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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! 😊
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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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31/Aug/2022

Written by hand therapist Catherine Reid, B.App. Sci, (OT), M.Sci (H&UL rehab), MAHTA (As awarded by the AHTA), CHT(USA)

It’s no secret I love hands! They’re amazing, complex and delicate structures. They help us connect with the world and each other. They allow us to touch, feel, carry objects, pick up kids and perform all kinds of everyday tasks.

That’s why I’m passionate about people being proactive and looking after them.

As an Accredited Hand Therapist* I’m often asked about the things people can do to look after their hands. Here are my top five tips.

1. Look after the skin on your hands

Your skin protects your hands from the outside world. It’s constantly renewing itself. Every time you wash your hands, you rub away dead skin cells. It’s important to look after your skin by keeping it as clean as possible and using a gentle hand wash. In some cases, gloves might be a good idea, for example if you’re using chemicals to clean your shower, or work in a café washing dishes.

Keeping your hands clean isn’t just about them looking good. It’s also about avoiding infections. Anyone who’s had an infection in their hand will tell you it‘s very painful. This is due to the many nerve endings you have in your fingertips. And because you use your hands so often, it’s hard to avoid banging or knocking an infected or injured hand.

An infection can also limit your hand’s movement, which, if left untreated, can become permanent.

Obviously, keeping your hands clean is impossible with some jobs, so keeping the skin in good shape is essential. Using a good moisturiser or barrier cream after washing is recommended to avoid small cracks developing in the skin. These cracks allow dirt and germs to enter your body, increasing your risk of infection.

Keeping your skin hydrated and moist helps keep your skin supple and leads to faster healing.

2. Stay strong

Many people don’t realise they’re losing strength in their hands until they have a functional problem, such as pain when opening a jar or difficulty gripping a doorknob.

That’s why I recommend exercises to strengthen your hands when you start to notice a problem. Many people strengthen their hands by squeezing a ball; if this is the case, I recommend a softer ball so your fingers can move through a greater range when squeezing. A cheap alternative to squeezing a ball is squeezing plumbing insulation. You can buy it by the metre at hardware stores for a few dollars and in different diameters to suit your hand size.

Accredited Hand Therapists can provide you with exercises for specific muscles or to deal with particular issues you’re having. They may use strengthening tools, exercise putty, and/or exercise bands.

3. Keep your joints moving

As the saying goes, ‘motion is lotion’ as far as your joints are concerned, so don’t let them stiffen up!

At the ends of the bones in your joints, you have a layer of cartilage. Cartilage is a firm cushion that absorbs shock and enables the bones to glide smoothly over each other. The joint is wrapped inside a tough capsule filled with synovial fluid. This fluid is the oil in your joints. It provides nutrition for the cartilage and helps provide a cushion between the cartilage. It moves across the joint’s surfaces like a drop of oil on a door hinge. When you move your hands, the synovial fluid is spread around the joint. So tasks that have you holding something for a long period without changing grip aren’t good for the joints. It’s not allowing the synovial fluid to lubricate the joint. Rather than not perform the activity, take frequent breaks and move your fingers. And try to avoid activities that push your fingers into extremes of range, for example, lifting items that are too large using only one hand.

Similarly, use bigger, stronger joints where possible. For example, carry shopping bags on your forearm rather than with your fingers.

Accredited Hand Therapists can instruct you in exercises for specific joints, such as the joint at the base of the thumb. To maintain good movement, moving your joints through the full range of movement and stretching out to the ends of the range is important. Tendon gliding exercises are often used for this purpose as they glide one set of tendons over the other and move each joint through its full range. Click here for examples of tendon glide exercises.

 4. Use the right tool for the job.

We often force our hands into extreme positions or keep going with a task until our hands are aching, especially if we’re in a rush or just want to get a job done.

But using the right tools can be gentler on your hands. For example, large or fat handles can spread loads more evenly or over several joints. Tools that use a lever to reduce the required force are also preferable; for example this tool (see image) helps open ring-pull cans.

There are also many electric tools for use in and around the home, reducing the required force. For example, instead of hand pruning a hedge, you can use electric shears. I know which I’d prefer!

