pain relief - Musculoskeletal Health Australia (MHA)

04/Jun/2020

The opium poppy is such a pretty, delicate looking flower. And humans have been actively growing them and enjoying their medicinal benefits since at least 3,400 B.C. The Sumerians referred to it as Hul Gil or the “joy plant.”

It’s from these delicate plants we get opioids, a group of medications with which we have a long and complex relationship. They can provide great pain relief, but can also cause great harm.

That’s why on 1 June 2020 the Australian Government introduced some changes which affect how we use and access opioids. So let’s look at what opioids are, how they work, and why these changes have been brought in.

What are opioids?

Opioids are pain relieving medications that come in a variety of formulations, dosages and strengths. They include: tramadol, codeine, morphine, oxycodone and fentanyl. You need a prescription from your doctor to buy any medications containing opioids.

Opioids may be:

natural – created using the milky substance found inside the pods of the opium poppy, or
synthetic – created in a lab to have a chemical structure similar to natural opioids.

How do they work?

Opioids attach to opioid receptors in brain cells and dull our perception of pain. The pain isn’t gone, nor is the cause of the pain. It’s simply been dampened so that we can function with less discomfort. They also cause the brain to release the hormone dopamine, which can make us feel happy or relaxed.

Opioids are used to treat severe pain associated with cancer or for acute pain – e.g. following surgery.

They’ve also been used for many years to help people with severe, persistent non-cancer pain, like the pain associated with musculoskeletal conditions. However their long-term benefit is controversial for persistent pain or chronic pain. This is mainly due to the large body of evidence that shows that opioids have a limited effect on this type of pain. In addition they can also have serious side effects particularly with long term use, including breathing difficulties, addiction, overdose and death.

We also know that our body adapts to opioids when we use them long-term. We have to increase the dosage to get the same effect, and an increased dose brings an increased risk of harm.

Every day in Australia there are nearly 150 hospitalisations and 14 emergency department admissions due to opioid use, and three people die from drug-induced deaths involving opioids. (1)

Because of these alarming statistics the Australian government has been changing the way we access opioids. Last year we saw all opioids, even the lowest dose available, requiring a prescription from your doctor. You can no longer buy them over-the-counter.

The latest changes are a continuation of this plan to reduce the harm that opioids can do, and ensure that we use them cautiously and safely.

What’s changing?

From 1 June 2020 changes include:

smaller medication packs containing fewer opioids will be provided for short-term opioid use – for example after surgery or an injury,
improvements in medication information so people are better informed about the potential risks of opioids and how to reduce them, and doctors are following best-practise when prescribing opioids,
updating prescribing ‘indications’ (or when they’re used) to ensure opioids are only prescribed where the benefits outweigh the risks. (2)

Can I still use them for my musculoskeletal pain?

If you’re using opioids to manage the pain associated with your musculoskeletal condition, continue taking them as prescribed and talk to your doctor.

We do know some people experience pain relief using opioids for persistent pain, so if they’re proving to be clinically effective for managing your pain, your doctor will be able to continue to prescribe them. However these new changes will require your doctor to weigh the risks and benefits of these medications, and to explore possible alternatives with you, including enrolling in a pain management program. Also, where opioid use exceeds twelve months or is expected to exceed this time, a second opinion will be required to renew ongoing prescriptions.

Opioids aren’t a magic bullet and should be used in conjunction with other pain management therapies such as physiotherapy, exercise, weight management, cognitive behavioural therapy and mindfulness.

What now?

Living with persistent pain is exhausting. And the possibility of changing your medication can be stressful, especially if you feel like you’re managing your condition and your pain effectively. If you’re worried about these changes, talk with your doctor. Be honest about how you feel, but also be open to the possibility of trying new things to manage your pain. The aim is to keep your pain at a level that allows you to live your life and do the things you want and need to do. Opioids may be part of that, or they may be something that you’ll be able to phase out. It’s something that you and your doctor will need to discuss so that you get the best and safest outcomes.

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

Prescription opioids: What changes are being made and why
Therapeutic Goods Administration, 29 May 2020
Prescription opioids: Information for consumers, patients and carers
Therapeutic Goods Administration, 29 May 2020
What are opioids?
Alcohol and Drug Foundation, 28 January 2020
Smaller pack sizes from today: could new opioid restrictions stop leftover medicines causing harm?
The Conversation, 1 June 2020
Opioid medicines and chronic non-cancer pain
National Prescribing Service, 2 October 2019
Managing your pain: An A-Z guide
Musculoskeletal Australia

References

(1) Prescription opioids: What changes are being made and why
Therapeutic Goods Administration, 29 May 2020

(2) Prescription opioids: Information for consumers, patients and carers
Therapeutic Goods Administration, 29 May 2020

Lisa Bywaters

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:

Lisa Bywaters

16/Apr/2020

Exercise is vital to our health, even while we’re in iso. It helps us manage our pain, our musculoskeletal conditions, our weight (especially with all the cooking we’re suddenly doing) and our mental wellbeing.

