Let’s take advantage of the warmer days and and look at how we can sweep away the winter cobwebs and make ourselves sparkle this spring!

  • Unplug. We’re always connected these days, immersed in the news, social media, video chats, work/school, and phone calls. We’re never far away from a phone, tablet or computer – and we need to step away. Schedule time to put it all aside: perhaps after dinner, or for an hour during your day, or for your entire Sunday. Whatever works for you and your commitments. Just make sure you take some time away from the digital world, step outside and breathe in the fresh, sweet-smelling spring air.
  • Say no. We’re wired to want to please others, so we often find it difficult to say no. But that can make us become overwhelmed and stressed with the number of commitments we have. That’s why we need to look after ourselves and start saying no. The next time someone asks you to do something, give yourself a moment. Don’t answer immediately with an automatic ‘yes’. Ask yourself if this is something you want to do. Are you able to do it – physically and mentally? Do you have the time to do it? Will it bring you happiness? If you answered no to these questions, then you should say no to the request. You may disappoint some people, and they may be a little unhappy with you. But you need to be true to who you are and stand firm. And don’t feel the need to give detailed reasons for saying no. Saying no is really hard, but it will become easier.
  • Change your routine. Do you feel like you’re stuck in a rut? I know it feels like Groundhog Day at times! So look at your routine. What can you change? Take your work/school commitments out of the equation for now. Do you spend your evenings on the couch? Or weekends doing the same old things? Stop and really think about what you would actually ‘like’ to do with your free time. Go for a bike ride? Take up painting? Visit a new place each week? Find things that you enjoy, and fill you with anticipation and happiness, and do them. Now think about your work routine. There may not be things you can change about work – but why not put on your favourite outfit/earrings/shoes/lipstick – even if you’re working from home. Or use some new stationary or bit of tech. It’s amazing how these small changes give us a mental boost.
  • Focus on the basics – eat well, move, sleep – repeat. This time of the year we have access to amazing fresh produce that’s just crying out to be made into delicious salads and stir fries. The days are getting longer and warmer so we can get outside more for our exercise. We can shed the heavy blankets and adjust our sleep habits. There’s never been a better time than now to focus on these basics and make improvements if needed. And finally, make sure you’re staying hydrated by drinking enough water each day.
  • Surround yourself with positive, upbeat people. Positivity and happiness is contagious. These people will inspire you, make you feel good about yourself and the world in general. Too much contact with negative people (in person and via social media) does the opposite and makes the world a gloomy place. So seek out the happy, positive people and enjoy their company. And if you can, ditch the negative people.
  • Take some time out to relax. Try strategies like mindfulness, visualisation and guided imagery. Or read a book, listen to music, walk the dog, create something, play a computer game, have a bubble bath or massage. Whatever relaxes you. And make sure you do these things on a regular basis. They’re not an indulgence – they’re a necessity and vital to our overall happiness and wellbeing.
  • Let’s get serious – sugar, fats, alcohol and drugs. Many of us seek comfort in sugary and/or fatty foods more than we’d like. Or we’ve been using alcohol and/or drugs to make us feel better. Over time this becomes an unhealthy habit. So it’s time to get serious. Ask yourself if your intake of these things has changed or increased? If it has – what do you need to do to fix this? Can you decrease their use by yourself? Or do you need help from your family, doctor or other health professional? The sooner you acknowledge there’s a problem, the sooner you can deal with it.
  • Nurture your relationships. It’s easy to take the people around us for granted, but these people support and care for us day in and day out. They deserve focused time and attention from us. So sit down and talk with your kids about their day. Make time for a date night with your partner and cook a special meal to share together. Call or visit your parents and see how they’re really doing. Reminisce with your siblings about childhood antics and holidays. Our relationships are the glue that holds everything together for us – so put in the effort. You’ll all feel so much better for it.
  • Quit being so mean to yourself. You’re valued and loved. But sometimes we forget that. And the negative thoughts take over. “I’m fat”, “I’m hopeless”, “I’m lazy”, “I’m a burden”. If you wouldn’t say these things to another person, then why are you saying them to yourself? Ask yourself why you even think these things? And how can you reframe these thoughts? If, for example, you tell yourself you’re fat – are you actually overweight or are you comparing yourself to the unrealistic media image of how a person should look? And if you do know you need to lose weight, and want to make that happen, put those steps in motion. Talk with your doctor for some guidance and help. And congratulate yourself for taking action. And as you make these changes be kind to yourself along the journey. There will be stumbles, but that’s expected. You can pick yourself up and move on. Kindly.
  • Throw away the ‘should’s. This is similar to the negative self-talk…we need to stop should-ing ourselves to death. This often happens after we’ve been on social media and seen someone’s ‘amazing’ life. You start thinking “I should be better at X”, “I should be doing X”, “I should be earning X”, “I should look like X”. Remember that most people only put their best images on social media, so everyone’s life looks wonderful. But you’re just seeing the superficial, filtered person, not the whole, and they probably have just as many insecurities as the rest of us. Instead of thinking “I should…”, be grateful for who you are and what you have.
  • Be thankful and grateful. You exist! And yes, the world is a strange and sometimes frightening place at the moment, but you’re here to see it. People love and care for you. Focus on the people in your life and the things you’re grateful to have in your life. Celebrating these things – both big and small – reminds us why we’re here. To bring joy and happiness to those around us, and to make the world a better place.

