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19/May/2022

Hi! I’m Thalia. I’m 17, and I’m currently completing my VCE. In my spare time I enjoy reading, music, dance, and getting involved with my local community.

I have also lived with not one, but two musculoskeletal conditions. At ten months old, I had a severe bone infection in my left hip. I was lucky to survive the infection, but it significantly damaged my hip joint. Over time, this damage developed into severe osteoarthritis. By age six, I was unable to sit on the floor and by age eight I had the hip of an average 75 year old.

My arthritis was getting worse quickly. Despite several surgeries, I ended up in a wheelchair because of a disease that most people didn’t think kids could get.

Now, if you saw a child in a wheelchair who looked completely fine, it would probably raise some questions, right? Well, it certainly did around me. I can’t count the number of times someone has asked me (usually an adult) “now what have you done to yourself?”. When I told people that I had osteoarthritis, many of them didn’t believe me. So, at the ripe old age of eight, I decided to try and change the perception of arthritis and other similar conditions as an “old people’s disease”.

That’s how I discovered what was at that point called Arthritis Victoria, now Musculoskeletal Australia or MSK. I set up a cake stall at my local farmers’ market and raised $722. I spread the message, within my tiny country town, that kids get arthritis too. And over the next few years, I continued to raise awareness and funds for MSK.

In 2017, at the age of twelve, I had a total hip replacement. I recovered quickly, and two months later I was living life like a completely normal teenager. I could walk, run, climb. I even did PE at school. For the first time in years, I was like any other kid. If you end the story here, I live happily ever after… but unfortunately that’s not quite how things turned out.

In early 2018, 8 months after my hip replacement, the pain was back. What I had previously felt in my hip was now all over my body. Muscles were weak and achy, joints felt like they were grating together and even my skin was on fire. People couldn’t touch me without causing me pain. I went back on medication and had countless tests to see why I was in pain, but there was no physical cause.

Eventually, I received a diagnosis: fibromyalgia. The most likely reason is that my brain is so used to being in pain, it thinks it still is; but because of the nature of this illness, we will never know for certain.

Growing up with a musculoskeletal condition is incredibly lonely. I still have not ever met someone my age with osteoarthritis or a hip replacement. I was the only person in my primary school in a wheelchair and it was hard for teachers and students at my primary school to understand my condition. Whilst this is not as prevalent at high school, it is still something I face every day.

MSK has provided me with a community. Through MSK I have met other people like me, people who have had their conditions from a young age, who know exactly what it feels like to wake up every morning not knowing how much pain you’ll be in, or how much function you’ll have. Having this family of people who get it is crucial; it means that I’m not alone anymore.

More recently, I’ve become a young ambassador for MSK’s Teen Talk platform. Teen Talk is an online chat group for those aged between 13-20 who live with a musculoskeletal or chronic pain condition. Teen Talk is a place to connect with other kids who understand what you’re going through. With chill-out spaces, memes, places to chat health and even a pets chat, Teen Talk is an amazing platform for everyone looking for community and support with their MSK journey. I hope to see you there!

In my future, I have no idea what I will be. I am interested in so many fields including psychology, fashion design, the arts, STEM and many, many more. I do know, however, that whatever the future holds for me, I will strive to make a difference in this world, for myself and the other children like me. I want to tell the world my story, to raise awareness for all of the kids out there who live without recognition of the trials they face. I will continue to spread the message that “kids get arthritis too”. And I will expand this message, to say “kids get a whole range of musculoskeletal conditions too”.


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04/May/2022

Did you know that some forms of arthritis are caused by crystals forming inside a joint?

Two of these conditions are gout and acute calcium pyrophosphate (CPP) crystal arthritis. CPP is a mouthful (!), but you may have heard of its old name, pseudogout, which means ‘false gout’.

So what are these conditions? And how do they affect people?

Let’s start with gout.

Gout is a common and painful form of inflammatory arthritis. It involves sudden flares of extreme joint pain, swelling and redness. It most often affects the big toe, but it can affect any joint, including your wrists, ankles, knees, elbows, and fingers.

Gout occurs more frequently and develops earlier in men, often between 30 and 45 years. Women are more at risk of developing gout after menopause. It affects both men and women equally over 65.

Gout occurs when uric acid builds up in your blood, causing needle-shaped crystals to form inside a joint.

Some things increase your risk of developing gout. They include:

  • being overweight or obese
  • having conditions such as high blood pressure, chronic kidney disease, diabetes and heart disease
  • drinking too much alcohol (especially beer)
  • eating a diet high in purines such as meat, sweetbreads, offal, shellfish, and fructose
  • using diuretics
  • becoming dehydrated
  • crash dieting, fasting or overeating.

Acute calcium pyrophosphate (CPP) crystal arthritis also involves sudden and painful flares of extreme joint pain, swelling and redness. This condition most often affects the knees and wrists but can affect other joints and tendons.

CPP affects both men and women, most commonly over age 60.