But when you’re not able to go to your usual exercise classes, gym, sporting club or fitness centre – online videos and exercise apps seem like the answer. And with most of us in some form of isolation or quarantine, there’s been a proliferation of them being shared on social media and across the internet in general.

But they’re not all created equal. Some are purely videos to watch and follow, others are apps that provide more interaction and features. Some are free, while others require payment.

So before you pull on your leotard, buy a new thingamajig or sign up to that app, here are some things to think about:

What are the qualifications of the leader? Are they a qualified exercise professional – e.g. physiotherapist, exercise physiologist, fitness instructor? With many fitness and wellness centres closed because of COVID-19 many qualified instructors have moved online. This is great news (for us) as there’s only so much walking we can do. But there are also lots of well-meaning people with time on their hands posting exercise videos, as well as other people looking to make a quick buck. So make sure that the instructor is qualified to teach or lead exercise classes.
Are they catering to the general public or people with musculoskeletal conditions? Many general exercise videos or apps will be useful for all of us – musculoskeletal condition or not – especially if they’re gentle. But there are some exercises that may actually be harmful to you. And some that you shouldn’t try without a proper assessment from a qualified instructor as well as guidance to ensure you’re actually doing the exercise properly. To misquote the tagline from Alien – “in your lounge room, no one can hear you scream”…except for the other people in your household, your pets and the neighbours (the walls are thinner than you think!). The point is it can be very easy to hurt yourself if you’re not shown how to do some exercises correctly and safely, particularly if you have a musculoskeletal condition or another health issue.
Which leads to our next point – can you ask questions or get more info from the instructor? If you can, it gives you the ability to ask if they’ve instructed other people with your condition, make sure the exercises are safe for you to do, and get advice if you’re not quite sure you’re doing things correctly. If you can’t interact with them in any way, maybe look for another online exercise class/video/app.
What’s the cost? Is it free, or is there a fee? Or can you access a free basic version, and another version with additional features which you need to pay for? Is there a free trial period so you can make sure you actually like it? And if you do have to sign-up for anything, make sure you read all the fine print so you know exactly what you’re agreeing to.
Does your equipment support the tech? If you’re downloading an app, can your desktop, tablet, phone, watch etc handle it? Do you need to download additional software to use it? Are you prepared and/or able to do that?
Are you set up for it? Is your computer in a location that allows you room to exercise? If you only have a smartphone or tablet, can you view the exercise videos clearly? Is your internet able to cope with any downloads or streaming? If the answer to any of these is no, maybe look at alternatives formats such as DVDs. And with DVDs ask yourself all of these questions as well. There are a lot of good exercise DVDs and a lot of variety as far as types of exercise, but there are also a lot of dodgy ones. So take time to evaluate them carefully.
Is the exercise something you enjoy doing? If you don’t enjoy doing it, you’re unlikely to continue to do it. So find something that you find fun, engaging, challenging and enjoyable.
Can you set goals for yourself? Exercise needs to challenge you so you continue to get the health benefits. If it’s too easy, or doesn’t progress over time, you won’t see any improvements. Setting yourself SMART goals – Specific, Measureable, Achievable, Realistic and Timed – can help with this. Find out how you can create SMART goals.

There are a lot of things you can do to remain active during this pandemic and stay safe. Check out our blog about exercising during the pandemic. It has a range of different things you can do to stay active while isolated.

For more information, visit our website or call our MSK Help line weekdays on 1800 263 265. Or email helpline@msk.org.au.

More to explore

Get active @ home
VicHealth – This Girl Can
We tested these home workouts for you
Life Hacker, July 2021
Exercise Anywhere Anytime
BJC Health
BJC Health is multidisciplinary clinic targeting musculoskeletal disease. They have created a range of exercise videos created by their exercise physiologists that you can do from home.
COFIT19 for adults
Australasian College of Sport and Exercise Physicians
This infographic gives you tips on how you can remain active in your isolation ‘bubble’.
Home exercises
Exercise & Sports Science Australia (ESSA)
ESSA accredited exercise professionals have put together a range of workouts that you can do in the safety of your own home.
How to stay fit and active at home during the coronavirus self-isolati on
The Conversation, 26 March 2020
How exercise can help during coronavirus
VicHealth, 2 April 2020
Fitness Studio exercise videos
NHS (UK)

Lisa Bywaters

31/Jan/2020

With our crazy, busy lives it can sometimes feel next to impossible to squeeze in time for exercise. Add to that the unpredictability of living with a chronic condition, and our planned activities can often go flying out the door.

