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osteoporosis.jpg
16/Nov/2022

We talk a lot about musculoskeletal conditions being invisible. With current treatments, most people diagnosed with a musculoskeletal condition will have no outward signs of their condition. However, someone living with these conditions can feel the pain and fatigue associated with them.

Osteoporosis is a different story. It really is invisible. There are no obvious signs when a person develops osteoporosis, and importantly, they don’t feel any different. Until they break a bone. Then it becomes obvious that something has happened.

So what is osteoporosis?

Osteoporosis is a condition that causes bones to become weak and lose their strength, making them break more easily than healthy bones. It’s more common in women, but men do get it too.

Another condition, osteopenia, is also associated with weak bones. A person with osteopenia has lower than average bone density but it’s not low enough to be diagnosed as osteoporosis.

Your bones

To understand how osteoporosis affects your bones, it’s helpful to know how they work.

Although we often think of them as dry and lifeless, bones are living tissue. They’re made of the protein collagen and are strengthened with the mineral calcium phosphate. They’re constantly changing throughout life. Specialised bone cells (osteoblasts) create new bone, while others (osteoclasts) break down and remove old bone. The rate at which this occurs changes as we age.

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, but they’re also developing their density. This determines how strong they are.

From about 25 to 50, your bones break down and rebuild at about the same rate. Your bones are at their strongest.

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

Women commonly experience a period of rapid bone loss after menopause. This is due to a drop in oestrogen levels.

Causes of osteoporosis

Osteoporosis is caused by a loss of bone density. Many things can cause you to lose bone density; some you can change, and others you can’t.

Risk factors you can’t change:

  • Family history of osteoporosis
  • Being female
  • Getting older
  • Early menopause (before 45) which results in reduced levels of oestrogen
  • Use of certain medicines, including long-term use of glucocorticoids (e.g. to treat rheumatoid arthritis or asthma), some chemotherapy drugs, epilepsy drugs, and proton pump inhibitors
  • Other health conditions including rheumatoid arthritis, coeliac disease, inflammatory bowel diseases, and diabetes.

Risk factors you can change:

  • Low levels of calcium in your diet
  • Not getting enough vitamin D
  • Being inactive or sedentary
  • Excessive alcohol intake
  • Smoking
  • Being underweight
  • Poor nutrition.

The International Osteoporosis Foundation has an online risk test you can use to check your risk factors. This isn’t a diagnostic tool, but it can help you understand your potential risks so you can discuss them with your doctor.

Symptoms of osteoporosis

For most people, there are no symptoms that you have osteoporosis. Bones becoming weaker has no visible signs until they become so weak that they break. This can cause pain from a fracture – for example, breaking the wrist or hip after a fall. If the bones in the spine (vertebra) have fractured or collapsed, it can cause back pain, loss of height and a stooped posture.

Diagnosing osteoporosis

If you’re concerned that you may have osteoporosis or be at risk of developing it, you should see your doctor.

Your doctor will assess your risk factors for developing osteoporosis and look at your medical history – including your family history.

Family history is significant because having a parent or sibling with osteoporosis puts you at greater risk of developing osteoporosis.

After assessing your risk factors, your doctor will decide whether you need a bone scan. This scan will measure the density of your bones. The best scan for assessing your bone density is a dual-energy x-ray absorptiometry – often referred to as a DEXA or DXA scan.

A DEXA scan is short and painless. While you lie on your back on a padded table, a scanning arm passes over your body to take images of your hips, spine, and in some cases, the forearm. It takes about 15-30 minutes. A report is sent to your doctor, who will discuss the results with you.

Treating osteoporosis

If you’re diagnosed with osteoporosis, or osteopenia, your doctor will work with you to develop a treatment plan to reduce your risk of fractures by protecting and strengthening your bones. This may include calcium, vitamin D, exercise, medicines and self-care.

Calcium

Most of your body‘s calcium is stored in your bones. That’s why we associate calcium with healthy bones and teeth. But your heart, muscles and nerves also need calcium to function properly.

Because your body can’t make calcium, you need to get it from the foods you eat each day. If you don’t have enough calcium to keep your body functioning properly, it will take it from your bones. Over time, this can lead to bones becoming weaker.

The amount of calcium you needs every day varies depending on your age. Find out about the recommended dietary intake of calcium you and your family need every day.

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

Vitamin D

Vitamin D is produced when your skin is exposed to the sun. It’s essential for strong bones because it helps increase calcium absorption, regulates the amount of calcium in your blood, helps strengthen your skeleton, assists with muscle function and reduces your risk of falls.

The main source of vitamin D is sunlight. Exposing your hands, face and arms to the sun daily is essential. But the amount of time you need to do this depends on where you live, the time of the year and your skin’s complexion. You also need to be careful that your exposure to the sun is safe. Healthy Bones Australia has developed a chart to help you work all this out.

Vitamin D can also be found in small quantities in foods such as fatty fish (salmon, herring, mackerel), liver, eggs and fortified foods such as low-fat milk and margarine.

However, it’s unlikely that adequate quantities of vitamin D will be obtained through diet alone.

Exercise

Besides having a calcium-rich diet and ensuring you get enough vitamin D, regular exercise is essential for maintaining healthy bones.

The types of exercise that benefit bone health include:

  • Weight-bearing: such as brisk walking, climbing stairs, tennis, and netball. Your body is carrying its own weight, and gravity exerts a force. Bones become stronger because they’re coping with the force placed on them.
  • High-impact: such as tennis, dancing, jumping or skipping. These exercises place high stresses on the bones of the spine and legs as your feet hit the ground.
  • Resistance training: also known as strength training. This involves using machines (e.g. leg press) or free weights (e.g. dumbbells). The strong muscle contractions required to move a heavy weight place stress on the bone where the muscle attaches. When bone feels this strain repeatedly, it responds by becoming stronger.
  • Balance training: exercises such as tai chi and yoga improve balance and mobility and reduce your risk of falling. This is essential for preventing fractures.

Before beginning an exercise program, speak with your health professional. Not every type of exercise will be suitable for all people.

If you’ve been diagnosed with osteoporosis, it’s especially important that you discuss any kind of exercise with your health professional before you begin. Some high/moderately high intensity exercises may be unsafe for certain levels of osteoporosis.

Medicines

If you have osteoporosis, your doctor will consider your age, general health, and fracture risk before deciding on the most appropriate medicine.

Most osteoporosis medicines slow down bone loss by reducing the ability of osteoclasts to remove bone and allowing osteoblasts to continue to build bone.

In Australia, the following medicines may be prescribed for osteoporosis:

  • oral bisphosphonates – e.g. alendronate and risedronate – weekly or monthly tablets
  • zoledronic acid – once a year infusion given through a needle into the vein
  • denosumab – twice a year injection into the fat just under the skin
  • teriparatide – daily injection for people with severe osteoporosis.

Other medicines:

  • Menopausal hormone therapy (MHT) – also known as hormone replacement therapy or HRT – is a synthetic version of the hormones oestrogen and progesterone and may be an option for some women around menopause.
  • Selective oestrogen receptor modulators (SERMS) – act on bones in a similar way to oestrogen. Because oestrogen levels drop at menopause, they may be prescribed for postmenopausal women who are at increased risk for osteoporosis or already have it.
  • Supplements – calcium and vitamin D are important for bone health. Your doctor may prescribe a supplement if you’re not getting enough through diet or exposure to sunlight.