It occurs when calcium pyrophosphate crystals form in the joint cartilage. They may also be found in the joint lining and the joint fluid. Unlike the needle-shaped crystals in gout, these crystals are rod-shaped with blunt ends. It’s not clear why the crystals form, but they increase in number as people get older.

Some things increase your risk of developing CPP. They include:

Diagnosing crystal arthritis

Many conditions can cause joint pain and swelling, so your doctor will talk with you about your symptoms and medical history and examine the affected joint. If they suspect you have gout or CPP, they will take scans of the joint.

They may also remove a fluid sample from your joint. This fluid is examined under a microscope for the presence of crystals or anything else that may be causing the pain and inflammation. This is the most definitive test for crystal arthritis and indicates whether uric acid crystals or calcium pyrophosphate crystals are present.

Treatment

The first step in treating gout and CPP is to control the pain and inflammation. This may involve medicines, cold packs, and resting the joint.

Your doctor will consider your medical history and other health issues when deciding which medicines are most appropriate and safe for you to use.

The most common medicine used to control pain and inflammation during a gout or CPP flare is a non-steroidal anti-inflammatory (NSAID). Another common medicine used to treat gout is colchicine. Corticosteroids (or steroids) can also be very effective.

In the case of gout, once the flare is under control, your doctor may prescribe medicines that lower uric acid levels in your blood. This will depend on things such as:

  • how often you have flares
  • if you’ve developed tophi (hard, uric acid deposits under the skin) or kidney stones
  • other health conditions you may have (e.g. kidney disease).

For both conditions, treating any underlying conditions is also important to prevent future flares.

Self-care

As well as taking your medicines as prescribed, you can reduce the pain and swelling of a flare by using an ice pack on the painful joint for short periods. You should also protect and rest the joint.

Other things you can do to prevent future flares:

  • Take any medicines as prescribed.
  • Lose weight if you’re overweight or obese. This needs to be done carefully and gradually, as crash diets or fasting can cause a flare for people with gout. Your doctor and/or a dietitian can support you in this.
  • Drink water regularly, as becoming dehydrated can increase your risk of a flare for both conditions.
  • Drink alcohol in moderation and avoid binge drinking.
  • Eat a healthy, balanced diet. If you have gout, avoid or eat in moderation foods high in purines. Talk with a dietitian for more information. There is no link between CPP flares and diet. Although the crystals are calcium pyrophosphate, there’s no evidence having a calcium-rich diet triggers a CPP flare. In fact, everyone should ensure they get enough calcium in their diet to reduce their risk of developing osteoporosis.
  • Exercise regularly.
  • Work closely with your doctor to prevent further flares and actively manage your condition.

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.

More to explore

 

 


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04/May/2022

It seems like every time you look at your socials, open a newspaper or listen to the radio, another awareness day, week or month is being promoted.

Just this week, to name a few, we have World Asthma Day (3 May), International Day of the Midwife (5 May) and International No Diet Day (6 May). Oh, and let’s not forget Star Wars Day (4 May), as in May the force (fourth) be with you. 😂

In fact, as far as musculoskeletal conditions go, May is chock-full of awareness days:

October also has its fair share:

And we have World Young Rheumatic Diseases Day (WORDDay) on 18 March.

So what’s the point of all of these days and the countless others that get shared around?

Awareness raising

In our 2020 national consumer survey, a common issue raised by many respondents was the lack of awareness of musculoskeletal conditions and the impact they have on people’s lives. It’s one of the reasons we named the subsequent report Making the Invisible Visible because, for the most part, these conditions have no visible signs to indicate the pain and suffering they cause. Or the tremendous effect they have on daily lives, finances, the ability to work and study, be social, exercise, have a family, travel, be intimate, and so much more.

Rattle Ya’ Bones Day came about as a vehicle for us to promote these issues, educate the public about them and lift the stature of musculoskeletal conditions. It also provides the opportunity to dispel many myths surrounding arthritis, back pain and other musculoskeletal conditions.

Promoting specific conditions

There are over 150 different musculoskeletal conditions, so it can be easy to get lost in the mix. Specific condition awareness days allow conditions like lupus, juvenile arthritis and fibromyalgia to shine and get the awareness they deserve.

Sharing personal stories

An important aspect of awareness days is sharing the voices of people living with the condition or health issue. These stories, experiences, and perspectives provide the broader community with insight into their lives. And that’s a powerful way to make people care.

Connecting people

When you live with a painful condition, it can be an isolating experience. If you don’t know anyone else with your condition, it can be even more isolating. Awareness days can provide an opportunity to connect with others online and at events.

And for those newly diagnosed who may be feeling a bit lost, these awareness days can help people find a community of people who understand what they’re going through.

Showing support

You can show your support for people living with specific conditions by sharing information about the awareness day, donating, volunteering, and so much more. Even liking a post and sharing it with your network goes a long way to supporting a cause and the people whose lives are affected. It’s a chance to say “this matters” and let others know it matters. And hopefully they’ll learn about it and care too.

