have joined MHA as a Project Officer, I love being part of the team here. My passion? Advocating for consumers navigating their musculoskeletal journey, raising awareness that these conditions affect people of all ages, and creating opportunities for everyone—no matter their condition—to keep moving.

I’m especially excited about using new and innovative strategies, including social media and AI to build awareness of the work we’re doing at MHA. I can’t wait to share more about the exciting projects we have lined up this year.

If you’d like to share your musculoskeletal story for our newsletter or social media, get to know me better, or join me in a chair-based workout, I’d love to hear from you! Reach out to me at: Isabella.fitzgibbon@muscha.org

Call our free national helpline

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

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 The Sydney Children’s Hospital Network SCFE information sheet


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Rheumatoid arthritis (RA), osteoarthritis (OA) and osteoporosis (OP) have some similarities in their names, but is that where it ends?

This article will explore the similarities and differences of these common musculoskeletal conditions.

First – let’s look at those names

Rheumatoid arthritis – OK, this is a little convoluted, so hold onto your hat 😉. For those that don’t want the history lesson in ancient Greek, essentially it means inflammation of the joints. But for those who do read on…

Rheumatoid comes from rheumatism, which comes from the Greek word rheuma, which describes something that flows. Hippocrates (460-370BC), considered the father of modern medicine, ‘attributed many illnesses, especially those causing muscle achiness to the abnormal flow of body rheums or humors’.(1)

Arthritis – comes from the Greek word arthron for joint and itis, which means inflammation. Put together – inflammation of the joints.

Osteoarthritis – this is much more straightforward. Osteo – means bone and arthritis (inflammation of the joints).

Osteoporosis – another straightforward one 😉. Osteo (bone) and porosis means porous. So we have porous bones.

OK, we’ve had a trip through history and etymology, but what does this mean? I’ll admit rheumatoid had me scratching my head trying to work it all out. It seems to me that the rheuma part isn’t as helpful in the 21st century as it may have been for the ancient Greeks! But the arthritis part obviously is much closer to the mark. And you’ll see that the rest of the names pretty well match up with what’s going on with these conditions.

Rheumatoid arthritis (RA) vs osteoarthritis (OA) – what are the similarities and differences?

We know they’re both a type of arthritis. That’s the easy part. People who have these conditions will have some common symptoms – inflammation, joint pain and stiffness.

That’s about where the similarities end.

Rheumatoid arthritis is an ongoing health condition that causes pain, stiffness and swelling in your joints.rheumatoid arthritis

It’s the result of your immune system working in a faulty way. This is an autoimmune condition.

Your immune system is designed to look out for and attack foreign bodies – like bacteria and viruses – that can make you sick. For reasons that we don’t fully understand, when you have RA, your immune system gets confused. It targets your joints and healthy tissues as if they were foreign bodies.

This causes ongoing inflammation and pain.

Symptoms:

  • swelling, pain and heat in the joints, usually the smaller joints of the hands or feet
  • stiffness in the joints, especially in the morning
  • persistent mental and physical tiredness (fatigue)
  • same joints on both sides of the body are usually affected (symmetrical).

Less often, RA may also affect other systems in your body, like your eyes and lungs.

RA can affect people of any age but most often appears between 30 and 60. It affects women more often than men. However, when women reach menopause, the incidence of RA becomes the same for men and women.

How RA develops and how severe it is will be different for each person. Symptoms can develop gradually or can start with a sudden, severe attack. Your symptoms can change from day to day, and at times they can become much worse (called a flare). At other times, your symptoms may go away (called a remission).

The good news is that modern treatments for RA are extremely effective at controlling the disease and reducing its impact on people’s lives.