What else can I do to manage my condition?

You can do many other things to reduce your risk of developing osteoporosis or the impact it has if you do develop it.

  • Learn about your bone health and osteoporosis.
  • Prevent slips, trips and falls, which can lead to broken bones. Falls are most commonly caused by poor muscle strength, poor vision, problems with balance, and home hazards that lead to tripping. Talk with your doctor for information about falls prevention.
  • Quit smoking – it’s linked to reduced bone density.
  • Consume in moderation (if at all) – alcohol, caffeine and salt, as they can all affect your bone density. Alcohol also increases the risk of falling and the chance of fractures.

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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16/Nov/2022

“Roadtripophobia (n.) The fear of not having any road trips currently booked.“

With the weather improving (finally), many of us are looking out our windows and dreaming about road trips to anywhere but here. We’ve been stuck in one place for too long, and it’s time to explore new places! 😎

However, living with arthritis, back pain, and other musculoskeletal conditions can sometimes affect your ability to drive. Pain, fatigue, joint and muscular pain, and brain fog can make driving and sitting for long periods difficult.

That really sucks when your road trip playlist is ready to go, and a bag of kool mints is waiting in your console!

But we’ve got some tips to help you get your motor runnin’… so you can head out on the highway and look for adventure.

“Never underestimate the therapeutic power of driving
and listening to very loud music.” – Unknown

1. Talk with your doctor before you hit the road

If your condition sometimes affects your driving ability, talk with your doctor. Depending on the problems you’re experiencing, your doctor may suggest a range of self-management strategies to help ease muscle tension, reduce pain, prevent you from stiffening up too much, and allow you to move more freely. You can use these strategies in the weeks leading up to your trip and as you travel all over the countryside.

For example, simple things like regular exercise, pain management techniques, aids and devices, and supportive cushions can be a great help on a road trip.

Your doctor may also review your medicines to ensure they’re managing your condition as effectively as possible, with as few side effects (e.g. drowsiness) as possible.

This brings us to the next tip…

2. Know how your medicines affect you

Do your medicines affect your concentration? Do they make you sleepy? Or affect your coordination or reaction time? If so, talk with your doctor about whether there’s another medicine you can use that won’t have this effect on you.

Understanding the effect medicines can have and whether or not they’ll affect your ability to drive safely is extremely important. If you’re unsure, chat with your doctor or pharmacist.

Remember to pack any medicines you may need on your trip, whether you’re gone for an hour or days. Pain and flares can appear unexpectedly, so take a leaf out of the Scout guidebook and ‘be prepared’.

3. Wear comfy clothes

There’s nothing worse than driving for a while and realising you’re wearing the absolute worst clothes for the trip. Your shoes are restrictive, your top doesn’t breathe, and your jeans are giving you an atomic wedgie! 😫

Road trips are fun, so you should feel relaxed and comfortable in the clothes you wear. Choose clothes with some give that allow you to stretch and move around easily, and are appropriate for the weather.

If you want to look more put together at the end of your trip, take a change of clothes and get changed at a rest stop close to your destination.

And don’t forget to pack a raincoat, sunhat and sunscreen – it’s Australia, after all. We can have all the seasons in one day! 🌞☔🌈⚡

4. Plan your trip

Planning and prepping will make you more confident during the drive and reduce the risk of stressful surprises. It also helps to build anticipation for the journey ahead.

  • Make sure your car is ready for the trip. Book it in from a service to ensure tyres, fluids, brakes etc., are up for the drive.
  • Print your maps or enter the route into your GPS. Plan your rest stops, fuel stops, and places you want to visit along the way.
  • If you’re making a long trip, stop every hour, get out of your car and stretch. Give yourself plenty of time; you don’t want to feel tense or rushed. Tension and stress can make your muscles tight and increase your pain levels. So take time to go slow and enjoy the ride. 😊
  • Be aware of changing road conditions. Much of Australia has had extensive rain and floods. This has caused many potholes to form, making driving stressful and potentially damaging to your car. Hitting a pothole can also cause significant jarring, increasing your muscle and joint pain. Read the RACV article: Stay alert, slow down, don’t swerve for info on how to safely navigate potholes.
  • As far as flooding goes, the information is clear – avoid flooded areas, and never drive through floodwaters. If you’re not sure about the state of the roads on your route or where floodwaters are, visit the website of your local roads authority and state emergency services.

“There is nowhere to go but everywhere,
so just keep on rolling under the stars.”- Jack Kerouac

5. Get comfortable in the car

Before you hit play on your playlist and set off, carefully adjust your seat and mirrors. If your feet and ankles are stiff, move your seat forward to push the pedals with your entire foot, not just your toes. Make sure your seat’s height lets you control the pedals without being uncomfortable. You should be able to reach and operate all of the controls, pedals, steering wheel etc., and have good visibility through your windows and mirrors.

If you have pain in your hips or legs, consider using a cushion that supports the lumbar spine, hips and buttocks. You can find these at chemists, auto shops, and any store that sells aids and equipment. Or you can see an occupational therapist for info and advice. Just be sure to do all of this before your trip, so you can try out the cushion to ensure it helps and doesn’t aggravate your condition.

Remember to empty your pockets of keys, wallet, small change and other bits and pieces. They can cause irritation and pain – especially if you have a long drive ahead.

6. Take breaks and notice the world around you

Don’t drive for more than an hour without a break. Stop, get out of your car, and stretch or massage tight muscles. Walk around. Drink some water. Check out what’s nearby – a coffee shop, a historical marker, or a breathtaking view. It’s incredible how much you can discover when you stop and look around. And the break will help you feel better and more relaxed at your destination than if you’d driven straight through.

Build these breaks into your overall trip time so that you have plenty of time to get from point A to point B safely and comfortably.

“Because the greatest part of a road trip isn’t arriving at your destination.
It’s all the wild stuff that happens along the way.” – Emma Chase

7. Stay hydrated and eat well

Water lubricates and cushions your joints, aids digestion, prevents constipation, keeps your temperature normal and helps maintain your blood pressure. When you’re not getting enough water, your body can’t work as well as it should. So make sure you fill your water bottles before you set out and take time to drink from them.

Pack healthy snacks like unsalted nuts, pre-cut fruit and veg, trail mix, or cheese and crackers. Check the nutrition panel to ensure they’re not high in fat, sugar or salt.

Alongside the healthy snacks, you may decide to add a road trip treat (because you’re only human 😉). For my family, that’s always been kool mints or snakes. Yum! 😛

8. Manage your fatigue

You may experience fatigue or intense tiredness due to your condition, the effects of some medicines, or lack of sleep. So plan around your fatigue. For example, if you’re generally fatigued most days around 3pm, plan to do your driving before this.

Your driving ability is compromised when you get tired, or your pain worsens. So don’t drive when you’re feeling foggy or sleepy. Share the driving with others. When you’re not the driver, you can keep the music playing, be the navigator, quiz master, or lolly dispenser. Or just put your head back and rest.