(Originally written and published by Lisa Bywaters 2020).

Call our Help Line

If you have questions about things like managing your pain, your musculoskeletal condition, treatment options, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email ( or via Messenger.

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Neck pain is a common problem many of us will experience at least once in our lives. The good news is that most cases of neck pain get better within a few days.

So what is neck pain? What causes it, and how can you manage it and get on with life?

Let’s start with a look at your spine

It helps to know how your spine works to understand some of the potential causes of neck pain.

Your spine (or backbone) is made up of bones called vertebrae, stacked on top of each other to form a loose ‘S’-shaped column.

Your spinal cord transports messages to and from your brain and the rest of your body. It passes through a hole in each of the vertebrae, where it’s protected from damage. It runs through the length of your spinal column.

Each vertebra is cushioned by spongy tissue called intervertebral discs. These discs act as shock absorbers. Vertebrae are joined together by small joints (facet joints), which allow the vertebrae to slide against each other, enabling you to twist and turn. Tough, flexible bands of soft tissue (ligaments) also hold the spine in position.

Layers of muscle provide structural support and help you move. They’re joined to bone by strong tissue (tendons).

Your spine is divided into five sections: 7 cervical or neck vertebrae, 12 thoracic vertebrae, 5 lumbar vertebrae, 5 fused vertebrae in your sacrum and 4 fused vertebrae in your tailbone (or coccyx) at the base of your spine.

So what’s causing the pain?

It’s important to know that most people with neck pain don’t have any significant damage to their spine. The pain they’re experiencing often comes from the soft tissues such as muscles and ligaments.

Some common causes of neck pain are:

  • muscle strain or tension – caused by things such as poor posture for long periods (e.g. hunching over while using a computer/smartphone or while reading), poor neck support while sleeping, jerking or straining your neck during exercise or work activities, anxiety and stress.
  • cervical spondylosis – this arthritis of the neck is related to ageing. As you age, your intervertebral discs lose moisture and some of their cushioning effect. The space between your vertebrae becomes narrower, and your vertebrae may begin to rub together. Your body tries to repair this damage by creating bony growths (bone spurs). Most people with this condition don’t have any symptoms; however, when they do occur, the most common symptoms are neck pain and stiffness. Some people may experience other symptoms such as tingling or numbness in their arms and legs if bone spurs press against nerves. There can also be a narrowing of the spinal canal (stenosis).
  • other musculoskeletal conditions such as osteoarthritis, rheumatoid arthritis, fibromyalgia, osteoporosis.
  • herniated disc (also called a slipped or ruptured disc). This occurs when the tough outside layer of a disc tears or ruptures, and the soft jelly-like inside bulges out and presses on the nerves in your spine.
  • whiplash – this is a form of neck sprain caused when the neck is suddenly whipped backward and then forward. This stretches the neck muscles and ligaments more than normal, causing a sprain. Whiplash most commonly occurs following a car accident and may occur days after the accident.