But there are things you can do to be more active. Incidental exercise – or the little bits and pieces you do over the course of your day – can really add up. It’s important to note that incidental exercise should not replace your regular, structured exercise program, but they’re a great way to boost your activity levels.

Here are some things you can do to increase your incidental exercise.

Watching TV? Whether you’re watching the latest episode of your favourite show or binge watching an entire series, get up and move around during the ads. No ads? No problems. At the end of each episode, do something active. Go outside and check the letterbox. Take the dog for a walk around the block. If you have an exercise bike or treadmill, use it while watching your show.
Love reading? Download an audio book and listen to it as you go for a walk. Just be mindful about how far you walk. It’s easy to get caught up in a book and walk further than you planned! Which has the potential to aggravate your condition and pain levels if you do too much.
Going for a long drive? Make your journey more interesting, and more active by scheduling stops for you to stretch, walk around and discover new areas. It’s amazing what you can find when you take the time to explore.
Shopping? Park your car a little further away from the shops than you normally would. Walk up or down the travellator or escalator – even if it’s just for part of the ride – rather than just standing in place.
Work meeting? Take it outside. Suggest that you have walking meeting. You get to be active and less sedentary, with the added benefit of fresh air.
Catching public transport? Get off a stop before your usual one. Explore your neighbourhood while getting some exercise and breathing deeply.
On the phone? Walk around while chatting, rather than sitting down. But avoid moving about if you’re texting or looking at your screen. Our aim is to increase activity levels safely, not get injured in the process!
Gaming? Fun! But it’s so easy to get caught up in the heat of the battle/chase/adventure, so set your phone alarm to go off every 30 minutes so you can get up and move.
Cleaning? Go hard. Give the tiles an extra vigorous scrub. Flatten your recyclables rather than just tossing them straight into your recycling bin. Clean your windows (groan – but how good do they look when you’re done?). Vacuum the house and use all of the little attachments (who knew they made such a difference?).

Obviously there’ll be times when these activities are not possible or practical – especially if you’re having a flare. However some of them may actually help with your pain – things like standing and moving when your back is really sore, breaking up long trips with stops and stretches – they’ll provide exercise and pain relief.

Give incidental exercise a try. Before you know it, you’ll be feeling more energised and noticing a difference with your pain levels, sleep quality and mood.

Plus your house will be sparkling! Win-win!

More to explore

Queensland Health – What is incidental activity?
Exercise Right – Does incidental exercise actually help?

Lisa Bywaters

23/Jan/2020

Using humour and laughter to help manage your pain

I think there’s a reason we respond so positively to the memes, social media posts and jokes that poke fun at pain, chronic illness and the trials and tribulations that come from living with both.

Having a foggy brain isn’t particularly funny, being unable to sleep isn’t a joke, and pain – wow, that’s probably the un-funniest thing you can think of. But we all do tend to laugh at, and share with others, the well-crafted meme or social media post that ridicules and scoffs at these things because we identify with the truth behind them. And with the best ones, you can tell that someone who knows what it’s like to live with pain and illness has created them. You’re recognising a fellow traveller.

Laughter and humour are such powerful forces. Just think about the last time you had one of those huge, spontaneous belly laughs with your friends or family. Something was said, a joke was told or you all saw something ridiculous. There’s nothing like it. You snort, you chortle, your eyes water, you gasp for breath, your belly starts to hurt and, when you look at each other, you laugh some more. When you finally do stop, you feel euphoric. Everything seems better, you feel happier and you can’t wait to do it again.

Always laugh when you can. It is cheap medicine. – Lord Byron

However when you’re in the grips of pain, laughing is probably the last thing you feel like doing. But laughter can actually help you deal with your pain. A good joke, a funny movie or just seeing something silly can distract you from your pain and make you feel better, at least for a while.

A good laugh heals a lot of hurts. – Madeleine L’Engle

Laughter causes a variety of chemical responses in your body. The ‘feel good’ hormones – endorphins, serotonin and dopamine – are released into your bloodstream. They boost your mood and make you feel more positive. Endorphins are your body’s natural pain reliever. Releasing them into the body reduces your feelings of pain. Laughter can also help boost your immune system. And, let’s face it, it’s just a lot of fun!