“You can pack for every occasion, but a good friend
will always be the best thing you could bring.”- Unknown

9. Check out aids and gadgets

There are many aids available to help make driving more comfortable, including:

  • A swivel seat cushion to help you get in and out of the car. You pop it on top of your car seat, sit on it with your body facing out and then swivel your body and legs aroundto face the dashboard.
  • A lumbar back support or a rolled-up towel to support your lower back.
  • A steering wheel cover can help make your steering wheel easier to grip if you have stiff, sore hands.
  • If you find it difficult to twist the petrol cap on or off, try using a petrol cap turner. It’ll make twisting the cap easier.
  • Grab handles and bars can be added to your car to help you get in and out of your car more easily.
  • A seat belt reacher can help reduce arm and shoulder strain when reaching for your seat belt and pulling it across your body.
  • Reversing cameras and parking sensors are available in most new cars and can be added to older ones. They can make parking and reversing easier if you have problems twisting, turning your neck or looking over your shoulder.

Talk with an occupational therapist for information and advice about what aids or gadgets may be helpful for you.

10. Use heat and cold treatments

Applying heat or cold to painful areas before you head out in your car can help relieve your pain. Generally speaking, heat can ease muscle spasms and tension, and cold can reduce swelling. Heat and cold treatments are available in a wide range (e.g. packs, rubs, gels, patches). Some are portable and can be left in your glovebox or bag, so you have them on hand when you need them. Always read the instructions carefully before using them.

11. And have fun!

Heading out on a road trip is a time-honoured tradition because it’s fun, gets us out of our bubbles, and leads to new and exciting adventures. So take some time to plan and prepare, and enjoy the journey! 🚗

“It doesn’t matter how old you get, buying snacks for a road trip should
always look like an unsupervised 9 year old was given $100.”- Unknown 😁😂

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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16/Nov/2022

Tips for preventing falls

The 80’s song ‘catch me I’m falling’ could have been my family anthem. We’re clumsy, uncoordinated, and with two left feet, always slipping, tripping, and falling. 😁

It‘s just the way we are. I’ve even gotten to the point of doing a ‘ta-da’ after a trip, extending my arms over my head like a gymnast at the end of a routine.😀

But now, as I’m getting older, it’s not so amusing. I’m conscious of the more serious repercussions of falling. In fact, just last week, I tripped over my cat, whacked the side of my head on the kitchen counter and broke my glasses. Fortunately, I wasn’t seriously injured. But it made me take stock, stop thinking about falls as something I have to put up with and start being more proactive in preventing them.

Because the good news is that falls aren’t inevitable. They can often be prevented, or at the least, any injuries that occur can be minimised.

Let’s start with some facts

Data from the Australian Institute of Health and Welfare shows that falls are Australia’s largest contributor to injuries that require a stay in hospital and are a leading cause of injury deaths.(1) More than half of the hospitalisations were due to broken bones – often hips, vertebrae and wrists.

Falls can happen anywhere and to anyone, but a fall that lands you in hospital is more common in older people and most likely to occur in the home.

The stats are alarming, and like me, you may think these were falls from a height or down stairs. But the truth is, ‘over half of all falls leading to hospitalisation occurred on a single-level surface (for example, by slipping), and only 7% of falls leading to hospitalisation involved stairs or steps.’(1) 😱

And if you have osteoporosis and your bones are already fragile, the risk of breaking a bone due to a fall is much greater.

So to avoid becoming one of these stats, we can’t see falls as an inevitable part of life and getting older. They’re a serious problem, and we all need to take steps to prevent them.

We know that falls can result in broken bones, but they can also cause:

  • Dislocated joints (e.g. shoulder)
  • Head injuries
  • Bruises, scrapes and sprains
  • A loss of confidence which can lead to restricting activities due to the fear of falling. For example, avoiding walks in the park or going into places that are unfamiliar, crowded or have stairs/steps due to fear of falls,

What causes people to fall?

Health issues

  • If you’ve fallen more than once in the past 6 months, you’re more likely to fall again.(2)
  • Medical conditions that lead to reduced strength and endurance (e.g. arthritis), loss of sensation (e.g. diabetic neuropathy), impaired balance (e.g. Parkinson’s disease) and cognitive impairment (e.g. dementia).
  • Medicine side effects, especially if you’re taking several medicines.
  • Poor eyesight and vision problems.
  • Incontinence. Rushing to the toilet can increase your risk of falling, especially at night.

The environment

  • Trip hazards in your home and the community, e.g. clutter, cords and cables, wet and/or slippery floors, uneven footpaths, and pets.
  • Poor lighting.
  • Inappropriate or ill-fitting footwear and clothing.

Reducing your risk

Falls are usually caused by a combination of factors. Changing some of these factors can lower your chances of falling. Or, if you do fall, reduce your risk of serious injury.

Exercise regularly

Australian physical activity and exercise guidelines recommend that all adults be active most days, preferably every day, for 30 minutes or more. Exercise is vital for good health, maintaining independence, and lowering your risk of falls and fall-related injuries. Physical activity helps to maintain and improve your mobility, strength, posture, coordination, balance and flexibility.

People with better posture, better balance and stronger muscles are less likely to fall or be injured. On the other hand, people who aren’t very active are more likely to fall and be injured than those who are more active.

Talk with your doctor, physiotherapist or exercise physiologist for information and advice about how you can safely become more active.

And read Exercise for preventing falls by The Royal Australian College of General Practitioners for more info.

Look after your health

  • Talk with your doctor about your medicines. Some medicines can help reduce falls, such as pain-relievers that decrease your pain and allow you to move more comfortably and be more active. However, some medicines or combinations of medicines can cause dizziness, drowsiness or confusion, which increases your risk of falling. Understanding your medicines and how they affect you is an important strategy for reducing this risk.
  • Eat a healthy, balanced diet with regular meals throughout the day to avoid feeling lightheaded, weak or dizzy. Stay hydrated and drink plenty of water each day.
  • Limit alcohol intake as it can affect your balance and coordination and increase your risk of falling.
  • Have your eyes tested regularly by an optometrist. If you wear glasses, keep them clean. If you have different glasses for different situations, e.g. reading or distance glasses, make sure you use the appropriate ones for the task. Be careful when going up and down stairs if you wear multifocals.
  • Wear sunglasses outside to minimise glare and squinting and to protect your eyes from UV damage.
  • When moving from a light to a dark space, or vice versa, allow time for your eyes to adjust.
  • See a podiatrist if you have problems with your feet that affect your balance or how you walk; for example, pins and needles, pain, swelling, or poor circulation. They can help you address these issues. They can also give you advice about appropriate footwear.
  • Take time to regain your balance after lying down or standing up after sitting.