The symptoms you experience will depend on what’s causing your neck pain but may include:

  • pain and/or stiffness in the neck and shoulders
  • pain when moving
  • difficulty turning your head
  • headache.

In most cases, neck pain goes away in a few days. But if your pain doesn’t get better, or you develop other symptoms, you should see your doctor.

Or you can answer a few questions in the neck pain and stiffness symptom checker by healthdirect to find out if you need medical care. Simply click on ‘N’ and select ‘neck pain and stiffness’.

Seeing your doctor

If you need to see your doctor because of your neck pain, you can expect a discussion about potential causes or triggers of your pain, whether you’ve had neck pain before, things that make your pain worse, things that make it better. Your doctor will also conduct a thorough physical exam.

This discussion and examination by your doctor will decide whether more investigations (e.g. x-rays, CT or MRI scans) are appropriate for you. However, these tests are generally unhelpful to find a cause of the pain unless there’s an obvious injury or problem (e.g. following an accident or fall). It‘s also important to know that many investigations show ‘changes’ to your spine that represent the normal passage of time, not damage to your spine.

Often it’s not possible to find a cause for neck pain. However, it’s good to know that you can still treat it effectively without knowing the cause.

For more information about questions to ask your doctor before getting any test, treatment or procedure, visit the Choosing Wisely Australia website.

Dealing with neck pain

Most cases of neck pain will get better within a few days without you needing to see your doctor. During this time, try to keep active and carry on with your normal activities as much as possible.

The following may help relieve your symptoms and speed up your recovery:

Use heat or coldthey can help relieve pain and stiffness. Some people prefer heat (e.g. heat packs, heat rubs, warm shower, hot water bottle), others prefer cold (e.g. ice packs, a bag of frozen peas, cold gels). Always wrap them in a towel or cloth to help protect your skin from burns and tissue damage. Don’t use for longer than 10 to 15 minutes at a time, and wait for your skin temperature to return to normal before reapplying.

Rest (temporarily) and then move. When you first develop neck pain, you might find it helps to rest your neck, but don’t rest it for too long. Too much rest can stiffen your neck muscles and make your pain last longer. Try gentle exercises and stretches to loosen the muscles and ligaments as soon as possible. If in doubt, talk with your doctor.

Sleep on a low, firm pillow – too many pillows will cause your neck to bend unnaturally, and pillows that are too soft won’t provide your neck with adequate support.

Be aware of your posture – poor posture for extended periods, for example, bent over your smartphone, can cause neck pain or worsen existing pain. This puts stress on your neck muscles and makes them work harder than they need to. So whether you’re standing or sitting, make a conscious effort to be aware of your posture and adjust it if necessary, or do some gentle stretches.

Massage your pain awaymassage can help you deal with your physical pain, and it also helps relieve stress and muscle tension. You can give yourself a massage, see a qualified therapist or ask a family member or friend to give you a gentle massage.

Take time to relax – try some relaxation exercises (e.g. mindfulness, visualisation, progressive muscle relaxation) to help reduce muscle tension in your neck and shoulders.

Try an anti-inflammatory or analgesic cream or gel – they may provide temporary pain relief. Talk with your doctor or pharmacist for advice.

Use medication for temporary pain relief – always follow the instructions and talk to your doctor about alternatives if you find they don’t help.