Seeking change

In our survey, many people expressed their frustrations and difficulties they faced living with musculoskeletal conditions and the shortcomings in the systems that should support them. By raising awareness of these issues, we can lobby for change.

Raising funds

Many awareness days also have a fundraising component to them. This may be for anything from providing services to supporting research.

Having fun

Whether it’s a serious awareness raising campaign or just a weird and wacky day that exists on its own (I’m looking at you, International Goof Off Day 😁), adding fun elements encourages people to get involved. And let’s face it, the world can be a grim place at times, so any extra fun we can cram into our days provides some necessary silliness.

Save the date! Rattle Ya’ Bones Day – 31 October 2022

Keep an eye on our socials and MSK News for information about this year’s Rattle Ya’ Bones Day (RYBD). RYBD aims to raise awareness of the impact of muscle, bone and joint conditions on the lives of those who live with them. You can help us do that. So stay tuned!

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.

More to explore 😉

 


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13/Apr/2022

We talk about inflammation a lot. But what is it? What’s happening in your body when you have inflammation?

Acute and chronic inflammation

There are two types of inflammation – acute and chronic.

Acute inflammation

Acute inflammation is your body’s reaction to things such as an infection (e.g. a cold or infected wound) or an injury (e.g. a sprained ankle or bee sting).

Symptoms associated with acute inflammation are:

  • pain
  • redness
  • swelling
  • heat
  • loss of function (e.g. difficulty moving a swollen ankle after spraining it or difficulty breathing through your nose when you have a cold).

What’s happening in your body with acute inflammation?

When you sprain your ankle, or get an infection, your immune system automatically springs into action.

Cells close to the source of the injury or infection release chemicals known as inflammatory mediators (e.g. histamine). They increase blood flow to the area, widening blood vessels and allowing more blood to reach the injured tissue. As a result, the area becomes red and feels hot.

The extra blood to the area enables more immune cells to reach the injured tissue. This includes white blood cells, or leukocytes, whose role it is to defend your body against infections and disease and start the healing process.

Depending on the cause, acute inflammation can occur quickly and generally goes away quickly.

Chronic inflammation

Chronic inflammation is persistent, low-level inflammation that lasts for months or years. With chronic inflammation, the inflammatory process often begins when there’s no injury or illness present; and it doesn’t end when it should. When this happens, white blood cells may target and damage nearby healthy tissues and organs.

We don’t really know why chronic inflammation occurs. It doesn’t seem to serve a protective purpose as acute inflammation does.

However researchers have identified factors that increase your risk of developing chronic inflammation, including:

  • chronic infections
  • physical inactivity
  • poor diet
  • obesity
  • imbalance of gut bacteria
  • disturbed sleep
  • smoking
  • stress
  • ageing.

Many people don’t know they have chronic inflammation, but they may feel symptoms such as:

  • body and joint pain
  • fatigue and insomnia
  • weight gain or loss
  • frequent infections
  • depression, anxiety and mood disorders
  • digestive problems (e.g. constipation, diarrhoea, acid reflux)
  • skin rashes.

Chronic inflammation is associated with many diseases, such as rheumatoid arthritis, lupus, heart disease, diabetes, cancer, and bowel diseases like Crohn’s disease and ulcerative colitis.

If you’re concerned about chronic inflammation and have symptoms like those above that have been troubling you for some time, see your doctor . They’ll talk with you about your symptoms, do a physical exam, and may decide that blood tests are necessary to look for signs of inflammation.

The blood test will look for elevated C-reactive protein (CRP), which rises in response to inflammation.

Inflammation is helpful until it’s not

It’s important to remember that inflammation isn’t inherently bad. Acute inflammation serves a vital role in our health and survival. It helps us recover from injury and infection. However, when it’s chronic, it can negatively affect our health.

Always talk with your doctor if you have symptoms that are distressing you or making you feel unwell.

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.

More to explore


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13/Apr/2022

Do you get to the end of your busy, tiring day, drag yourself to bed and then have trouble falling asleep? Or staying asleep?

If so, you’re not alone. It’s a common problem, especially for people with musculoskeletal conditions or chronic pain. The Australian Institute of Health and Welfare (AIHW) reports that about two-thirds of Australians aged 18 and over with chronic conditions such as arthritis, diabetes and mental health issues report at least 1 sleep difficulty or problem.(1)  And so while it’s probably no surprise to you that poor sleep affects your pain levels and quality of life, did you know it can put you at risk of developing other chronic conditions, including high blood pressure, diabetes and heart disease? (2)

That’s why it’s important to develop a healthy and consistent bedtime routine that allows your body and mind time to wind down and relax so that you can sleep well.

What are the elements of a bedtime routine?

First, a good bedtime routine needs time. Rushing is counterproductive and can lead to more stress and anxiety right before you hop into bed. So give yourself enough time, at least 30 minutes each night. Also, allow time for your new routine to stick. We’re creatures of habit, but when we create new routines, we have to give them time to become second nature.