Move around safely

  • If you’re unsteady on your feet or have painful feet, hips or knees, you may need some support to get around. A physiotherapist or occupational therapist can help you decide if a mobility aid (e.g. a walking stick or walker) is appropriate for you. They’ll also help you learn how to use it correctly and adjust it to your requirements.
  • Plan your outings to fit how you’re feeling. For example, if you’re at the shopping centre and feel tired or your feet begin to hurt, you might need to sit and rest for a while. Or, avoid going for a long walk if you’re having a day when your pain and fatigue levels are high. Take a shorter walk instead.
  • Be aware of the weather and how it can affect your environment. For example, footpaths are often slippery when wet, especially if there are wet leaves on them. Or, on sunny days, sun glare can make visibility more difficult, and you may not be able to see as clearly as usual.

Choose your clothing and footwear carefully

  • Avoid long trousers or skirts that may get caught underfoot or on furniture.
  • Wear well-fitting, supportive shoes with non-slip soles. Avoid high heels, floppy slippers, shoes with slick soles, and walking around in your socks.
  • Hip protectors may be an option for people with osteoporosis or those who fall often. They’re plastic shields or foam pads that fit into the pockets of specially designed underwear and reduce hip fractures from a fall. Your doctor can give you more information about hip protectors.

Reduce the hazards in your home

  • Make sure mats, rugs and carpet edges are lying flat on the ground and well secured. If they’re loose or curled up, they can cause you to trip.
  • Clean up spills from the floor immediately. If you have balance issues and bending over is a problem, ask someone else to clean the floor or use a light mop.
  • Ensure your walkways are clear of clutter, and you have plenty of space to walk between furniture without anything getting in your way.
  • Remove cords and cables from walkways. Secure them to skirting boards or close to the wall.
  • Install non-slip mats in the bathroom.
  • Pets can be a trip hazard (as I learned the hard way), especially if they like to be close to you or it’s meal time. 😼 So be aware of where they are when you’re up and about. 🐶
  • Make sure your home is well-lit so you can always see where you’re going. If you get up in the night frequently to go to the toilet, make sure you have a bright bedside light or use a torch so you can see clearly. Motion sensor lights are also handy and can be plugged into power points on the way to the toilet.
  • Consider installing a handrail on at least one side of any stairs and next to baths, showers and toilets.
  • Safety strips on the edges of outdoor stairs are also a good idea. They provide additional grip and help you see exactly where the edge of the step is.

What to do if you fall

Sometimes, no matter how careful you are, you can still have a fall.

So if you have a fall, it’s important that you try not to panic (easier said than done 😑). And although your first reaction may be to get up quickly, especially if you’re in public, because you’re embarrassed (been there, done that), take a moment.

  • Assess the situation. Are you hurt? Is it safe to get up? Have you damaged your glasses? Or lost your walking stick?
  • Make a decision whether or not to try to get up. Factoring into your decision will be whether you’re safe where you are, e.g. have you fallen onto a footpath or the road?

If you can get up:

  • Take time to recover. Sit and let yourself get over the shock. Drink some water. Take stock of your injuries.
  • Tell someone you’ve had a fall and/or seek medical advice. Don’t just brush it off. Falls can signify that something’s wrong – e.g. medicine side effects, balance problems, or a new health issue.

If you can’t get up:

  • Try sliding or crawling to seek help.
  • Use your phone or personal alarm, call for help or make a loud noise to attract attention.
  • Make yourself as comfortable as possible until help arrives
  • Seek medical advice/or call an ambulance.

Services to help keep you safe

If you’ve done all you can to prevent falls and are still concerned about your risk, there are services available to help you.

  • Falls and balance clinics provide multidisciplinary assessment and management planning for people who’ve had falls and have mobility and balance problems. People receive information on making their homes safer and are referred to physiotherapy, occupational therapy, exercise classes and other allied health professionals. Talk with your doctor about whether this might be an option for you.
  • Personal alarms. There are two basic personal alarm options; a pendant you wear around your neck and a smartwatch worn on your wrist. Pressing the button on the alarm will trigger contact with the service company, who’ll then contact your nominated relative, friend, neighbour or a response service. Some people can access free or reduced-cost personal alarms through government schemes such as the Commonwealth Home Support Program, National Disability Insurance Scheme (NDIS) and Department of Veterans’ Affairs. Visit their websites or speak with your doctor to see if you’re eligible. A variety of private companies provide this service for a fee if you don’t qualify for the free service.
  • Red Cross Telecross is a free service offered by the Australian Red Cross. It aims to provide people who live alone and are at risk of illness or accident the peace of mind that someone is looking out for them. Each morning, every day of the year, trained volunteers make a short call to people’s homes. If the call goes unanswered, Red Cross will take action to make sure that the person is OK. For information about accessing Telecross, call Red Cross on 1300 885 698.

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.

More to explore

References

(1) Falls, Australian Institute of Health and Welfare, 2022.
(2) Falls and the elderly, healthdirect, 2020.


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13/Oct/2022

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. 😊

Call our 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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13/Oct/2022

Tips to help you sweep away winter

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

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

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

Planning, prioritising and pacing

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

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

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

Take breaks

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

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

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

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

Get the right tools for the jobs

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

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

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

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

Choose your battles

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

Let the cleaning products do the hard work

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

Beware of dust and toxic smells

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

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

Recycle old socks

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

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

Use your dishwasher for more than dishes

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

Consider reorganising your pantry, laundry or kitchen

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

Get some wheels

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

Repackage it

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

Alternate your cleaning activities

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

Get the family involved

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

De-clutter

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

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

Hire someone

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

Distract yourself with music, podcasts and audiobooks

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

Give your medicine cabinet a spring clean too

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

Things don’t have to be perfect…

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

Call our Help Line

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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20/Sep/2022

Most people think that arthritis only affects older people, but children can get it too. It’s estimated that between 1 in 800 and 1 in 1,000 children in Australia have arthritis.

What is juvenile idiopathic arthritis (JIA)?

JIA is a group of inflammatory conditions that cause joint pain and swelling in children and teens under 16.

What causes JIA?

We don’t really know what causes JIA. That’s what ‘idiopathic’ means, ‘from an unknown cause’.

But we do know it occurs due to a malfunctioning immune system.

The job of your immune system is to look out for and attack foreign bodies – like bacteria and viruses – that can make you sick. However, in the case of JIA, the immune system mistakenly targets healthy tissue in and around the joints, 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.

Types of JIA

There are several types of JIA, each with distinct features.

Oligoarthritis JIA

This is the most common type of JIA. It’s also called oligoarticular or pauciarticular JIA. Both ‘oligo’ and ‘pauci’ mean not many or few. Less than five joints are typically affected, most commonly one or both knees. Children with oligoarthritis may also develop inflammation of the eye, called uveitis.

Polyarthritis JIA

Polyarthritis (or polyarticular) JIA affects five or more joints. ‘Poly’ means many. It often affects the joints in the fingers, toes, wrists, ankles, hips, knees, neck and jaw.

There are two types of polyarthritis JIA, based on whether rheumatoid factor (proteins produced by the immune system) are found in the blood. They are polyarthritis JIA (rheumatoid factor positive) and polyarthritis JIA (rheumatoid factor negative).

Enthesitis-related JIA

Entheses are the tissues that attach tendons and ligaments to the bone. Enthesitis-related JIA causes inflammation and pain in the entheses (enthesitis) and joints (arthritis). The most common locations for enthesitis are the knees, heels, and bottoms of the feet. Arthritis is generally in the hips, knees, ankles, feet, and spine.