Osteoarthritis is the most common form of arthritis and affects the cartilage covering your bones’ ends.osteoarthritis

Healthy cartilage acts like a slippery cushion absorbing shock and helping your joints move smoothly. With OA, the cartilage becomes brittle and breaks down. Some pieces of cartilage may even break away and float around inside the joint. Because the cartilage no longer has a smooth, even surface, the joint becomes stiff and painful to move. Eventually, the cartilage can break down so much that it no longer cushions the two bones. Your body tries to repair this damage by creating extra bone. These are bone spurs. Bone spurs don’t always cause symptoms, but they can sometimes cause pain and restrict joint movement.

OA is most likely to develop in people over 45, but it can also occur in younger people.

Symptoms:

  • joint stiffness
  • joint swelling (inflammation)
  • grinding, rubbing or crunching sensation (crepitus)
  • joint pain
  • muscle weakness.

It was once thought to be an inevitable part of ageing, a result of a lifetime of ‘wear and tear’ on joints. However, it’s now understood that OA is a complex condition and may occur due to many factors. The good news is that many of these factors can be prevented.

Treating RA and OA

Both rheumatoid arthritis and osteoarthritis can be managed effectively. Things you can do – whether you have RA or OA – include exercising regularly, maintaining a healthy weight (or losing weight if required), and taking any medicines as prescribed.

Treatment for rheumatoid arthritis will also focus on controlling your overactive immune system and preventing joint damage.

What about osteoporosis (OP)?

Osteoporosis doesn’t affect the joints as OA and RA do. It affects the bone itself.

Bones are living tissue that’s constantly growing, rebuilding, replacing and repairing. From birth to about 25 years of age, you build more bone than you lose. Your bones are not only getting bigger as you grow during this time, but they’re developing their density. This determines how strong they are.

From about 25 to 50 years of age, 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 years of age, you start to break down more bone than you rebuild. While this means that we’ll all experience some bone loss, it doesn’t mean that everyone will develop osteoporosis.

Women commonly experience a period of rapid bone loss after the onset of menopause. After this time, there’s a steady but less rapid loss of bone.

When a person develops osteoporosis, their bones become more porous, lose strength and become fragile. Osteoporotic bones break (or fracture) more easily than normal bones. Even a minor bump or fall can cause a serious fracture.

Many people with osteoporosis don’t know they have it. It doesn’t have any obvious signs or cause pain unless a bone has broken.

Common risk factors for osteoporosis include a family history of OP, having conditions such as RA, coeliac disease or diabetes, smoking, and not getting enough calcium or vitamin D. You can check if you’re at risk of OP by using the Know Your Bones online tool.

Treating osteoporosis

OP can also be effectively managed and involves regular weight-bearing exercise and a healthy diet incorporating calcium-rich foods. Depending your age, general health and fracture risk, your doctor may prescribe medicines to help slow down bone loss or increase the amount of bone that’s made. Find out more about OP and the ways it’s treated.

More to explore

Reference

(1) How rheumatism got its name
The Rheumatologist


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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


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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 painmusculoskeletal condition, treatment options, mental health issuestelehealth, or accessing services. They’re available Monday to Thursday between 9am-5pm on 1800 263 265; email (helpline@muscha.org) or via Messenger.

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21/Jun/2023

What do a 10th-century Viking/poet, the subject of a 16th-century painting, and an 18/19th-century composer have in common?

Researchers at one time or another speculated they all had Paget’s disease of bone. That the physical features of Egil Skallagrímsson and the Ugly Duchess, and Beethoven’s deafness resulted from living with untreated Paget’s disease.

Later research has thrown shade on these speculations. And in reality, we may never know if they did or didn’t have Paget’s disease. And remember, one’s a painting! But it’s an interesting bit of trivia to store away in the back of your brain. You never know when it might come in handy. 😉

So what is Paget’s disease?

Paget’s disease of bone is a chronic condition that causes abnormal enlargement and weakening of bones. Any part of the skeleton can be affected, but the most common sites include the skull, spine, pelvis, thigh bone, shin and upper arms. It can affect one bone or many bones.

Paget’s disease tends to affect people over the age of 50. It affects slightly more men than women.