So next time your pain is getting you down, why not give laughter a go?

Finally, it’s important to remember that laughter and humour are temporary distractions from pain. They’re great and we should definitely cram as much into our day just for the sheer joy of it. But when you have a chronic illness and persistent pain, a balanced treatment approach that involves appropriate medications and medical care, healthy lifestyle, exercise, mindfulness and yes – laughter – is the best way to live with a chronic condition.

Laughter serves as a blocking agent. Like a bulletproof vest, it may help protect you against the ravages of negative emotions that can assault you in disease. – Norman Cousins

Things to try:

watch/stream a funny movie, TV show
listen to a funny podcast
talk with a friend and reminisce about a funny experience you had together
watch cat/dog/panda videos on YouTube (you know the ones you see pop up on social media regularly!)
think about the funniest joke you ever heard.

Lisa Bywaters

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.

Lisa Bywaters

12/Sep/2018

As someone who wears a lot of black you might be forgiven for thinking that adopting a ginger coloured cat was probably not the smartest thing to do. Sure, it’s a little frustrating when you’re in a hurry and you notice the fur coating your clothes. Or when your house looks like a giant fur-ball.

But armed with my new best friend – the lint roller – I know that the benefits of owning a pet (in my case two very cute cats) was one of the best things I could do for my health and happiness.

When you live with a chronic condition, you often go through periods when you’re up, and then you’re down. It’s just the nature of the beast. But sometimes those downs can be really down. You’re in pain, things can look bleak, and it can be hard to ‘turn that frown upside down’.

But I find that the crazy antics of two young cats – chasing after toys, wrestling with each other, ninja fighting something only they can see – has a great impact on my mood. Sure, the pain is still there, but the distraction they provide, and the unconditional love, has real health benefits.

Research has shown that owning a pet can:

decrease cholesterol levels and blood pressure
decrease feelings of loneliness
reduce stress
improve mood
increase opportunities for exercise and outdoor activities.

I’m sold – let’s go shopping!

Hold your horses for just a minute. If you’ve been thinking of getting a pet, and you think now’s the time, it’s important that you do your research. It’s easy to get swept up in the excitement of adopting a pet, and you want to make sure the fit is right for you and the animal. The RSPCA has several resources to help you decide on the right pet for you. Check the More to explore section below for links.

I love animals, but I can’t have a pet 🙁

Sadly owning a pet isn’t an option for everyone. They can be expensive, you may live somewhere that doesn’t allow pets, you don’t have space, or you work long hours and aren’t home very much.

If that’s the case, but you want to be around animals more, there are other options:

offer to walk a family members/friends/neighbours pet (I saw a person walking an alpaca on a lead recently!)
volunteer time at an animal shelter – there are lots of things you can do – grooming, feeding, playtime socialisation, patting cats, walking dogs
look after a family members/friends pet when they go on holidays
think outside the litter box – there are others pets you can adopt that may be an option – fish, birds, spiders, mice and rats. They may provide a bit more flexibility than the traditional cat or dog ownership
watch videos online. The internet is practically one big animal video…cute cats, playful pups, sneezing pandas. It’s all there waiting for you to find. And even though you’re not in physical contact with an animal, this connection can boost your mood and relieve stress.

More to explore

What do I need to know before I get a new pet? – RSPCA
Smart Puppy Buyer’s Guide – RSPCA
Smart Kitten and Cat Buyer’s Guide – RSPCA
Connecting with pets – Head to Health
Pets are good for your health, and we have the studies to prove it – MNN.com

Lisa Bywaters

02/Aug/2018

Written by Thalia Salt

My name’s Thalia and I’m twelve years old. I was diagnosed with osteoarthritis when I was five years old, which was caused by a joint infection in my left hip when I was ten months old. I like to sing and act, and I love hanging out with my friends after school.

Living with arthritis from such a young age is hard, but it has some advantages. I’ve been finding different ways to cope for my whole life, which means I have some quite effective strategies up my sleeve. But there are many things that aren’t so great. I learned to walk with arthritis, so my gait was awkward. I don’t know what it’s like to have no pain, and sometimes when I do have lots of pain my body tunes out of it until it’s unbearable.

The arthritis has also gotten in the way of my life outside of school activities. I have to sit down when I sing, and I’ve had to do several performances in my wheelchair. When I’m with my friends, we have to limit our activity accordingly. I haven’t been able to participate fully at school and have had to resort to a mobilised scooter in the past just to get around.