Psoriatic JIA

Children with psoriatic arthritis have inflammatory arthritis of the joints and the skin condition psoriasis. It often affects the fingers and toes, but other joints can be affected. It can also cause pitted fingernails and swollen fingers or toes.

Systemic JIA

Systemic JIA can affect many areas of the body, not just the joints. It usually starts with fever and rash that come and go over a period of weeks. It’s the least common type of JIA.

Undifferentiated JIA

This is where the condition doesn’t fit any of the above types of JIA.

What are the signs that my child may have JIA?

The signs or symptoms of JIA vary depending on the type of arthritis a child has. Some of the more common symptoms include:

  • Pain, swelling and stiffness in one or more joints
  • The skin over the affected joints may be red or warm
  • Mental and physical tiredness (fatigue).

Less common symptoms include:

  • Fever
  • Rash
  • Feeling generally unwell
  • Eye inflammation (uveitis).

The symptoms of JIA vary from child to child and are likely to change as they get older.

At times, symptoms can become more intense; this is a flare. Flares can be unpredictable and often seem to come out of nowhere.

There may also be times when your child experiences a remission – where their symptoms go away for a time.

What is uveitis?

Uveitis is inflammation of parts of the eye. It’s also the result of a malfunctioning immune system.

The most common type of uveitis has no symptoms (sometimes called silent uveitis). This means that it doesn’t hurt, and you won’t be able to tell if your child has uveitis just by looking at their eyes. Some children do have symptoms such as blurred vision, light sensitivity, and in rare cases, eye redness and pain.

If uveitis isn’t treated, it can cause permanent vision loss. This means that all children with JIA need regular check-ups with an ophthalmologist (specialist eye doctor) to check for uveitis and start treatment if needed.

How is JIA diagnosed?

JIA can be challenging to diagnose because the symptoms differ between children, and many symptoms are similar to those experienced with other illnesses.

There isn’t one single test that can be used to diagnose JIA, and your doctor will usually use a combination of tests to confirm your child’s diagnosis, including:

  • a physical examination to assess joint tenderness, flexibility, and stiffness
  • blood tests to check for inflammation associated with JIA, which can also help to work out which type of JIA your child has
  • scans such as x-ray and MRI (magnetic resonance imaging) to check for joint inflammation and damage
  • an eye examination.

If you visit your family doctor (GP) and your child has symptoms that suggest it might be JIA, they’ll usually order some of these tests and refer you to a doctor who specialises in juvenile idiopathic arthritis, called a paediatric rheumatologist. Seeing a rheumatologist as soon as possible is essential to ensure your child gets the best outcomes.

How is JIA treated?

While there’s no cure for JIA, there are many treatments to help manage the condition and its symptoms so your child can continue to lead a healthy and active life. Because every child’s experience of JIA is different, treatment will be tailored to best meet your child’s needs.

Finding the right combination of treatments may take time and is likely to change as the JIA symptoms change or your child grows.

For most children and young people, treatment will include exercises to keep joints moving and muscles strong, medicines to reduce inflammation, splints to support joints, and pain management strategies.

Medicines

Most children with JIA – regardless of the type – will need to take some form of medicine at some time. The medicines that your rheumatologist prescribes for your child will depend on their symptoms, including how much pain and inflammation they have.

There are many different types of medicines that work in different ways. The main types of medicines used to treat JIA and help manage its symptoms include:

  • Analgesics (or pain relievers) provide temporary pain relief. They can range in strength from mild to very strong. You can buy many of them over the counter at your pharmacy or supermarket. However, stronger medicines, including those containing codeine, require a prescription.
  • Creams and ointments (also called topical analgesics and anti-inflammatories) applied to the skin over a painful joint can provide temporary pain relief.
  • Non-steroidal anti-inflammatories (NSAIDs) also provide temporary pain relief, specifically pain associated with inflammation. You can buy some over-the-counter, but stronger NSAIDs require a prescription.
  • Corticosteroids act quickly to control or reduce inflammation, pain and stiffness. They can be taken in tablet form, or may be given as an injection into a joint, or from a drip into a vein.
  • Disease-modifying anti-rheumatic drugs (DMARDs) control your child’s overactive immune system. They help relieve pain and inflammation and reduce or prevent joint damage.
  • Biological disease-modifying medicines (bDMARDs, or biologics and biosimilars.) also work to control the immune system. However, unlike other disease-modifying drugs, biologics and biosimilars target the specific cells and proteins that cause inflammation and tissue damage rather than suppressing your entire immune system.
  • Eye drops to treat eye inflammation (uveitis).

What can we do to control symptoms?

As well as taking any medicines as prescribed, things you and your child can do to manage JIA include:

  • Learning about JIA. Understanding the condition and how it affects your child means you can make informed decisions about their healthcare and actively manage it.
  • Following the treatment plan that your health professionals have developed. That means taking medicines as prescribed, doing the exercises the physiotherapist and/or occupational therapist have provided, and letting your doctor know of any changes to your child’s symptoms and how they’re feeling. All these things give your child a better chance of managing their JIA well and reducing the risk of long-term problems.
  • Staying active. Regular exercise is the key to maintaining muscle strength, joint flexibility and managing pain. A physiotherapist or exercise physiologist can help design an individual program for your child.
  • Learning ways to manage pain. There are many ways your child can manage pain from heat and cold treatments, distraction, massage and medicine. Try different techniques until you find the things that work best for your child.
  • Eating a healthy, balanced diet. While no diet can cure JIA, a healthy diet is the best for good health, especially for growing children. Keeping to a healthy weight is also important as extra weight strains your child’s joints, especially load-bearing joints such as hips, knees and ankles.
  • Protecting the joints. Aids, equipment, and gadgets can make activities easier for your child. They include an ergonomic mouse and keyboard for your child’s computer, a supportive chair or back support cushion, and foam rubber to make pencils, pens, brushes, and cutlery handles easier to grip. An occupational therapist (OT) can advise you on available equipment and techniques to reduce strain on joints from everyday school activities.
  • Using splints. Splints are commonly used as a treatment for JIA, particularly for wrists and feet. They’re used to rest or support sore or inflamed joints, stretch out a joint, and help make some activities easier.
  • Staying at school. This is essential for your child’s health and wellbeing, as well as their education and socialisation. Talk with your doctor, allied health professionals and teachers about ways to help your child stay at school and keep up with school.

Contact our free national Help Line

Call our nurses if you have questions about managing your painmusculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

MSK Kids

Our free MSK Kids program provides a range of programs and services along with evidence-based information and resources for children living with juvenile arthritis (JIA) and other musculoskeletal conditions. Resources are available for the child, family and school. Find out more about MSK Kids.

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20/Sep/2022

Tips to help you in the garden

Note: Apologies in advance. At the time of writing, I was in a pun-ey state of mind 😂. I’m a succa’ for a bad pun or dad joke. Hopefully, it ‘grows’ on you. 😣

With spring well and truly in the air, our gardens are coming alive 🌻🌼🌷. It’s the perfect excuse to get outside and dig in the dirt. Time to celery-brate!