Paget’s disease of bone is named after Sir James Paget, a 19th-century English surgeon and pathologist. Paget was quite the go-getter and was the first to describe many medical conditions, several of which bear his name. However, they shouldn’t be confused with Paget’s disease of bone.

Bones and Paget’s disease

To understand how Paget’s disease affects bones, it’s helpful to know how bones work.

Although we often consider them dry and lifeless, bones are living tissue that are constantly changing throughout life. This is called ‘remodelling’.

Bone cells called osteoblasts build new bone (formation), while other bone cells, osteoclasts, break down and remove old bone (resorption). This process is controlled by hormones such as calcitonin, parathyroid hormone, oestrogen (in women), testosterone (in men), and vitamin D.

In a person with Paget’s disease, the osteoblasts become overactive, producing too much bone tissue. The abnormal growth results in the affected bones becoming deformed (e.g. bowed leg bone), enlarged and weak. The new bone also contains more blood vessels than normal bone.

The reason for this accelerated bone growth is unknown. A combination of genetic and environmental factors (e.g. a virus) is suspected.

Causes, symptoms and diagnosis

As with most musculoskeletal conditions, we don’t know the cause of Paget’s disease. However, some factors increase your risk of developing it. They include:

  • Genetics. You’re more likely to develop it if you have a family history of Paget’s disease.
  • Ethnicity. It’s more common in people from England, Scotland, central Europe and Greece, and countries settled by European immigrants (e.g. Australia and New Zealand).
  • Age. Paget’s disease becomes more common with age, but it’s rare before age 55.

Many people don’t realise they have Paget’s disease because they don’t have any symptoms or only mild symptoms. Symptoms vary but may include:

  • bone pain
  • enlarged or misshapen bones
  • warmth over affected bones due to increased blood supply to the bone
  • osteoarthritis.

Paget’s disease is often discovered by accident when x-rays are taken for another reason or a bone is broken. Diagnosis can be confirmed with further x-rays, bone scans or a blood test that checks for an enzyme crucial to bone growth called alkaline phosphatase.

Treatment

There’s no cure for Paget’s disease; however, your symptoms can be effectively managed with medicines and self-care.

Your doctor may refer you to a specialist, such as a rheumatologist or endocrinologist. Rheumatologists are doctors who specialise in diagnosing and treating problems with joints, muscles, bones and the immune system, while endocrinologists specialise in diagnosing and treating problems of the endocrine system.

Medicines.

The types of medicines used for Paget’s disease include:

Calcium and vitamin D may be recommended as both are essential for good bone health. You can get calcium through your diet and vitamin D through safe exposure to sunlight. If you’re concerned you’re not getting enough calcium and vitamin D, talk with your doctor about whether you need supplements.

Stay active.

Exercise helps maintain bone health and joint mobility and strengthens muscles. However, as bones are weaker and more susceptible to fracture, some exercises may not be suitable for people with Paget’s disease. It’s best to talk with a physiotherapist or exercise physiologist about the most appropriate exercise plan for you.

Enjoy a healthy, well-balanced diet.

This can help you maintain a healthy weight and reduce your risk of other health problems. Make sure you include calcium-rich foods.

Learn new ways to manage pain.

There are many ways to manage pain, and different strategies will work for different situations. Read our A-Z guide for managing pain for more information.

Complications

For most people, Paget’s disease progresses slowly and can be managed effectively. However, in some cases, complications can arise, including:

  • Osteoarthritis. In joints close to bones affected by Paget’s disease, the cushioning cartilage on the ends of the bones can break down, causing pain and stiffness.
  • Broken bones. The new bone growth is fragile and more susceptible to breaking than healthy bone.
  • Hearing loss may be caused by pressure on nerves in the ear.
  • Numbness or tingling in the spine caused by pinched nerves in the spinal cord.
  • Too much calcium in the blood. When several bones have active Paget’s disease, the increase in bone breakdown can lead to an elevated blood calcium level. This is rare, but it can cause symptoms such as fatigue, weakness, abdominal pain, constipation, and loss of appetite.
  • Very rarely, Paget’s disease can cause heart failure or bone cancer.
  • In severe cases, surgery may be required to relieve pinched nerves or bone fractures or to replace a joint severely affected by arthritis.