Treating ongoing neck pain

Sometimes neck pain lasts longer than a few days, and you may have ongoing neck pain. There are things you can do to manage this:

  • See your doctor if the pain is worse or if you have other symptoms in addition to your neck pain such as numbness, pins and needles, fever or any difficulty with your bladder or bowel.
  • See a physiotherapist or exercise physiologist – they can provide you with stretching and strengthening exercises to help relieve your neck pain and stiffness.
  • Injections – some people with persistent neck pain may benefit from a long-acting steroid injection into the affected area. Talk with your doctor about whether this is right for you.
  • Surgery – is rarely needed for neck pain. However, it may be required in cases where severe pain interferes with daily activities, or the spinal cord or nerves are affected.

(Originally written and published by Lisa Bywaters 2022)

Contact our free national Help Line

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

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I’ve never really thought about my shoulders. They’re just there. Useful for hanging a handbag on or supporting a heat pack for my neck. I only really notice them when, graceful person that I am 😉, I bash one on a door frame.

That was until a few years ago when I slipped in the bathroom and fell hard on my arm, with my shoulder in an unnatural position. I was suddenly very keenly aware of my shoulder! I honestly thought I’d broken it. Fortunately, scans revealed nothing had broken, but I had injured the soft tissues.

However, it was during that time I learned about shoulders. I know, I know, the crazy fun times never end for me 😂. But in my defence, I was stuck on the couch for a few days with my arm in a sling and an ice pack on constant rotation. So I didn’t really have a lot going on.

And what I learned was fascinating.

And since shoulder pain is incredibly common, I thought I’d share what I learned with you. Because if you haven’t had shoulder pain, you probably know someone who has. So buckle up, and let’s learn about shoulders, shoulder pain and how to treat it.

Let’s start with the basics – how your shoulders work.

DYK, the shoulder has not one, but four joints???

This makes them complex, flexible structures with a large range of movement. Unfortunately, this flexibility can also put the shoulder at risk of injury and dislocation, especially through contact sports and falls.

Your shoulder is made up of three bones: the shoulder blade (scapula), collarbone (clavicle), and upper arm bone (humerus).

The main joint is the glenohumeral joint. This is where your humerus connects with your scapula. Like the hip, it’s a ball and socket joint. The top of your humerus is shaped like a ball and fits inside the socket or cup-shaped indentation in your shoulder blade. However, this socket is shallow, giving your shoulder great flexibility but also making it less stable.

The other joints are:

  • the acromioclavicular joint – where the top of your shoulder blade (acromion) meets your collarbone
  • the sternoclavicular joint – where your collarbone meets your breastbone (sternum) near the base of your neck
  • and the scapulothoracic joint – where your shoulder blade meets the chest wall (thorax). It allows your shoulder blade to move smoothly over your ribs.

Soft tissues surround the glenohumeral joint to form a capsule. This keeps the head of the arm bone in place in the joint socket. The joint capsule is lined with a synovial membrane that produces synovial fluid to lubricate and nourish the joint. Tendons, ligaments, bursa, and muscles also support the joints and bones in your shoulder to stabilise it and allow it to move freely. The bones, joints and soft tissue work together to make your shoulders incredibly mobile, so you can do all kinds of things like throw a ball, hug a friend, brush your hair, and scratch your back.

When things go wrong – shoulder pain.

Shoulder pain may come on quickly, e.g. if you injure yourself, or it can occur more gradually. It can be mild pain or, as I experienced, very painful 😥.

There are many causes of shoulder pain, not all due to problems with the shoulder joints or associated structures. They include:

  • Other musculoskeletal conditions, such as rheumatoid arthritis, osteoarthritis, and polymyalgia rheumatica can affect the shoulder, causing pain.
  • Inflammation or injury to the soft tissues (e.g. muscles, bursae, tendons, ligaments) in and around the shoulder, for example, bursitis and frozen shoulder.
  • Ongoing stress or anxiety that causes your muscles to remain tense.
  • Neck and upper back joint and nerve problems can cause pain to be felt in and around the shoulder.
  • Referred pain. Shoulder pain may also be caused by problems affecting your abdomen (e.g. gallstones), heart (e.g. heart attack) and lungs (e.g. pneumonia).