Next, your bedtime routine should involve things that you enjoy, help calm your body and mind, and let your body know it’s time for sleep.

Here are some suggestions for things you might include in your routine:

  • Set a time for going to bed, and stick to it as much as possible. When you have a consistent sleep schedule, your body naturally adjusts and begins to feel tired at the right time each day, making it easier to fall asleep.
  • Don’t use technology during your wind-down time. It’s easy to lose track of time while reading emails, checking social media or watching the latest TV series. The next thing you know, you’re still awake at midnight. So put the technology away.
  • Write it down and get it out of your head. Put pen to paper and write down your worries, concerns, and things you need to do the next day. Basically, anything playing on your mind and interfering with your ability to relax and sleep. Don’t do this right before you hop into bed, as they’ll still be on your mind. Instead, do it a few hours before bedtime, and then put it away.
  • Avoid caffeine, alcohol, nicotine and big meals close to bedtime. They can affect your ability to fall asleep and the quality of your sleep. Instead, drink water, herbal tea or non-caffeinated drinks. And if you’re hungry, eat a light snack, for example, a piece of fruit, some yoghurt or a small handful of nuts.
  • Adjust the temperature. Your body’s core temperature needs to drop a few degrees for you to fall asleep. So for your bedroom temperature, it’s best to aim for cooler (but not cold) rather than warm. A helpful tip from the American Academy of Sleep Medicine is to think of your bedroom as a cave: it should be cool, quiet, and dark.
  • Have a warm shower or bath an hour or two before bed. This is also about achieving optimum body temperature for good sleep. The shower or bath will initially warm your body, but then as the water evaporates from your skin, you’ll quickly cool down. The warm water also stimulates blood flow from your core to your hands and feet, lowering your body temperature.
  • Don’t forget your teeth! While it doesn’t directly relate to sleep quality, it’s part of the winding down process at the end of your day.
  • Take your regular medicines (if required).
  • Avoid strenuous exercise before bedtime. It raises your temperature and heart rate, making it difficult to fall asleep. Instead, save these kinds of activities for your morning or afternoon.
  • Do something you enjoy – for example, read a book, listen to music, talk to your partner/kids/pet. These enjoyable activities create a feeling of calm. They can also improve your mood and help you manage stress and anxiety.
  • Try other ways to relax – such as gentle yoga, meditation, stretching, deep breathing and progressive muscle relaxation.
  • Have sex! Research suggests that having sex improves sleep, whether you’re alone or with a partner. Orgasm releases several hormones, including oxytocin, which when elevated as a result of sexual intercourse improves sleep quality. Cuddling may also help you fall asleep, as it can make you feel calm and comforted.
  • Prep for the next day. Take the stress out of your morning routine by doing some prep the night before. Sort out your lunch, outfit, kid’s homework etc, so you can go to bed feeling confident your morning will start well.

These simple suggestions to help you wind down at the end of your day can help you relax and sleep better. And in the end, we all want to sleep well and feel as refreshed as possible when we wake up. So why not give some of these things a go? You’ve got nothing to lose and so much to gain.

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.

More to explore

Reference

(1-2) Sleep problems as a risk factor for chronic conditions 
Australian Institute of Health and Welfare (AIHW)


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13/Apr/2022

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

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

First – let’s look at those names

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

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

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

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

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

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

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

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

That’s about where the similarities end.

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

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

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

This causes ongoing inflammation and pain.

Symptoms:

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

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

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

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

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

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

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

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

Symptoms:

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

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

Treating RA and OA

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

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

What about osteoporosis (OP)?

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

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

From about 25 to 50 years of age, your bones break down and rebuild at about the same rate. They’re in a state of balance. This is when you’ve achieved your ‘peak bone mass’. Your bones are at their strongest.

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

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

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

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

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

Treating osteoporosis

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

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.

More to explore

Reference

(1) How rheumatism got its name
The Rheumatologist


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24/Mar/2022

Osteoarthritis (OA) is the most common type of arthritis, affecting 1 in 11 Australians.* It can develop in any joint but commonly occurs in weight-bearing joints like your knees and hips.

Your hip joint hip joint osteoarthritis

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

Your hips are one of the largest joints in the body. They’re called ball and socket joints. That’s because the head of your thigh bone (femur) is shaped like a ball that fits inside a rounded socket (acetabulum) in your pelvis.

The ends of your bones are covered in a thin layer of cartilage that acts like a slippery cushion absorbing shock and helping your joints move smoothly.

With OA, the cartilage becomes brittle and breaks down. Because the cartilage no longer has a smooth, even surface, the joint becomes stiff and painful to move.

Eventually, the cartilage can break down so much that it no longer cushions the two bones. This causes pain, stiffness and swelling.