You can buy aids and other tools from supermarkets, chemists, hardware stores, and home health care stores. Musculoskeletal Australia also has a range of tools available through their online shop.

5. Seek professional help

If pain or inflammation persists for more than a few days, seek professional help. Pain can be a warning sign that your joints are being overworked. Inflammation can be due to joints, muscles and/or tendons being overused or other health issues such as diabetes or heart disease. Prolonged inflammation can make it difficult to move your fingers. It may be that the structures in your hand need a rest to allow them to heal.

Your GP or a practitioner in hand therapy can help diagnose the problem and provide you with techniques to manage the pain or prevent the problem from becoming worse.

Accredited Hand Therapists can be located via the Australian Hand Therapy Association’s web page under the “Find an Accredited Hand therapist” section.

And check out my other article, ‘Can a hand therapist help you?’.

*As awarded by the Australian Hand Therapy Association

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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31/Aug/2022

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

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

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

Laughter and humour are such powerful forces. Just think about the last time you had one of those huge, spontaneous belly laughs with family or friends. Something was said, a joke was told, or you all saw something ridiculous. You snort, giggle, and guffaw. Your eyes water, you gasp for breath, and your belly starts to hurt. When you look at each other, you laugh some more. When you finally do stop laughing, you feel euphoric. Everything seems better, and you feel happier 😊.

However, when you’re in the grips of pain, laughing is probably the last thing you feel like doing. But laughter can actually help you deal with your pain better. A good joke, a funny movie, or just seeing something silly can distract you from your pain and make you feel better, at least for a while.
Laughter also causes your brain to release some feel-good chemicals that boost your mood and make you feel more optimistic. They include endorphins, serotonin and dopamine. Endorphins are your body’s natural pain reliever; releasing them into the body temporarily reduces your feelings of pain. Serotonin produces feelings of calmness and happiness. And dopamine is part of your brain’s reward system and gives you a sense of pleasure. It also helps reduce feelings of anxiety.

Other health benefits of a good giggle

As well as helping you cope with your pain and the stress of living with chronic health issues, laughter has many other health benefits. Laughing regularly:

LOL ideas

To bring on the laughs, giggles, chortles, snickers, cackles and guffaws, give these ideas a go:

  • Watch/stream a funny movie or sitcom – check out these lists from Flickchart and Rolling Stone for their top picks.
  • Listen to a funny podcast – this list from Time Out will get you started if you need ideas.
  • Run through a sprinkler on a hot day.
  • Talk with a friend and reminisce about a funny experience you had together.
  • Watch cat / dog / panda videos (you’re welcome!). 😹
  • Grab the kids, friends, partner or housemates and play. Anything! … Keep a balloon off the floor. Throw a frisbee. Charades. Pub quizzes. Truth or dare. Never have I ever. The floor is lava…
  • Have a pillow fight.
  • Think about the funniest joke you ever heard or your best (worst) dad jokes.
  • Jump on a trampoline.
  • Take silly selfies and send them to your bestie.
  • Grab a microphone (or a hairbrush) and sing out loud!
  • Join a laughter club. Simply google ‘laughter clubs’ for your state or territory.
Laughter serves as a blocking agent. Like a bulletproof vest, it may help protect you against the ravages of negative emotions that can assault you in disease. – Norman Cousins

Sadly it’s not all fun and games

It’s important to remember that laughter and humour are temporary distractions from pain. They’re great, and we should definitely cram as much into our day as possible. Just for the sheer joy of it 🤡.

But when you have a chronic illness and persistent pain, a balanced treatment approach should include self-care, appropriate medications and medical care, a healthy lifestyle, exercise, mindfulness and, yes, laughter.

Laughter may not be the best medicine (as the old saying goes), but it’s pretty close to perfect.

So, make sure you take a dose (or better yet – several!) every day!

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

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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Photo by MI PHAM on Unsplash


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10/Aug/2022

Although it sounds like it, a Baker’s cyst isn’t named after an occupation like housemaid’s knee (prepatellar bursitis), policeman’s heel (plantar calcaneal bursitis) or writer’s cramp (hand dystonia). It has nothing to do with the act of making delicious, delicious bread 🍞 or other baked goods 😋.