Contact our free national Help Line

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

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dodgy-knee.jpg
18/May/2023

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 painmusculoskeletal condition, treatment options, mental health issuestelehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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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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25/Jan/2023

In October 2022, the Albanese Government announced that they would invest almost $7 million in stem cell research. The ARISTOCRAT project, led by MSKs Director Emeritus, and orthopaedic surgeon Professor Peter Choong, will allow researchers to develop new therapies to improve the lives of people with conditions like osteoarthritis.

So what does this mean? What are stem cells? And, will they be the miracle treatment we’ve been waiting for?

Let’s take a look.

But first, what’s osteoarthritis?

Osteoarthritis, or OA, is the most common form of arthritis. It most frequently affects the joints in the knees, hips, feet, spine and hands.

OA was once thought to be a natural part of ageing or a lifetime of ‘wear and tear’ on joints. But we now know it’s much more complex than that and may occur due to many factors.

With OA, the cartilage that lines the ends of bones in a joint, enabling them to move smoothly over each other, becomes brittle and breaks down. Because the cartilage no longer has a smooth surface, the joint becomes stiff and painful. Eventually, the cartilage can break down so much that it no longer cushions the two bones.

There are currently no treatments, including medicines, that can affect the underlying disease process of OA. Instead, symptoms (e.g. pain and stiffness) are managed using exercise, weight management and medicines that provide temporary relief.

The lack of targeted treatments to prevent OA from worsening or reversing the damage it causes makes the promise of new and innovative treatments, such as stem cells, very exciting.

So what are stem cells?

Cells are the basic building blocks of all living things. They provide structure for the body, take in nutrients from food, convert those nutrients into energy, and carry out specialised functions. Cells also contain the body’s hereditary material and can make copies of themselves. We have many different types of cells, such as nerve, bone, fat, blood, and stem cells.

Stem cells differ from other cells in the body in three ways:

  1.  they can divide and renew themselves over a long time
  2.  they’re unspecialised, so they can’t do specific functions in the body
  3.  they can become specialised cells, such as muscle cells, blood cells, and brain cells.

There are many types of stem cells. However, the type of stem cell most often promoted as a treatment for osteoarthritis is the mesenchymal stem cell or stromal cell. They’re generally referred to as MSCs (because no one can say mesenchymal 😉). These cells can be obtained from many parts of the body, including bone marrow and fat.

MSCs can become bone cells (osteoblasts), cartilage cells (chondrocytes), muscle cells (myocytes), or fat cells (adipocytes). They can also release substances that may alter how the immune system responds to injury and encourage other cells to grow.

This has led scientists and doctors to explore whether MSCs can restore function to damaged joints and tendons.

EuroStemCell has an interesting article that explains MSCs – what they are, what researchers are investigating when it comes to MSCs, and the challenges they face.

More research is needed

For most conditions, stem cell treatments are still considered experimental. They have yet to prove safe or effective in clinical trials for osteoarthritis.

While there’s a lot of excitement about the future, we need more research to understand how to best obtain, handle and administer stem cells or the cells made from them.

We need to know some of these answers to ensure that new stem cell treatments don’t cause more harm than good.

We also need more information about potential side effects and the long-term safety of stem cell treatments.

Be wary

Unfortunately, despite the lack of reliable evidence that stem cell treatments work and are safe to use, they’re actively promoted for osteoarthritis and many other health conditions by clinics in Australia and overseas.