Gardening’s a wonderful way to get some fresh air and vitamin D. It can also be extremely relaxing and a good workout. What’s not to love?

But sometimes your condition or pain may affect your ability to garden. Fortunately, there are things you can do to manage these issues. It just takes a little trowel and error. Here’s our sage advice.

Lettuce do our best: Pacing

It’s easy to get carried away and overdo things when you’re feeling good and having a great time in the garden. But you generally pay for it the next day (or three 😑) with increased pain and fatigue. That’s why it’s so important that you pace yourself.

Break your gardening projects into smaller jobs – for example, weed a small section of a garden bed rather than the entire thing. Or, mow the front lawn one day and the back lawn the next.

Not everything has to be done at once, though your inner perfectionist may want that. Don’t listen to that voice! Instead, make a realistic plan about how much you can do and stick to it.

And remember to take regular breaks. That’ll help you conserve your energy, and it’s also a good opportunity to drink some water while you sit back and admire your work, contemplate what to do next, and imagine future gardening projects 😊.

Just dill with it: Warming up is important

Gardening is physical, so get your body ready for it, just as you would before doing any form of exercise. Do some stretches, or go for a walk around your yard or the block, so your muscles warm up, and you feel looser. Then ease into the gardening.

Cactus makes perfect! Good posture and technique

Be aware of your posture and use good technique when lifting and carrying things. It’s easy, especially if you’ve been working all day and you’re tired, for poor technique to slip in. Remember to carry things close to your body (or use a wheelbarrow or cart), be careful when kneeling or squatting that you don’t overbalance and maintain the natural curve of your spine. Try not to stay in the same position or do lots of repetitive movements for long periods. Swap your activities to use a range of muscles and joints rather than overworking one part of the body. For example, if you’ve been digging and giving your back and shoulders a solid workout, take a break and sit at a garden bench while you pot some herbs or cuttings.

Do you have the thyme? Know your limits

Planning is essential to ensure you don’t become a slave to your garden and constant weeding, mowing and pruning. Ask yourself – ‘what can I realistically do?’ Consider the size of your garden, the amount of work required to maintain your garden, how much time you want to commit to it, and how your health may affect what you can do now and in the future. Once you’ve considered these factors, you can consciously plan a garden that works for you and not against you.

No need to grow big or go home: There’s beauty in small things

Love gardening but don’t have the time, space or inclination to commit to regular gardening? Then go small. Have a few indoor plants or small containers on your patio, deck or balcony. You can still enjoy gardening on a small scale that suits your lifestyle.

If bush comes to shove: Love local

Take some of the time, money, effort and excessive water use out of gardening and choose native plants that are indigenous to your local area. Because they’ve adapted to local environmental conditions, they generally require less maintenance and water. And they’re less likely than more high-maintenance plants to keel over and die on you, saving you the cost of replacing them. Plus, they attract native insects and birds to your yard. And let’s not forget the fact that they’re stunning!! Win, win, win! 🌿 For information and resources about using natives in your garden, visit the Australian Native Plants Society website.

Pot it like it’s hot: Contain your garden

Use pots and other containers for small, manageable gardens. This is perfect if you only have a small space, live in a rental property, or want the flexibility to change plants and plant locations regularly. You can use regular garden pots or containers, or be creative and use other things you have lying around – e.g. old wheelbarrows, teapots, colanders, tyres, and boots.

Check out Pinterest for some great ideas – just make sure you have plenty of time – Pinterest is a great place to lose track of time. You’ve been warned! 😂😂

What a re-leaf! Raised and vertical gardens

If you have a sore back, hips or knees, give them a break by using raised garden beds and vertical gardens. While these gardens can take a bit more planning and work, they allow you to access your garden with much less bending or kneeling. You can build your own – there are lots of videos and guides online to show you how to do this – or you can buy them in various shapes and sizes from gardening and hardware stores.

Say aloe to my little friend: Tools and gadgets

There’s a massive range of gardening tools and equipment to help you manage in the garden. They’ll help prevent injury, pain, and fatigue. Depending on the size of your garden and the amount of time you spend in it, some tools you may want to have on hand include:

  • Gardening gloves. It’s worth paying a bit more and getting a good quality pair (or two) that provide some padding, good grip and protect your skin.
  • Tools that do the work for you. This includes ratchet-style secateurs that allow you to cut branches with much less effort and long-handled tools that save you from bending down to weed or stretching overhead to reach branches.
  • Thicker handled garden tools. They’re perfect if you have sore hands or difficulty gripping. You can also buy thick rubber or foam tubing from the hardware store, cut it to length and fit it over the handles of your existing gardening tools.
  • Wheelbarrows or garden carts help you carry heavier items from one place to another or several smaller things in one go. Just be careful not to overload it or try to move more than you know you should. Listen to your body.
  • Cushioned knee supports. This includes knee pads, kneeling mats, or gardening stools that can help cushion and protect your knees and help you get up and down off the ground.

I’m very frond of you: Asking the crew to get involved

Get some help – from family, friends, a local handyman, or gardener – if you have some big jobs that need doing. For example, creating raised garden beds, pruning trees, and mowing lawns. You don’t have to do everything. Save the things you really enjoy for yourself and let someone else tackle the less enjoyable jobs. 😊

Water you doing today? Staying hydrated

Gardening can be hot, strenuous work, so don’t become dehydrated. Make sure you drink plenty of fluids and stay hydrated. Tuck a water bottle in your garden cart or have it on your porch ready for when you need it.

And speaking of water, use a lightweight watering can or a garden hose when watering your garden. And be careful you know where the hose is at all times to avoid tripping on it 😫.

Here comes the sun(flower): Protecting yourself from harmful rays

The warming spring weather and longer hours of sunlight give us many more opportunities to work and play in the garden. But you need to balance the desire to be outdoors with protecting yourself against sunburn, skin cancer, photosensitivity and flares. And ensuring you get your daily dose of vitamin D. But there are ways you can find the right balance – from using sunscreen, wearing a hat and appropriate clothing, seeking out shade and more. Find out how.

Time to turnip the heat: Loosen those tired muscles

After your exertions in the garden, have a warm shower. Even when you pace yourself and take it easy, muscles can become tight, especially if the weather is on the cooler side. Or, if it’s been warm while you’ve been gardening, a shower can loosen those muscles and cool you down. After you’ve showered, try not to sit down immediately if you can help it. Go for a short walk to continue to loosen things up. You’ll feel so much better for it in the long run.

Need some encourage-mint? See an OT

An occupational therapist can help you find ways to modify your activities to reduce joint pain and fatigue and save energy. They can also give you tips and ideas about different aids and equipment available to make gardening easier and more enjoyable.

Don’t moss around, get out there!

With the weather warming up, getting outdoors and playing in the garden is a lovely way to forget the worries of the world. It really can give you some inner peas.😊

So plant some bright flowers in pots or garden beds around the entrance to your house. Prune trees and shrubs and remove any dead winter growth. Add some mulch to the garden beds. Plant some vegies for summer salads. Then grab a cold drink, sit back and enjoy the fruits of your labours.