Baker’s cysts are named after Dr W.M Baker, the 19th-century surgeon who first described cysts that form on the back of the knee. Their clinical name is popliteal cyst. Often people don’t know they have a Baker’s cyst, especially if it’s not causing pain. However, sometimes they can cause problems.

Your knee – a complex joint

To understand how a Baker’s cyst affects your knee, it’s helpful to know a little about your knee joint.

Your knee is a large and complex joint where three bones meet: your thighbone (femur), shinbone (tibia) and kneecap (patella). 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.

Surrounding the joint is a tough capsule filled with a lubricating fluid (synovial fluid). This fluid allows your knee to move freely.

A Baker’s cyst can form when an injury or arthritis causes your knee to produce too much synovial fluid. This excess fluid bulges from the joint capsule behind the knee as a protruding sac (see image).

Cysts can vary in size and cause symptoms such as pain or stiffness in the knee joint.

Baker’s cysts may not require treatment, but if they do, they can be treated effectively with self-care and medical treatment.

Causes

Some of the common causes of Baker’s cyst include:

Symptoms

Often, there are no symptoms, and you may not even know you have a cyst. If symptoms do occur, they can include:

  • a lump or swelling behind the knee
  • knee pain
  • stiffness or tightness of the knee
  • limited range of knee movement (if the cyst is large).

Diagnosis

Many people don’t know they have a Baker’s cyst as it may be small and painless.

However, you should see your doctor if you notice a painful lump in the space behind your knee.

Your doctor will ask about your symptoms and medical history and examine your knee. They’re usually able to diagnose a Baker’s cyst based on this.

Sometimes a doctor may organise scans of the joint, usually an ultrasound, or if the diagnosis is uncertain, possibly an MRI (magnetic resonance imaging). This is to rule out other rare causes of the lump, such as a popliteal aneurysm, blood clot or tumour.

Complications

The symptoms of a Baker’s cyst are usually mild; however, in rare cases, the cyst may burst, leaking fluid into the calf region. This can cause increased pain in the knee and swelling or redness in the calf.

If you experience swelling or warmth in your calf, you should seek medical advice quickly.

It can be difficult to tell the difference between the complications of Baker’s cyst and more serious but less common problems such as a blood clot in a vein in your leg. So it’s better to be safe and get it checked out.

Treatment

You probably won’t need treatment if you have no symptoms or only mild pain.

However, if it is causing you pain, your doctor will develop a treatment plan that may include:

  • Self-care. You can reduce the pain and swelling by using an ice pack on your knee for short periods. Make sure to wrap it in a cloth so the pack doesn’t come into direct contact with your skin. You should also protect and rest the joint. Elevate your knee while resting it, and avoid activities that strain your knee (e.g. jogging). You may also find it helpful to use a cane or crutches for a short period or wear a knee support.
  • Medicines such as paracetamol or non-steroidal anti-inflammatory medicines (e.g. ibuprofen) may provide temporary pain relief. These medicines are available over-the-counter or with a prescription, depending on their dosage and other ingredients.
    A corticosteroid (steroid) injection may be helpful for people who haven’t found relief from other treatments or if they have severe pain.
  • Treating the underlying condition (e.g. arthritis) is also important, so your doctor may discuss other medicines and treatment options.
  • Seeing a physiotherapist or exercise physiologist for gentle strengthening and range of movement exercises to reduce symptoms and maintain knee function.
  • Draining the cyst by inserting a needle into it (needle aspiration) and removing the fluid. This may be done under ultrasound.
  • Surgery is rarely needed to treat a Baker’s cyst. However, it may be an option in some cases to treat the cause of the cyst (e.g. an injury) or to remove the cyst if all other treatments haven’t provided relief.

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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10/Aug/2022

Written by hand therapist Catherine Reid, B.App. Sci, (OT), M.Sci (H&UL rehab), MAHTA (As awarded by the AHTA), CHT(USA)

A surgeon once told me that the human body’s most elegant anatomy was in the hand. I might be slightly biased, but I had to agree! The hand is amazing and complex in the way it’s structured and works.