Note: if you feel shoulder pain radiating down your arm or you’re experiencing a tight feeling across the chest and shortness of breath, dial 000 immediately.

Symptoms of shoulder pain.

Unsurprisingly, the main symptom of shoulder pain is pain! Other symptoms include:

  • Reduced movement, stiffness and pain when moving your shoulder.
  • Weakness of the shoulder/upper arm.
  • Pain when lying or putting pressure on the affected shoulder.
  • Pins and needles (tingling). This is more likely to be associated with neck problems than the shoulder itself.

Diagnosing shoulder pain.

If you have shoulder pain that’s causing you distress or affecting your ability to do your daily activities, you should see your doctor. Your doctor will:

  • ask you questions about your shoulder pain, including potential causes (e.g. recent injuries, other health conditions), if you’ve had shoulder pain before, and how it affects you
  • ask about any other symptoms or health issues you have
  • do a thorough physical examination.

From this, they can work out the likelihood of particular structures in the shoulder being involved.

Sometimes they’ll suggest that scans are needed. They may include X-rays, ultrasounds, computed tomography (CT), or magnetic resonance imaging (MRI). The type of scan/s required will depend on the suspected cause of your shoulder pain. However, it’s important to know that many scans show changes to your shoulder that will likely represent the normal passage of time (even by age 45), not damage to your shoulder.

Treating shoulder pain.

Treating shoulder pain begins with understanding the cause of the problem. What works for one shoulder issue may not work for another. Your doctor will create a treatment plan based on your diagnosis.

The following are some commonly used treatments for shoulder pain.

  • Heat and cold packs may provide temporary relief from pain and stiffness. Generally speaking, heat can relieve muscle spasms and tension. Cold can reduce swelling.
  • Physiotherapy will aim to fix problems such as shoulder, neck and upper arm stiffness and weakness. A physiotherapist will provide exercises to help improve mobility and the range of movement for your shoulder. They’ll also help you modify movements and activities that worsen your pain. This often includes learning new ways to do things related to your work, sport, or everyday activities that aggravate your shoulder. They may also tape your shoulder and show you how to use taping to support your shoulder and reduce stress on it.
  • Occupational therapy. If your shoulder pain makes everyday activities difficult, seeing an occupational therapist (OT) may be helpful. They can help you learn better ways to carry out activities such as bathing, dressing, working or driving. They can also provide aids and equipment to make everyday activities easier.
  • Medicines may help reduce the pain you’re experiencing while you work to maintain and restore movement and function. But it’s important to understand they’re not a long-term solution to shoulder pain. Talk with your doctor or pharmacist for advice about pain medicines. There are different types available, both over-the-counter and by prescription. They include:
    • Non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs reduce inflammation and pain but have side effects, so using the lowest dose for the shortest period is best.
    • Topicals. Rubs, gels, ointments, sprays, patches and creams applied to your skin (topically) can provide temporary pain relief.
    • Corticosteroid injection. If you have persistent shoulder pain and haven’t had relief from oral medicines or other treatments, your doctor may suggest a corticosteroid (steroid) injection. Corticosteroid injections into the joint can reduce inflammation and provide short-term pain relief for some people. However, pain relief varies and may last a few days to weeks. The number of injections you can have is limited due to potential harm. Discuss the benefits and risks of steroid injections with your doctor.
  • In cases of a frozen shoulder, hydrodilatation may be recommended. This is an injection of fluid (saline and a steroid) into the joint. There’s some evidence that it may relieve symptoms and improve range of motion. However, it’s unclear if this is due to the hydrodilatation, the steroid in the injection, shoulder exercises, or a combination.