“We might think we are nurturing our garden, but of course, it’s our garden that is really nurturing us.”
Jenny Uglow

 

Contact our free national Help Line

Call our nurses if you have questions about managing your painmusculoskeletal condition, treatment options, mental health issues, COVID-19, 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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20/Sep/2022

Is there anything better than pulling on your comfy trainers and heading outdoors for a walk? With the first breath of fresh air and the sun on your face, you feel better. Your muscles warm up, your joints loosen, and you settle into a comfortable stride. The rhythmic movement helps you relax and boosts your mood.

I love going for a walk. It’s such a great exercise.

It costs nothing, is suitable for most people, and gets you out of the house. You can walk at a leisurely pace or take it up a notch and increase the speed and intensity of your workout. Or do a combination of both for some interval walking.

If you don’t exercise much, it’s an ideal way to build up your activity levels. Be sure to talk with your doctor first to get the all-clear, especially if you’ve recently had surgery or have other health conditions. Then start slow and gradually increase your distances and times.

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

If you can’t walk 30 minutes at a time, you can easily break the walking up over your day. You don’t have to do it all in one go to reap the benefits. So during your day, you can do three 10 minute walks, two 15 minutes walks or six 5 minute walks, whatever works for you. It all adds up 😊.

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

14 tips for better walking

Dress the part

Let’s start with the most important element of your walking outfit – your shoes. They need to be comfortable, fit properly, and support your feet. Look for light, flexible shoes with thick, non-slip soles. Avoid slip-on shoes, and if laces are difficult to fasten due to arthritis in your hands, Velcro or elastic laces might be an option.

Your clothes should be loose and/or stretchy enough to allow you to walk without restrictions. Make sure you wear a hat and sunglasses on sunny days. And grab any mobility aids you use before you head out.

Warm up and cool down to prevent injuries or pain

While you might be eager just to get out there, it’s important to take the time to let your muscles and joints warm up. So start your walk slowly, and gradually increase your pace. And when you’re close to finishing your walk, take the time to slow it down and give your body the chance to cool down. You can also incorporate some basic stretches to warm-up and cool down. Check out these stretches from the Arthritis Foundation (USA). 

Walk briskly

Did you know that 10 minutes of brisk walking is classified as cardio as long as you’re slightly out of breath? Brisk walking at a moderate intensity provides more health benefits than a simple stroll. How fast you need to walk for it to be moderate intensity will depend on your age and fitness level. So it differs from person to person. You can tell if you’re walking at a brisk, moderate-intensity pace if you’re breathing heavier than usual but can still have a conversation. But if you can walk and sing (which is a little unusual) 😉, you need to kick the intensity up a notch.

Make walking a part of your routine

To make walking a daily activity, you need to build it into your routine. Go at the same time each day – e.g. before/after work, before breakfast/after lunch. Whatever time suits you best and allows you the space to commit to it. Before long, when that time arrives each day, you’ll find yourself automatically reaching for your walking shoes. 👟👟

Listen to music, audiobooks, podcasts

Going for a walk by yourself gives you space for some alone time. Listen to something that interests or relaxes you as you exercise. There are many entertaining podcasts and audiobooks you can access free online. Or you can borrow audiobooks from your public library and download them to your phone.

You can also make yourself a walking playlist featuring your favourite music that starts slower (for your warm-up), gets faster (for your main workout) and slows down again towards the end of your walk (for a cool down).

Make it social

At other times, it’s nice to walk with others. It’s fun and will help keep you motivated. You can chat, shoot the breeze, catch up and just be social 😊. So walk with friends or your family. And if you have a dog, bring it along! They need the exercise too. And dog owners are always up for a chat 🐶!

Explore new places

As many of us discovered during past lockdowns, walking the same paths day after day can become a little tedious. Mixing it up will make your walks more enjoyable. So look at your maps and discover new walking trails, parklands and suburbs.

Or try a variation of this idea. Comedian and radio host Tony Martin and his partner have spent more than ten years exploring the streets of Melbourne, with the goal to walk every street! While you may not want to go that extreme, you could start smaller and check out different streets of your neighbourhood. Or pull out the old Melways or use your GPS to discover new and interesting places to walk.

Take a water bottle

Walking can be thirsty work, so you may need to take some water to remain hydrated. And depending on how far you’re walking, consider taking a small backpack for your water bottle and any other supplies you think you may need, such as snacks, sunscreen, a map, band-aids (just in case) and your phone.

Be mindful while you’re walking

Take time to be in the moment and experience the walk. How do your feet feel as they connect with the ground? What can you smell? How does the wind feel on your face? What can you see around you? Take the time and opportunity to really connect with what you’re doing and savour every moment.

Track your walking with a pedometer or fitness activity tracker

This’s a great way to see how you’ve progressed over time. And many of the walking apps allow you to challenge others, so if you can’t physically walk together, you can in spirit. And a little healthy competition can help you push yourself to achieve more 😉.

Increase the distance and intensity of your walks over time

To see the health benefits from your walking, you need to push yourself to go further and harder. Just be mindful that you don’t push too hard, too soon. Especially if you’ve been unwell, had surgery, or you’re having a flare. Listen to what your body is telling you. A physiotherapist, exercise physiologist or fitness instructor can provide tips and guidance if you need help.

Walk indoors

If it’s raining or just too hot or cold to take your walk outdoors, stay in! There are many ways you can walk indoors. For example, you can walk around your home if you have the space. Or you can follow an online video of walking exercises (there are many available to suit your specific needs and fitness level). Or you can take your walk to the shopping centre. They have lots of open areas to walk and places to rest and hydrate when you need to. Just try not to get distracted and slow down to shop! 😂 You can also take your walk to the local fitness centre or gym. Many have indoor walking tracks you can use for free if you’re a member or for a small fee if you’re not.

Be aware of walking surfaces

They’re not all equal. Natural surfaces such as grass, fine gravel, dirt and woodchip are softer and generally easier on your joints. However, they’re not always even surfaces, so you need to be aware of potential trip hazards. Manmade surfaces such as asphalt and concrete can be more jarring on sore joints. However, they’re generally smoother. So factor walking surfaces into your plans. If your hips, knees, ankles or feet are particularly sore, go for the softer, more natural surfaces. If you’re concerned about falling or bad weather, manmade surfaces may be your best option.

Join others

Consider joining a walking or bushwalking group. You’ll meet other people who love walking, explore new places together and get lots of tips and advice to make walking more enjoyable and challenging.

Another option is parkruns. They’re free, weekly community events with 5km walks and runs in parks and open spaces on Saturday mornings. Everyone is welcome, there are no time limits, and best of all, no one finishes last! 😊
——
So what are you waiting for? Pull on your walking shoes, grab a friend or your headphones, and as the INXS song goes, just keep walking!

Contact our free national Help Line

Call our nurses if you have questions about managing your painmusculoskeletal condition, treatment options, mental health issues, COVID-19, 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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Walks in your state or territory


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31/Aug/2022

Are you like me and find supermarkets ridiculously cold? It doesn’t matter what season it is outside; inside a supermarket, it’s Arendelle, and Elsa has just turned everything into snow and ice ❄⛄.