There are 27 bones in your hand compared with just 3 in your leg. These bones are moved by over 30 muscles, all working in unison to provide smooth, coordinated movements. Your nerves help you control these movements enabling you to adjust your strength or fine coordination to suit the task.

Your hands can convey your feelings through touch and gesture and help to communicate your thoughts. In fact, some people will tell you they can’t talk without using their hands!

Your wrists, elbows and shoulders work together to position your hands in space. Any problem along the chain of your upper limbs affects your ability to fully function. Imagine how difficult it would be to reach up to do your hair if your shoulder was stiff, or to do downward dog in yoga with a painful wrist!

We connect with the world through our hands, performing everyday activities, and many of us earn our living with our hands. That’s why it’s essential that we take good care of our hands.

For some people, this may include seeing a professional.

What is hand therapy?

Considering the importance of our hands, it should be no surprise that there are professionals devoted solely to their rehabilitation.

Hand surgeons are either orthopaedic or plastic surgeons who’ve undergone additional training and study to specialise in treating problems of the hands, wrists and arms. They may use surgical and/or non-surgical treatments.

Hand therapy practitioners are qualified physiotherapists or occupational therapists registered with the Allied Health Practitioner Regulation Agency (AHPRA). They have extensive knowledge and skill in understanding and treating problems with the fingers, wrists, elbows and shoulders. The Australian Hand Therapy Association (AHTA) defines hand therapy as “the art and science of rehabilitation of the upper limb – shoulder to fingertip”.

What is an Accredited Hand Therapist (AHT)?

In 2017, the Australian Hand Therapy Association implemented a credentialing program to ensure accredited therapists offer a high standard of practice. All Accredited Hand Therapists have undertaken advanced education and assessment of the upper limb and have had over 3,600 hours of hand therapy clinical practice. After they’re assessed as competent to provide safe, evidence-based diagnosis, advice, and treatment, they’re awarded the credential of Accredited Hand Therapist by the Australian Hand Therapy Association Credentialing Council.

What conditions are treated?

Accredited Hand Therapists diagnose and treat a large variety of musculoskeletal conditions of the upper limb. They include:

  • arthritis
  • nerve compressions (e.g. carpal tunnel syndrome)
  • fractures, joint injuries and dislocations
  • tendinopathies (e.g. tennis elbow) and other soft tissue injuries
  • pain conditions
  • nerve and tendon injuries
  • burns and scar management
  • sporting injuries
  • work-related injuries
  • post-surgical conditions.

What happens at an appointment?

When you meet with an Accredited Hand Therapist, you’ll work together to develop a treatment plan. It will take into consideration your specific situation, symptoms, and the environment in which you live and work.

Some treatments aim to resolve a problem, for example, improving muscle strength or range of motion after a fracture. Some treatments may be preventive and involve teaching you to manage symptoms like pain or swelling in response to an injury or illness.

Assessments may involve specific measurements; for example, the therapist measures your wrist’s range of movement or grip strength. Assessments also include your experience of the problem, for example, when you describe the location of the problem, how your symptoms feel and affect you, and the things you noticed or experienced when you first noticed your symptoms.

Treatments often use heat, ice or electrotherapy to improve healing, orthoses (splints) to rest soft tissues (e.g. muscles, tendons, ligaments), and specifically targeted exercises to improve movement and strength.

You’ll be encouraged to complete a home program when possible, so education will also be a large part of your treatment.

To achieve the best outcomes, therapists may collaborate with other health professionals such as hand surgeons, rehabilitation consultants or GPs.

Where do I find an Accredited Hand Therapist?

Accredited Hand Therapists can be found throughout Australia in private practice (sometimes co-located with hand surgeons), in public hospitals and in community settings. In Australia, there are over 400 Accredited Hand Therapists in metropolitan, rural and remote locations. You can contact a hand therapist through the AHTA “Find an Accredited Hand therapist” web page or email the AHTA at enquire@ahta.com.au.

You use your hands all day long, so receiving the best care to recover after surgery, injury, or a medical condition is essential. Your hands deserve the best, and so do you!