This story has a happy ending though. In June 2017, I had a total hip replacement. Since then, I‘ve been walking up to 3km, running, getting around school without my walking aids. I’ve also been swimming and riding my bicycle.

Something else that’s changed is the amount of medication I’m taking. Before, I was taking a large range of medications, including some very strong painkillers. Now I take hardly any medication. My personal lifestyle has also been greatly altered. I’ve been able to move around the house freely, participate in my outside of school activities like any other person, although I’m still not up to standing up for more than a few minutes. I’ve been discharged from the physiotherapist and have started to see a personal trainer.

In the future, I should be able to participate in P.E. at school, stand up for as long as I like, walk around my neighbourhood with my friends after school. I should have no pain, which is something that I’ve not experienced before. I can’t wait to go to the beach without my crutches and being able to do whatever I want when I get there, without worrying about the consequences.

My top 5 pain management tips

Heat packs. Something that affected me a lot was the cold in the dead of winter. A heat pack when relaxing can often ease the pain, particularly when I go to sleep.
Crutches. These help take the stress off your joints. Obviously this only works for pain in your legs.
Reducing movement before a large amount of exercise. If I know that I’m going to participate in an activity that requires a lot of physical movement, I’ll take it easy for a few days, as if I’m “saving” the soreness for later.
Not constantly being on all the meds. That way, when you’re in a lot of pain you have something you can take.
Stretch constantly. I know that maintaining the right amount of exercising and protecting your joint is hard, but a large cause of pain is stiffness from not moving enough. So, you need to stretch. A lot.

Our guest blogger

Thalia is a positive ambassador for young people living with arthritis and chronic pain.

She’s worked tirelessly to raise the profile of arthritis in young people and how it affects them. She’s held fundraising events, received many awards, created a Facebook page, a vlog on YouTube about her surgery and much more.

Lisa Bywaters

27/May/2018

A book by people like you

Chronic pain is a common and complex problem that affects 1 in 5 Australians.

It’s exhausting, a bit tricky and hard to know where to start.

Fortunately, with our book Managing your pain: An A-Z guide you can start anywhere!

Medications, sleep, laughter, fatigue, breathing. Think of it as a ‘choose your own adventure’ to getting on top of your pain.

The book emphasises practical strategies tried and tested by people like you – consumers living with musculoskeletal conditions. There are also a bunch of quotes and useful insights to keep it real.

You might also like…

We also have a helpful kids pain book called The worst pain in the world. It’s beautifully illustrated and loaded with practical advice for children living with pain (not just those with arthritis). It also gives kids who don’t live with pain an understanding of what their friends or family are going through.

Lisa Bywaters

26/May/2018

Have you had a massage lately? We often think of them as an indulgence, or something we get every now and again as a treat. However many people find that regular massages really helps them manage their pain.

Massage is a hands-on therapy that involves rubbing and manipulating the soft tissues of your body, especially your muscles. It can improve blood circulation, ease muscle tension and help you feel more relaxed. A massage can also help relieve stress and help you sleep.

You can relieve many of your own muscular aches and tension by giving yourself a massage. You may even find that you do it unconsciously – when you’re sitting at the computer and you rub your neck, when you have a headache and you gently rub your temples, or when you’re applying a heat rub to your sore knee.

Self-massage tips

Warm up first – ease some of your muscle tension with a warm shower or applying a heat pack (warm not hot) to the painful area.

Use smooth, firm strokes. You’ll feel the difference between strokes that are relieving muscle tension, and those that are adding to it. Adjust the pressure, from hard to gentle, based on your pain.

Add some massage oil (or lotion) – it can help your hands move smoothly over the skin, however, they aren’t essential; it’s a personal choice.

Use massage aids – you can use a foam roller, massage balls or other massage aids; e.g. use a tennis ball or a golf ball to massage the soles of the feet. Simply place the ball on the floor, place your bare foot on top of it and gently roll the ball along the length of your foot. If you’re unsteady on your feet, sit down while you do this. You can also use the shower to provide a massage, especially on your neck, shoulders and back.

Do it regularly – to prevent muscle pain and tension building up.

See a qualified massage therapist –they’ve been trained to know how your body works, how to relieve muscle tension and how to help relieve your pain. They can also get to the hard to reach places, and give you tips and advice on your self-massage techniques.

Massage is a fantastic and simple way to relieve muscle aches and pains. And when you give yourself a massage, you can do it almost anywhere, and it’s free! Try it next time you feel tense and sore.

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