Symptoms

The symptoms of hip osteoarthritis usually happen gradually and vary from person to person. They may include:

  • pain in the hip joint
  • pain in your groin or thigh that radiates to your buttocks or your knee
  • stiffness and/or swelling of the hip joint
  • grinding, creaking or crunching sound when moving the hip
  • it may feel like your hip ‘locks’ or ‘sticks’ during periods of activity
  • reduced range of movement.

Causes

Many factors can increase your risk of developing osteoarthritis of the hip, including:

  • age – OA occurs more often in people over 45
  • being overweight or obese – extra weight on your hips can increase strain and may lead to premature or increased joint damage
  • gender – 3 in 5 people who develop OA are female*
  • family history of OA
  • joint damage – for example, from a sports injury or a car accident
  • joint abnormalities – for example, developmental dysplasia of the hip, a condition that affects the hip joint in babies and young children.

Diagnosis

If you’re experiencing pain or stiffness in or around your hip, it’s important that you discuss your symptoms with your doctor. Getting a diagnosis as soon as possible means that treatment can start quickly. Early treatment will give you the best possible outcomes.

To diagnose your condition, your doctor will:

  • take your medical history – this will include finding out about your symptoms, how long you’ve had them, what makes them better or worse
  • physically examine your hip.

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

Treatment

There’s no cure for hip OA, but it can be managed effectively using exercise, weight management, medicines, self-management and in some cases, surgery.

Exercise

Exercise is one of the most important strategies for managing OA. A tailored exercise program developed by a physiotherapist or exercise physiologist can help reduce your hip pain and improve your hip function. Evidence suggests that while no one particular type of exercise is better than another, a combination of certain exercises is likely to be the most effective.

These exercises include:

  • strength training specifically targeting your legs
  • aerobic exercise – these are exercises that get you moving and increases your heart rate (e.g. brisk walking, cycling, swimming) and will help improve the health of your heart and lungs (cardiovascular system)
  • balance training
  • exercises that move your joint through its full range (range of motion exercises).

When choosing an exercise for yourself, think about what you enjoy and what you’re likely to keep doing. The best results occur when you exercise at least three times per week.

If pain prevents you from exercising, you may find that warm water exercise is a good starting point. Warm water pools offer the comfort of warmth and the buoyancy of the water to ease the load on your joints. For those able, cycling is a good option for non-weight-bearing exercise.

Weight management

Being overweight or obese increases the risk of developing hip OA. It’s also highly likely to speed up how quickly your OA develops or progresses. Evidence shows a relationship between weight loss and relief of symptoms such as pain and stiffness; even a small amount of weight loss can help. If you’d like to lose weight to improve your symptoms, your doctor and/or a dietitian can assist you in losing weight safely.

Medicines

For some people, medicines are an important part of managing their OA. Tablets, creams, gels or injections may help to reduce pain and improve function.

There are a variety of medicines used in the management of hip OA. Each comes with varying degrees of evidence to support them. These include:

Non-steroidal anti-inflammatory medicines or NSAIDs (e.g. Nurofen, Celebrex, Voltaren)
NSAIDs are available over-the-counter and with a prescription, depending on their dosage and any other ingredients. They may be taken by mouth (orally) as a tablet or capsule or applied directly to the skin (topical) in the form of gels and rubs.

Oral NSAIDs are considered the preferred first-line drug treatment for OA and have been shown to reduce pain and symptoms in hip OA.

Although there’s no solid evidence either for or against topical NSAIDs, it may be worth giving them a short trial to see if they help.

It’s important to note that NSAIDs are designed to be taken at low doses for short periods. Always talk to your doctor before starting NSAIDs as they can cause harmful side effects, especially in older people.

Paracetamol (e.g. Panadol, Panamax)
Research has shown that paracetamol provides only low-level pain relief and, in some cases, no pain relief at all compared to a placebo in hip OA. However, some people do report that it helps reduce or take the edge off their pain so that they can be more active. If you can’t take NSAIDs they may also be an option. Before using paracetamol, talk with your GP to see if it’s appropriate for you.

Corticosteroid injections
If you have persistent hip pain and haven’t had relief from oral medicines or other treatments (e.g. exercise, weight loss), your doctor may suggest a corticosteroid (steroid) injection. Corticosteroid injections into the hip joint can provide short-term pain relief for some people with hip OA. However, the duration of pain relief can vary from a few days to a few weeks, and the number of injections you can have is limited due to potential harm. It’s important that you discuss the benefits and risks of steroid injections with your doctor to have all the information you need to make an informed decision.

Opioids
Opioids are powerful pain-relieving medicines. They’re effective at reducing acute pain (or the pain resulting from an injury or surgery), but evidence shows 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 hip OA.

Glucosamine and chondroitin
Studies have found that there’s no benefit from taking glucosamine for osteoarthritis. The Australian Rheumatology Association and the Royal Australian College of General Practitioners recommend against taking glucosamine.

Glucosamine supplements are usually made of shellfish, so if you have a shellfish allergy, don’t use glucosamine. Glucosamine can also affect your blood sugar levels and may adversely affect diabetic, cholesterol, chemotherapy and blood-thinning medicines.