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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10/Aug/2022

Creams, sprays, liniments, ointments, patches, rubs & gels

If you open most medicine cabinets or bathroom cupboards, you’ll more than likely find a tube or jar of a pain-relieving rub. With varying degrees of smelliness!!😱

Many of us turn to these products when we wake up with a stiff neck or overdo it in the garden. The soothing ointments, creams, sprays, liniments, patches, rubs and gels that we apply directly to our skin (topically).

But what are they? How do they work? Are they effective? And are they safe?

First, there’s a vast array of topical products available in many forms and using different ingredients. Many are available to buy over-the-counter from your chemist or supermarket. However, some require a prescription.

Let’s look at some of the more common varieties.

Counterirritants

These products use ingredients such as menthol, methyl salicylate, eucalyptus oil and camphor. They’re called counterirritants because they create a burning, cooling or ‘tingling’ sensation in the area where they’re applied that distracts you from your pain.

Medicated products

Many topical products contain non-steroidal anti-inflammatory drugs (or NSAIDs) such as ibuprofen, diclofenac or piroxicam. NSAIDs block the action of specific enzymes (cyclooxygenase or COX) that are involved in inflammation.

Topical NSAIDs may be an option for you if you can’t take oral NSAIDs due to other health issues (e.g. high blood pressure) or the risk of complications (e.g. stomach problems), as less medication is absorbed into the bloodstream.

If you’re using a topical NSAID, you should avoid taking NSAIDs orally (pills or tablets) unless you’ve discussed this with your doctor. Although the amount of medicine that enters your body through the skin is less than when taking them orally, there’s still the risk of getting too much when using both forms.

Corticosteroids, or steroids, simulate the naturally occurring hormone cortisol. One of the many functions of cortisol is to suppress or reduce inflammation. Steroid creams come in varying strengths. They rarely have serious side effects if used correctly, so it’s essential that you follow the instructions carefully. If you have any concerns, discuss these with your doctor or pharmacist.

Capsaicin

Capsaicin is the substance found in chilli peppers that gives them their heat and spicy kick, making your mouth tingle and burn. Applied to the skin as a cream, it works by interfering with the pain signals between your nerve endings and brain.

Benefits of using topicals

Most topicals, when used correctly, provide quick, temporary pain relief and have fewer potential side effects than oral pain-relieving medicines.

They may be a good option if you only have pain in a few joints or muscles, as they work in the immediate area you apply it to, rather than affecting your whole body.

Topicals also provide the soothing benefit of a mini-massage when you apply them to your skin. Seriously, how good does it feel when you rub the cream into your sore neck, and you feel the muscles loosening? Or when you apply a warm gel to your stiff, aching knee? Bliss. 😊

Another benefit of topicals is that they’re very portable; you can have some at home, in your drawer at work, in your handbag or gym locker, and use them as needed.

Do they work?

Many people swear by these products for quick pain relief. And there’s solid evidence that they can provide pain relief for acute pain, such as strains and sprains. However, research shows only modest benefits for chronic pain. But, if you feel better when using these products, and you’ve discussed it with your doctor, they’re safe to use and are better tolerated than oral medicines.

Potential side effects

Topicals, both medicated and non-medicated varieties, can cause side effects. They include skin irritation, redness, rash, or a burning, stinging or itchy sensation in the area it’s been applied.

Very rarely, some people may experience nausea, breathlessness, indigestion or an allergic reaction to the topical. If you experience any of these symptoms, stop using the topical and talk with your doctor or pharmacist for advice.

Cautions

As with any medication, there are things you need to be aware of to prevent any problems from occurring:

  • Taking oral and topical medicines containing the same ingredients (e.g. NSAIDs) at the same time may increase the risk of side effects. Talk with your doctor about this risk.
  • Always read the consumer medicine information carefully and follow the instructions. Take note of how to apply the topical, how often and how much. Don’t go overboard and slather it on. You can get too much of a good thing!!
  • Wash your hands thoroughly after applying.
  • Be careful to avoid contact with your eyes or other sensitive areas 😖.
  • Don’t use these products on wounds or damaged skin.
  • Don’t use with heat packs as this may cause burns.
  • Only use one topical medicine at a time.
  • Check the use-by-date and discard any out-of-date products.