Some clinics use cells obtained from the person on the same day they’re collected, while others may grow the person’s or donor cells in the lab over several weeks before returning them to the person. It’s important to know that even when the cells are taken from a person and returned to the same person, there’s still risk involved. Even though they’re your own cells, the fact that they’ve been removed means there’s the risk that they may have become contaminated.

Most clinics charge substantial fees (thousands of dollars). They encourage multiple treatments and may imply they’re doing research but aren’t usually part of a registered clinical trial. They also often use celebrity patients’ testimonials or endorsements to support their claims of success.

That’s why participating in a clinical trial is currently the safest way to access stem cell treatments. Researchers must follow strict rules to ensure that participants are safe. Each clinical trial also follows a careful study plan or protocol that describes what the researchers will do.

Before joining a clinical trial, you’ll be told what to expect as a participant and all the things that might happen. For example, someone from the research team will explain possible side effects or other risks of the treatment. You’ll also have a chance to ask questions about the trial. In most cases, you won’t be required to pay any costs involved in participating in a clinical trial. There may be out-of-pocket expenses, such as travel, which may be reimbursed to you.

Ask questions

If you’re considering trying a stem cell treatment, you need to be well-informed – so ask lots of questions. For example:

  • Is this treatment part of a registered clinical trial listed on the Australian New Zealand Clinical Trial Registry (ANZCTR), ClinicalTrials.gov, or elsewhere?
  • Was ethics review and approval obtained, and by whom?
    Note – All clinical research projects in Australia must be approved by a Human Research Ethics Committee (HREC), which checks that the research conforms to the National Statement on Ethical Conduct in Human Research requirements.
  • Does the doctor, or any of the researchers involved, have any conflicts of interest, including financial?
  • What are the total costs of the treatment, and how much will I be expected to pay? Remember, if you’re taking part in a clinical trial, no costs should be involved.
  • Will you use my own cells, or are they from a donor or other source?
  • How does this treatment compare to other treatments?
  • Is there any scientific evidence (not testimonials or anecdotes) that the treatment improves my health condition?
  • What are the potential side effects or risks involved?
  • How many treatments are required?
  • How long do you monitor the effects of my treatment?

Stem cell treatments are still considered experimental for osteoarthritis, so don’t be embarrassed to ask lots of questions. Learn as much as possible about the treatment and how it might affect you. You should also have a chat with doctor or specialist about your intentions and get their input.

Stem cells and cell therapy are an exciting new frontier in medicine, but it’s still early days. So watch this space.

And watch our video, Stem cells and muscle, bone and joint health: Hope, hype and reality, presented by Professor Megan Munsie, Deputy Director – Centre for Stem Cell Systems, The University of Melbourne; Head – Education, Ethics, Law & Community Awareness Unit, Stem Cells Australia.

Contact our free national Help Line

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

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13/Oct/2022

Osteoarthritis is the most common form of arthritis. And because of this, I think it’s often dismissed, and its effects underestimated.

I mean, how often have you heard people say, ‘it’s just wear and tear’, ‘we’ll all get it eventually’, or my personal favourite ‘it’s just a bit of arthritis’ 😤? These offhand comments trivialise the considerable pain and disability that osteoarthritis (OA) causes many Australians.

If you have OA or know someone who does, you know it can significantly impact every aspect of life. Symptoms such as persistent pain, fatigue, stiff and swollen joints, weakened muscles, anxiety, depression, and sleep problems can affect a person’s ability to be as involved in social, community and work activities as they might like.

So, no, it’s not ‘just’ arthritis.

Let’s look at what it is.

What is osteoarthritis?

As we know, OA is the most common form of arthritis. It’s most likely to develop in people over 45, but it can also occur in younger people. It frequently affects weight-bearing joints, such as the knees, hips, feet, and spine. The joints of the hands, including the thumbs, are also commonly affected.

While it was once thought to be an inevitable part of ageing, resulting from a lifetime of wear and tear on joints, we now know it’s a complex condition and may occur due to many factors.