This can be really uncomfortable, especially if you have a musculoskeletal condition. And if you have Raynaud’s phenomenon, it can make your extremities – especially your fingers – turn white and numb.

What is Raynaud’s phenomenon?

Apart from having a really cool name – it’s a phenomenon, for goodness sake! 🙃 – what is Raynaud’s??? First, it’s named after the French doctor who originally described it, Maurice Raynaud, and being French, it’s pronounced ‘ray-nose’ (with a silent D).

Raynaud’s phenomenon causes the blood vessels to the extremities, usually the fingers and toes, to constrict more than usual in response to cold temperatures or stress. When this happens, the blood flow is restricted, causing the extremities to become cold and turn white, then blue. When blood flow returns, the skin becomes red and returns to its normal colour.

Raynaud’s phenomenon can occur on its own – this is primary Raynaud’s phenomenon. Or it can occur alongside or ‘secondary’ to another disease or condition – this is secondary Raynaud’s phenomenon.

Both primary and secondary Raynaud’s phenomenon episodes can last from a few minutes to hours.

Other parts of your body, such as the nose, lips and ears, can be affected too.

Fortunately, Raynaud’s phenomenon rarely causes permanent damage.

Maintaining a balance: vasoconstriction and vasodilation

Your body protects your internal organs (your core) by maintaining a stable core temperature – it’s not too hot, not too cold, but just right 🐻🐻🐻.

One of the many ways your body maintains this stable temperature is through vasoconstriction and vasodilation. This essentially means that your blood vessels (vaso) narrow (constrict) or widen (dilate) as needed.

In the cold, blood vessels constrict to reduce blood flow to your extremities, such as the fingers and toes. This keeps your core warm. In the heat, blood vessels dilate, and blood flow increases to your skin, moving the warm blood away from your core.

These processes help your core remain at a constant temperature, usually around 36-37°C.

For people with Raynaud’s phenomenon, for some unknown reason, blood vessels constrict, not to keep your core temperature stable but in response to cold, stress or emotional upset.

Blood vessels in your extremities narrow quickly, and your skin changes colour due to a lack of blood supply. During a Raynaud’s episode or attack, you may experience pins and needles, tingling and/or numbness in your fingers or toes. You might find it difficult to do things with your hands, as lack of blood can make them clumsy and stiff. And when the blood returns to the area, you may feel slight discomfort or stinging pain.

These changes occur in the extremities, most often the fingers. Circulation in the rest of the body is generally normal.

Primary Raynaud’s phenomenon

This is the most common form of Raynaud’s phenomenon. It’s also called Raynaud’s disease. Women, generally under 30, are more likely to develop primary Raynaud’s phenomenon than men. It can also run in families, so if you have a family member with primary Raynaud’s, you’re more at risk of developing it.

Secondary Raynaud’s phenomenon

People living with conditions such as scleroderma, systemic lupus erythematosus (lupus) and rheumatoid arthritis may develop secondary Raynaud’s phenomenon. This usually occurs later in life but can happen at any age, depending on the underlying cause.

Other risk factors for secondary Raynaud’s phenomenon include:

  • mechanical vibration – for example, using a power tool for extended periods
  • medicines – e.g. beta-blockers, some migraine or cancer drugs, amphetamines
  • smoking.

Diagnosing Raynaud’s phenomenon

Your doctor can determine if you have Raynaud’s by talking with you about your symptoms. It can be helpful to take a photo of your hands if you experience a Raynaud’s episode so you can show this to your doctor.

Although it’s generally not too difficult to diagnose Raynaud’s phenomenon, it can sometimes be hard to tell whether it’s primary or secondary Raynaud’s. Your doctor may use a range of methods to work this out, such as:

  • taking a complete medical history, including asking about family members who may have Raynaud’s phenomenon
  • a physical examination
  • blood tests
  • examining fingernail tissue with a microscope.

Living with Raynaud’s phenomenon

Most people with Raynaud’s phenomenon can manage it effectively with self-care and lifestyle changes. In some cases, medicines may be necessary.

Self-care

To prevent a Raynaud’s episode, the best thing you can do is to keep your body and extremities warm. Dress appropriately for the cold with gloves, thick socks and warm layers. It can be helpful to keep a spare pair of gloves or hand warmers in your car or bag that you can use if you’re caught out in a cold or stressful situation (e.g. a trip to the supermarket! 😱).

If you’re outside and your extremities start feeling cold and numb, go indoors and soak your fingers or toes in warm (not hot) water. Or you can warm them with a heater. Just be very careful of the heat – it’s easy to burn yourself when your skin is numb.

If you can’t go indoors, try these things to increase the circulation to your extremities:

  • Wiggle your fingers or toes.
  • Rub your hands together.
  • Make circles with your arms.
  • Massage your hands or feet.
  • Place your hands in your armpits. However, if you’re like me, your armpits aren’t always warm enough, and you may need to ‘borrow’ someone else’s warmth! Make sure it’s someone you’re close with – random strangers won’t appreciate your ice-cold fingers in their armpits! 😂
  • If a stressful situation triggers the attack, remove yourself from the situation, take some deep breaths and try to relax.

Medical care

Talk with your doctor if your Raynaud’s isn’t controlled by these simple measures. You may need to use medicines that widen your blood vessels and improve circulation.

For secondary Raynaud’s phenomenon, it’s also essential that the underlying condition (e.g. lupus) is treated effectively.

Tips for avoiding triggers

There’s no cure for Raynaud’s phenomenon, so avoiding things that trigger a Raynaud’s episode is key.

  • Avoid being out in the cold for long periods, especially if you’re not dressed warmly.
  • Make sure your whole body is kept warm, using several layers of clothing to trap body heat.
  • Keep your extremities warm with gloves, woollen socks, earmuffs and/or a beanie.
  • Use hand warmers. These small, often disposable products produce heat on demand and are helpful when gloves aren’t enough; you can buy them from supermarkets and chemists.
  • Remember, hand sanitisers often have a cooling effect, so when using them, be prepared to warm your hands quickly.
  • Avoid smoking cigarettes or drinking caffeinated drinks as nicotine and caffeine constrict blood vessels.
  • Review your medicines with your doctor; if they’re causing the problem, discuss possible alternatives.
  • Be aware that holding something cold, such as a can of drink, can trigger symptoms.
  • Learn to recognise and avoid stressful situations.
  • Keep a journal of when episodes or attacks happen, as this may help identify triggers.
  • Look after the skin on your hands and feet – with our frequent hand washing and use of hand sanitiser, it’s easy for our hands to become dry and cracked. Cracked skin is an opening for germs to get in and potentially cause an infection.
  • Exercise regularly to maintain blood flow and skin condition. Being active also has many other health benefits.

Complications

For most people, Raynaud’s phenomenon is uncomfortable and a nuisance but is basically harmless, with no lasting effects. However, in rare cases, loss of blood flow can permanently damage the tissue. This may lead to skin ulceration, tissue loss and scarring.

Talk with your doctor if you notice any changes in your symptoms.

Contact our free national Help Line

Call our nurses if you have questions about managing your painmusculoskeletal condition, treatment options, mental health issues, COVID-19, 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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