Much like glucosamine, the effects of chondroitin are unclear. Some studies have found an impact, while others did not. Speak with your doctor before trying glucosamine or chondroitin.

Stem cell injections
Currently, there’s no evidence to support the use of stem cell injections in the treatment of hip OA despite it being commercially available. The International Society for Stem Cell Research and the Australian Rheumatology Association does not support the use of stem cell injections for osteoarthritis. It’s recommended that stem cell administration should only take place under a rigorously designed clinical study that prioritises individual health and safety.

Self-management

There are many things you can do to manage your OA:

  • Learn about your condition – knowing as much as possible about your OA means that you can make informed decisions about your healthcare and play an active role in managing your condition.
  • Learn a range of strategies to manage your pain – such as heat and cold, muscle relaxation, meditation, visualisation and massage. For more tips on managing pain, check out our online book Managing your pain – an A-Z Guide.
  • See a physio – a physiotherapist can provide you with techniques to improve movement and reduce pain. This can include designing an individualised exercise program tailored to your needs and offering advice on ways you can modify your daily activities.
  • Talk to an OT – an occupational therapist can advise on pacing yourself and managing fatigue, as well as how to modify daily activities both at home and work to reduce strain and pain on your joints.
  • Grab a gadget – things such as walking aids, long-handled shoehorns and long-handled reachers can reduce joint strain and movements that cause you pain. An OT can give you advice on aids and equipment to suit you. You can also check out some aids available in our online shop.

Surgery

For some people with hip OA, when all non-surgical treatment options have failed, and hip pain and reduced hip function impact their quality of life, surgery may be an option. In this case, your doctor may refer you to an orthopaedic surgeon to discuss your options.

A total joint replacement of the hip is the most common type of surgery for hip OA. It can provide significant pain relief and improved function. However, it’s important to remember that a total hip replacement is major surgery and requires you to commit to months of rehabilitation.

Contact our free national Help Line

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

More to explore

Reference

* Osteoarthritis, AIHW, 2020.


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24/Mar/2022

We have a long and complex relationship with opioids. Humans have been actively growing poppies and enjoying their medicinal benefits since at least 3,400 B.C. The Sumerians referred to it as Hul Gil or the ‘joy plant’.

However, we now know that while these medicines can provide significant pain relief when used appropriately, they can also cause great harm.

Did you know that every day in Australia, nearly 150 people are hospitalised, and 3 people die due to issues related to opioid use? (1)

That’s why in 2020, the Australian Government made changes to how we use and access opioids.

What are opioids?

Opioids are pain-relieving medicines that come in various formulations, dosages and strengths. They include tramadol, codeine, morphine, oxycodone and fentanyl.

There are two groups of opioids:

  • opiates – created using the milky substance found inside the pods of the opium poppy, and
  • synthetic or man-made opiods – created in a laboratory using chemicals.

Opioids can be taken as tablets, injections or patches on the skin.

How do they work?

Opioids attach to opioid receptors in the nervous system and slow down the messages between the body and brain, including pain messages. This dulls your perception of pain – it’s not gone, nor is the cause of the pain. It’s simply been dampened so that you can function with less discomfort. They also cause the brain to release the hormone dopamine, making you feel happy or relaxed.

However, opioids can also slow your heart rate and breathing.

Opioids are used to treat severe pain associated with cancer or acute pain, for example following surgery.

They’ve also been used for many years to help people with severe, persistent non-cancer pain, like the pain associated with musculoskeletal conditions.

However, extensive research now shows that opioids don’t provide ‘clinically important improvement in pain or function compared with other treatments’ for most people with persistent pain or chronic pain.(2) This research, combined with our knowledge of the serious side effects of opioid medicines, particularly with long-term use, mean that these medicines should be used with caution.

Side effects

All medicines have side effects, so it’s important to know what they are. Side effects of opioids include sleepiness, constipation and nausea. More serious side effects include shallow breathing, slowed heart rate and loss of consciousness. These serious side effects may be due to too many opioid medicines being taken (an overdose). This can be life-threatening, so you need to ensure that you know when and how to take your medicines to prevent an accidental overdose.

Addiction is also a possible side effect of opioids.

Opioids, when taken long-term, can also make you feel more pain. This is called opioid-induced hyperalgesia. It happens because opioids make the brain and nerves more sensitive to pain.

Tolerance, dependence and withdrawal

Your body adapts to opioids when you use them long-term. This is called tolerance. To get the same pain relief, you need to increase the dosage. However, it’s not safe or sustainable to continue to increase the dosage of opioid medicines because of the serious risk of harm associated with their long-term, high-dosage use.

Dependence is when your body requires a specific dose of the medicine to avoid withdrawal symptoms when the dose is reduced or stopped. Symptoms of withdrawal can include: disturbed sleep, hot and cold flushes, sweating, feeling anxious or irritable, cravings for opioids, nausea, vomiting, diarrhoea, lack of appetite and tremors.(3) You’re more likely to experience withdrawal symptoms if you’ve been taking opioids for a long time and/or taking high doses.