Osteoarthritis and your joints osteoarthritis

To understand how OA affects your body, it’s helpful to know a little about your joints.

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

Covering the ends of your bones is a thin layer of tissue called cartilage. It provides a slippery cushion that absorbs shocks, helps your joints move smoothly and prevents bones from rubbing against each other.

Around most of your joints is a tough capsule that holds your bones in place. The inside of the capsule is lined with synovial membrane, which produces synovial fluid. This fluid lubricates and nourishes the cartilage and other structures in the joint.

With OA, the cartilage becomes brittle and breaks down. Some pieces of cartilage may even break away and float in the synovial fluid. Because the cartilage no longer has a smooth surface, the joint becomes stiff and painful to move.

Eventually, the cartilage can break down so much that it no longer cushions the two bones. Your body tries to repair this damage by creating extra bone. These are bone spurs (or osteophytes). Bone spurs don’t always cause symptoms but can sometimes cause pain and restrict joint movement.

OA causes and risk factors

Many things can increase your chances of developing OA, including:

  • your age – people over 45 are more at risk
  • being overweight or obese
  • your genetics – the genes you inherit can play a role in developing OA
  • other conditions – such as rheumatoid arthritis and gout, can cause damage to your joints and lead to OA
  • gender – 3 in 5 people who have OA are women
  • repetitive movements associated with your job or occupation (e.g. constant kneeling, squatting, lifting heavy loads)
  • significant injury, surgery, damage or overuse of a joint.

Signs and symptoms

The symptoms of OA can vary from person to person. Some of the more common symptoms include:

  • joint pain, stiffness and swelling (inflammation)
  • grinding, rubbing or crunching sensation (crepitus)
  • muscle weakness.

These symptoms can sometimes worsen, especially when you feel stressed, upset, overdo things, or don’t get enough sleep. This is called a flare or flare-up.

Diagnosing OA

If you’ve been experiencing joint pain, it’s essential you discuss your symptoms with your doctor. Getting a diagnosis as soon as possible means that treatment can start quickly. This will give you the best possible outcomes.

To diagnose your condition, your doctor will do some exams or tests. They may include:

  • Your medical history. Your doctor will ask you about your symptoms, family history and other health issues.
  • Physical examination. Your doctor will look for swelling in and around the joint and test your joint’s range of movement. They’ll also feel and listen for grinding, rubbing or creaking in the joint.

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

Treating OA

There’s no cure for osteoarthritis; however, your symptoms can be effectively managed with exercise, weight management, medicines, and self-care.

Exercise

Because of the old ‘wear and tear’ myth, many people are worried that exercising joints with OA will cause more joint damage. But regular exercise can actually help reduce some of your symptoms (e.g. pain, stiffness) and improve your joint mobility and strength. It will also move synovial fluid through the joint, providing essential nutrients and removing waste.

Exercises that move your joints through their range of movement will also help maintain joint flexibility; this is often lost due to OA. Strengthening the muscles around your joints is also important. The stronger they are, the more weight they can take. This will help support and protect your joints.

An exercise program that promotes muscle strength, joint flexibility, improved balance and coordination, and general fitness will give you the best results. Start exercising slowly and gradually increase the time and intensity of your exercise sessions over weeks and months. A physiotherapist or exercise physiologist can help you work out an exercise program that’s right for you.

Weight management

Being overweight or obese increases your risk of developing OA and the severity of your condition. The additional weight also increases pressure on your joints, especially your weight-bearing joints (e.g. hips, knees, feet), which is likely to cause further pain and damage.

The amount of overall fat you carry is also significant because fat releases molecules that contribute to low but persistent levels of inflammation across your whole body. This, in turn, increases the level of inflammation in the joints affected by OA.

For these reasons, maintaining a healthy weight is essential if you have OA. Your doctor or dietitian can advise you on safe weight-loss strategies if you need to lose weight.

Weight loss can be a long process for many people. It’s challenging, especially when pain affects your ability to be as active as you’d like. But 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. It just takes time, commitment, and support.