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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21/Jul/2022

COVID numbers are up and masks are back. The stupid virus and its many variants just keep on giving 😥.

We’ve dealt with isolations, lockdowns, and massive life changes in the past few years. We’ve made sourdough bread, completed countless jigsaws, consumed gallons of quarantinis (or was that just me? 😉🍸) and given online yoga a go.

But now what? Yoga has become a source of calm and relaxation, but we’re sick of sourdough, can’t bear to see another jigsaw, and for the sake of our livers, we’ve moved on to non-alcoholic mocktails (again, maybe just me? 🍹).

It’s time to cast aside the things that make us unhappy or trigger feelings of lockdown anxiety. It’s time to embrace the things we love, that make us fulfilled and satisfied. The things that feed our curiosity and creativity. And the things that support self-care.

Here are some simple things you can add to your routine to boost your happiness. Hopefully, one or two of them will strike a chord with you 😊.

Give thanks

Sometimes we can be consumed with what we don’t have or what others have… money, good health, the latest gadget, a great job, travel opportunities… Unfortunately, all this does is create feelings of envy or dissatisfaction – and that’s no way to live.

When I find these feelings creeping in, I stop myself. I think of three things I love about my life and make me grateful for the life I’m living. And there’s so much to choose from! My partner, the absolute love of my life 😍. Having a nice place to live in the green outer suburbs. A fabulous collection of shoes that I’m rediscovering after years of lockdown slippers and runners 😁 Psychotic balls of fluff (aka two cats) that rule my home and make me laugh. The fact that I live in a country where I can attend a non-violent protest for women’s rights. The chilli plant I bought as a small seedling that now produces deliciously hot chillies 🌶🌶 A library within walking distance. Without even breaking a sweat, that’s seven things I could list in a few short minutes!

We have lots to be thankful for in our lives – we just need to take a moment to think about and value them.

Learn new things

Nerd alert! For me, there’s nothing like watching a documentary, learning a new skill, attending a webinar/seminar/class, reading an article or talking with someone with unique experiences and knowledge. It always inspires me to discover more and delve deeper into a subject.

Learning new things challenges us and fires our curiosity and imagination. And that’s not only good for our mental health and satisfaction with life in general, but it’s also excellent for our brain health. I’m currently messing around with learning to play the guitar. I’m not sure if you could call the sound I create music, but it’s a lot of fun! If there’s something you’ve been wanting to learn, don’t put it off any longer. Book that class, take that online course, speak with people in the know – you won’t be disappointed!

Enjoy the company of friends and family

Seeing our important people face-to-face is all the sweeter when we remember the restrictions we endured in 2020 and 2021. It’s hard to imagine that there were periods when we could only connect via phone or video. So cherish the time you have together.

Do things for others

I find being useful and helping others a rewarding experience.

It doesn’t matter if it’s something small, e.g. letting a car into traffic in front of me, or something big, e.g. helping an aunt move into a retirement village, then out of a retirement village, and later relocate 500 kilometres away in the space of 18 months (true story 😝). To me, if it helps make someone’s life a little easier, it’s worth it.

There are many ways you can help out or do things for others, including volunteer work, mowing your neighbour’s nature strip, being kind to your barista, cooking a meal for a sick friend. Whatever you do, you’re sure to feel warm and fuzzy inside, and make your corner of the world that much brighter.

Laugh

Having a good laugh, chuckle or giggle is the best 😂😆🤣. Everything seems so much better, you feel happier, and you can’t wait to do it again.

Laughter releases the ‘feel-good’ hormones – endorphins, serotonin and dopamine. They boost your mood and make you feel more positive. And endorphins are your body’s natural pain reliever and can reduce your feelings of pain. Yay!

So next time you feel a little down, or you’re in pain, watch funny cat/dog/panda videos (I’ve heard there are a couple on the internet 😉), talk with a friend about a silly experience you had together, watch a comedy, listen to an entertaining podcast. Do whatever makes you laugh and enjoy those happy vibes.