Your doctor will slowly reduce your dosage to lessen your risk of withdrawal symptoms. This is called tapering.

Using opioids safely

Because of the risks associated with their use, opioids aren’t a first-line treatment for managing pain associated with musculoskeletal conditions. Instead, your doctor may suggest strategies such as exercise, maintaining a healthy weight, cognitive behavioural therapy (CBT), heat and cold packs, distraction, and short-term use of medicines such as paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs).

If you are prescribed opioids, it’s important that you:

  • take them as prescribed
  • don’t drink alcohol while you’re taking them
  • don’t change the dosage or stop taking them without discussing this with your doctor – you may need to reduce your dosage gradually
  • talk with your doctor about other medicines or supplements you’re taking – some may not be able to be used at the same time you’re taking opioids
  • let your doctor know about any side effects you experience
  • discuss other options you can use to help manage your pain with your doctor – for example, gentle exercise, CBT, heat and cold.

While using opioid medicines, you should also monitor whether or not they’re working for you. If you’re still experiencing severe pain that’s affecting your quality of life and ability to do daily activities, discuss this with your doctor. Together you can look at alternative treatment options.

Finally – it’s important to understand that opioids reduce our perception of pain. They don’t ‘kill it’, because there’s no such thing as a ‘pain killer’. Medicines and other strategies such as heat and cold, exercise, distraction and CBT can help you reduce pain to levels that enable you to live a healthy and happy life.

Contact our free national Help Line

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

More to explore

References

  1. Prescription opioids: What changes are being made and why
    Therapeutic Goods Administration 
  2. Prescription opioids: Information for consumers, patients and carers
    Therapeutic Goods Administration 
  3. Opioid withdrawal symptoms
    Healthdirect

morning-coffee.jpg
24/Mar/2022

Do you get to the end of your day and wonder where all your time went? Between work, family commitments, random phone calls, catching up with friends, walking the dog, feeding the cat and endlessly scrolling through socials, your day has flown by, your to-do list has barely been touched, and you still need to scrounge up something for dinner?

If this sounds familiar, I’m right there with you 🙃. Adjusting to our ‘new normal’ is taking a bit of getting used to. Finding the right balance between work and home life, commuting to the office (or moving from my couch to my desk 😉) is challenging. And my routine, once the foundation of my day, is in tatters and needs some help.

Why do we need routine?

When so much is out of our control, developing a morning routine can help you gain some control so you can do the things you need to do in your day. This boosts your confidence, makes you feel more positive and reduces feelings of stress.

Having a morning routine allows you to plan and prioritise activities so that if things go pear-shaped – as they sometimes do – your most important activities have (hopefully) been accomplished. And having a regular routine means you’re less likely to forget something, which is especially helpful if you’re feeling a bit ‘foggy’.

So how can you create (or update) your morning routine?

First, let’s start with the foundation of your morning routine – getting a good night’s sleep. We all know what it’s like when we haven’t slept well. We drag ourselves through the day, bleary-eyed and unfocused. But we also know that getting a good night’s sleep can sometimes be tough when you live with a musculoskeletal condition and persistent pain. Fortunately, there are many things you can do to improve your sleep quality and quantity, and wake up feeling refreshed. Read our article on sleep for info and tips.

The next step is planning. For your morning routine to be effective and have a positive flow-on effect for the rest of your day, you need to be prepared and have a plan. This may include:

  • Getting things ready the night before. Do whatever you can at the end of your day so that your mornings are less hectic. For example, check the weather and decide what you want to wear the following day; prep healthy breakfasts/lunches/snacks so you can just grab them as you head out the door in the morning.
  • Make a list of the things you need to do in the day and prioritise them to know what absolutely needs to be done. Include appointments, exercise, work/school/family/social commitments and recreation.

Now it’s time to get moving.

  • When the alarm goes off, it’s tempting to hit the snooze button, but resist the urge! Endlessly hitting snooze will make you lose valuable time, and it could also affect your health. Find out how.
  • Build extra time into your morning routine in case you wake up feeling blah. The extra time will also make you feel less rushed and stressed.
  • Do some gentle stretches while in bed to warm up and loosen stiff muscles and joints.
  • Have a warm shower for the same reason. It’ll also help clear your head and wake you up fully.
  • Sit down and eat a healthy breakfast and drink some water.
  • Take your medications (if required).
  • Do some exercise. Take your dog for a walk, do some yoga, hit the gym, go for a swim. Whatever exercise you enjoy and you’re committed to doing, do it. Not only will it help you manage your condition and health overall, exercising in the morning improves your concentration, energy levels and mood.
  • Do something nice for yourself. Try mindfulness meditation, deep breathing, practising gratitude, listening to upbeat music, hug your partner/kids/pet. Choose something that makes you happy and puts a smile on your face as you start a new day.
  • Review your day ahead so you know what to expect, what you need to do, what things to take with you etc.
  • Set up alerts or alarms on your phone or computer to help you stay on track with your day.