Medicines

No medicines can affect the underlying disease process of OA, but combined with exercise, weight management, and self-care, medicines may provide temporary pain relief and help you stay active.

The most commonly used medicines for OA are:

  • Non-steroidal anti-inflammatory medicines or NSAIDs (e.g. ibuprofen). These medicines are available over-the-counter and with a prescription, depending on their dosage and other ingredients. They come in tablet/capsule form (oral NSAIDs) or as a gel or rub applied directly to the skin (topical). It’s important to note that oral NSAIDs are designed to be taken at low doses for short periods. Always talk with your doctor before starting NSAIDs, as they can have side effects.
  • Paracetamol. Research has shown that paracetamol provides only low-level pain relief for osteoarthritis. However, some people report that it helps reduce their pain so they can be more active. For this reason, it’s worth discussing a trial of paracetamol with your GP to see if it‘s appropriate for you.
  • Corticosteroid (steroid) injections may be helpful for people who haven’t found relief from other treatments (e.g. exercise, weight loss) or other medicines. Corticosteroid injections into a joint can provide short-term pain relief; however, the number of injections you can have each year is limited due to potential harm.

Note: Opioids are powerful pain-relieving medicines that effectively reduce acute pain (or the pain resulting from an injury or surgery). In the past, they were prescribed to treat pain associated with conditions like osteoarthritis; however, there’s strong evidence that they have little effect on OA pain. Opioids also have many potentially serious side effects. That’s why they’re not recommended in the management of OA. Read the Choosing Wisely Australia resource ‘5 Questions to ask about using opioids for back pain or osteoarthritis’ for more info.

Self-care

There are many other things you can do to reduce the impact of your symptoms, including:

  • Learning about your condition. Understanding OA and how it affects you means you can make informed decisions about your healthcare and actively manage it.
  • Learning ways to manage your pain. Pain is the most common symptom of osteoarthritis, so it’s crucial to learn to manage it effectively. Read our A-Z guide for managing pain for more information.
  • Working closely with your healthcare team. The best way to live well with OA is by working closely with the people in your healthcare team (e.g. GP, physio) and keeping them informed about how you’re doing and alerting them to any changes.
  • Protecting your joints. Supports such as walking aids, specialised cooking utensils, ergonomic computer equipment and long-handled shoehorns can reduce joint strain and make life easier. An occupational therapist can advise you on aids, equipment and home modifications. You can also check out our range of aids in our online shop.
  • Taping, knee braces and orthotics may be helpful if you have OA in your knees or feet. A physiotherapist or podiatrist can advise you on these.
  • Improving sleep quality. Not getting enough quality sleep can worsen your symptoms; however, getting a good night’s sleep when you have osteoarthritis and chronic pain can be challenging. If you’re having problems sleeping, talk with your doctor about ways you can address this.
  • Managing stress. Stress can also aggravate your symptoms, so learning to deal with stress is extremely helpful. Things you can do to manage stress include planning your day and setting priorities, using relaxation techniques such as going for a walk, getting a massage or listening to music, and, where possible, avoiding people and situations that cause you stress.
  • Eating a healthy, balanced diet. While there’s no specific diet for OA, it’s important to have a healthy, balanced diet to maintain general health and prevent weight gain and other medical problems, such as diabetes and heart disease.

Surgery

In most cases, surgery isn’t required for people with osteoarthritis. However, surgery may be an option if all non-surgical treatment options have been unsuccessful and you’re still experiencing significant pain and loss of function.

The most common surgery for osteoarthritis is a joint replacement. When considering surgery, you should be informed about what it involves, the rehabilitation process, and its potential benefits and risks.

Note: An arthroscopy isn’t recommended to treat knee OA. Evidence shows it’s not effective in improving OA knee pain or function.

Contact our free national Help Line

Call our nurses if you have questions about managing your painmusculoskeletal 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.

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