Get out into nature

Whether it’s the local park, a walk on the beach or bushwalking through the hills, just getting out into nature makes me feel happy 🍁🍂. We’re surrounded by so much beauty.

When you head outdoors, keep your phone in your pocket and look around. Listen to the birds in the trees, notice how the trees sway in the wind, enjoy the dogs playing in the park, and appreciate the scenery around you. Take the time to pay attention and be mindful, and you’ll immediately feel a boost in your mood.

Discover new places

This often goes hand in hand with the previous one. And it’s something that kept me sane during lockdowns. I’d look at maps of my local area and the radius in which I was allowed to travel. I’d then look for all the green spaces – and it’s amazing how many parks, reserves, playgrounds, and abandoned golf courses I could find. When I visited them, I’d discover new, interesting things – a pretty creek alongside the path, a group of goats brought in to deal with the weeds, a flock of cockies gathered in a tree throwing seedpods at the people walking below 😆. Discovering new places brings out the intrepid explorer in me and I feel like I’m seeing so much more of the world.

Stay active

Activities that exercise your body and mind in challenging, new ways are great for your physical, mental and emotional wellbeing. And choosing activities that you enjoy will ensure you do them regularly.

For example, I’ve recently rejoined the gym because my strength and stamina have declined due to my sedentary COVID life. So I’m combining my usual walking and hiking with strength training, yoga and Pilates to increase my fitness, take some weight off my joints and help me sleep better. It’s early days, but I’ve already noticed a difference.

Like millions of others, I’ve also been enjoying the daily mental challenge of Wordle. It stimulates the brain and provides social competitiveness as we compare our wins and losses 😃. And I’m trying to learn to do cryptic crossword puzzles, though that’s proving more difficult!

The important thing is that I’m engaging both body and mind in demanding activities. They’re pushing me out of my comfortable status quo and making me grow.

Hug your people

Physical distancing and being unable to get close to others for fear of germs is a lonely experience. And it can leave us feeling sad at the lack of closeness. So the people I can touch, I touch a lot! Not in a creepy, unwelcome way 😄 but in a caring, loving way.

Being able to touch or hug others reduces stress, anxiety, and depression and makes us feel good. And here’s a tip from me to you: don’t save your hugs for when you’re feeling down. Hug each other when you feel happy, excited, or just because it’s Thursday.

Clean and declutter

Ooh, I did a lot of this during the first few lockdowns. And I know many of you did the same. Op shops were bursting at the seams with our discarded books, clothes, jigsaws and appliances. There’s nothing like decluttering and cleaning your home and work spaces to make you feel satisfied and in control. And your new tidy rooms will hopefully have the added benefits of preventing falls as trip hazards are moved or given away. Just be careful while doing your big clean not to overdo it physically. Take your time and pace yourself.

Try new recipes and new ingredients

Full disclosure, I’m a terrible cook. But I’ve been trying a new recipe and/or ingredient at least once a week. It gets me out of my ‘Tuesday night stir-fry’ rut. It helps to have tasty recipes from our talented volunteers, Lauren and Kitty. I’m also blessed that my partner is a great cook and has introduced me to spices and condiments I’ve never used before. There have been many, many disasters in the kitchen (and a trip to the hospital for a deep cut from slicing capsicums 😫), but there have also been successes. And that’s incredibly satisfying.

Acknowledge it’s been hard

So far, the things I’ve listed have been light and happy. But we should acknowledge that there have been dark, traumatic times without fun, joy or happiness. There have been tears, arguments, and moments of intense anxiety and stress. And before this pandemic is done, we’ll likely experience more of these moments. So it’s important to remember that we’re not going through this alone. We have people who love and care for us. We also have access to professional support if we need it to get through. We just need to ask.

The COVID-19 pandemic will pass. It’ll take some more time, but we can adapt. We’ve been doing it for years, and even though we’re weary, we can continue to do it. And finding the things that make you feel happy, strong, and in control of your world will help you get through.

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.

Contact Lifeline Australia

13 11 14 for 24 hour crisis support and suicide prevention.

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