Making your routine stick

Once you’ve established your routine, you need to be consistent and stick to it. That way, it’ll become second nature.

And be flexible. Sticking to your morning routine as often as possible is great, but you’ll also need to learn to be flexible if something unexpected happens.

When it’s all said and done, routines may sound boring, but they’re a great way to stay on top of your commitments and get to the end of the day feeling accomplished and relaxed. So if you struggle to achieve all of the things you set out to do each day, why not try a couple of these strategies to see if they can help? You’ve got nothing to lose and so much to gain.

Contact our free national Help Line

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

More to explore


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23/Mar/2022

Written by Buffy Squires, with input from Mikayla O’Neill

Note: the names of the completion certificates vary across the country, e.g., VCE in Victoria and HSC in NSW. In this section, we refer to them all collectively as SSCE.

Wow! You’re heading into your final years of secondary school! Congratulations! It’s a really exciting time for you.

But perhaps you’ve heard from friends and others who’ve already gone through it, that it’s a lot of hard work. This may be making you a bit worried about how your body’s going to hold up. It’s ok to feel like this, but we’ve got plenty of tips and resources so that you can deal with the challenges and get on with your studies. And in doing so you can make your final years of secondary school as successful and enjoyable as possible.

Keep in mind that there are lots of different options for completing your SSCE. You may choose to do it over 3 years rather than 2 or do less subjects or an ungraded SSCE. It’s a matter of talking with your parents and your school and working out what works best for you.

All students should have the opportunity to sit their exams on as level a playing field as possible. This means that your arthritis or musculoskeletal condition shouldn’t put you at a disadvantage to your peers.

So, as exam time approaches, it’s important to remember that you may be eligible for special consideration. This could include extra time to do your exam, take breaks, use a keyboard instead of handwriting, access your medication, heat and cold packs and more. The process differs depending which state or territory you live in so check out the Curriculum and Assessment Authority links below for more information. Your school will help you with this, and they’ll lodge the application on your behalf.

Tip 1 – Start early

Special exam arrangements aren’t just for your final exams. If you live with a chronic condition (like arthritis), you can apply to have them in place right through your schooling to cover things like NAPLAN. But many students first apply for special exam arrangements as they approach their final school years.

Some students will be doing a final year subject in year 11, so if that’s you, you’ll want to start thinking about the process of applying for special consideration at the end of year 10. Speak with your rheumatologist about it, as they’ll have to write a letter supporting your need for special consideration. It might also be a good time to make an appointment with the hospital’s occupational therapist. They can do a writing assessment to see if you’d benefit from a laptop/keyboard and recommend other aids to help you. In the public hospital system, you might need to wait a few months, so again, start the process early!

Speak with the head of senior school or find out who is responsible for managing special exam arrangements in your school. Make sure they’re aware of your limitations and ask them for a list of anything they need you to provide.

Tip 2 – Have a support system in place

Make sure you have a support system in place at school. If you feel comfortable in doing so, it’s a great idea to talk openly with your teachers and the head of senior school so that they know your needs and limitations and are able to offer help around test or exam time. You may also want to have one particular teacher who’s your main “point of contact” so that, if you’re unwell or need to take time off school, you can deal with any issues through them.

After significant appointments it may be helpful to take into school a doctor’s letter or organise a quick meeting with teachers to keep them in the loop. You may also find that by keeping your teachers updated regularly, they’re better able to understand your condition. Then, when exam time comes around, you’ve already got that support system in place which makes it easier to organise the help you may need.

Tip 3 – Manage stress

Yes, it’s easier said than done, but if you put some plans in place and find some strategies that work for you, year 12 really doesn’t have to be that stressful. In a few years you’ll look back and wonder what all the fuss was about! Check out our A-Z pain guide (link https://msk.org.au/pain-guide/) and the pain section of our website (link https://msk.org.au/kids-pain) for tips on dealing with pain. Find things you enjoy that make you feel great. It might be something active like a walk with a friend or a game of soccer, or perhaps you enjoy meditation, music, gaming or colouring in. Whatever it is, have some options you know work for you, and use them as soon as you feel the stress starting to build.

Tip 4 – Check, and check again

Once you’ve got the paperwork in place, check with your school to see if there’s anything else they need from you. If you haven’t had confirmation to say your special consideration has been approved, don’t be afraid to ask them to follow it up. The creaky gate gets the oil!

Things may change as you get closer to exams. Perhaps you have a flare-up and find that you can’t sit for long periods. Keep the lines of communication open with your contact person at school and make sure they know what’s going on. They can always make later applications for amendments to your plan – for example, a stand-up/sit-down desk to help manage back pain.

Got any tips you’d like to share? We’d love to hear from you. Send them to buffy@msk.org.au

More to explore

State and territory resources




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

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