What about surgery?

For most people, shoulder pain will improve over time with appropriate, conservative treatment. However, in some cases, surgery may be required.

When considering surgery, you should be informed about what it involves, the rehabilitation process, and its potential benefits and risks.

Managing shoulder pain to prevent future problems.

Most people with shoulder pain will find it gets better over time. But there are things you can do to proactively prevent future problems.

  • Learn more about your shoulder pain. Are there activities or jobs that trigger your shoulder pain or make it worse? Knowing as much as possible about your shoulder pain means that you can make informed decisions about your healthcare and actively manage it.
  • Follow the advice of your healthcare team. The information, exercises, and modifications provided by your physio or occupational therapist during the worst of your shoulder pain will help prevent you from aggravating your shoulder and causing future issues.
  • Exercise regularly. Although you might think you need to protect your shoulder by not moving or resting it, it’s made for movement. And resting can make things worse. Regular exercise is vital for maintaining flexibility, muscle strength, and bone health. When starting an exercise program, you should incorporate activities that improve flexibility, muscle strength, balance, and overall fitness and endurance. Start exercising slowly and gradually increase the time and intensity of your exercise sessions over weeks and months. A physiotherapist or exercise physiologist can help you work out an exercise program right for you.
  • Manage your stress. Living with stress or anxiety can worsen your pain by causing the muscles throughout your body to tense or spasm. This is often felt in the shoulders and neck. There are many ways to reduce stress or anxiety, including exercise, massage, mindfulness, heat, breathing exercises, and guided imagery.
  • Get back to your normal activities. Try to be as active as possible and get on with your day-to-day life, including work and exercise. Returning to heavy manual jobs may take longer, and you may need support from a physio and/or OT.

Contact our free national Help Line

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

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Not much has changed since ABBA sang in 1976 “All the things I could do, if I had a little money.” Money – or the lack of it – has been causing us headaches and stress since we started using it.

Living with a musculoskeletal condition – or multiple conditions – can be expensive. Medications, healthcare appointments, time off work (or not being able to work), exercise classes, complementary therapies, and aids and equipment are costly on top of everyday expenses.

When you add rising living costs, financial stress is almost inevitable.

Fortunately, there are things you can do if you’re in this situation. And it starts now.

Acknowledge the situation.

This is the crucial first step. As much as we’d like to bury our heads in the sand when we feel anxious or worried about anything (I know that’s my go-to reaction 😑), it won’t solve the problem. We need to look it in the eye, acknowledge it exists and start to deal with it – one step at a time.

Create a budget.

This may sound daunting, but you need to know where your money’s going. You need to be able to track what money is coming in and what you’re spending it on. MoneySmart is an Australian Government website with many tools and resources to help you manage your money. They have a section on budgeting to help you create a budget that works for you and your circumstances.

By understanding where your money’s going, you can start to see where you can make some savings or cut some costs. It’ll also put you in a better position when/if it comes time to talk with your bank, utility companies etc.

Know your rights.

When you’re struggling and stressed, it’s easy to become overwhelmed. But there are laws to help protect you if you’re suffering from financial hardship. The National Debt Helpline has information to help you understand your rights and protections.

Seek help.

If you’re finding it challenging to create a budget or find a way out of your financial problems, contact the National Debt Helpline and talk with a financial counsellor. They’re free, confidential, and independent. You can call them on 1800 007 007 weekdays 9.30am-4.30pm. They also have a live chat function on their website, available weekdays from 9.00am-8.00pm, or you can also send them a message outside of hours, and a counsellor will get back to you. National Debt Helpline also has a huge range of other resources to help you if you’re struggling with debt or controlling your finances.

Talk to your bank.

If you’re having difficulties paying your mortgage, personal loans or credit card repayments, talk with your lender about your options, such as making smaller repayments over a longer period or pausing repayments.

The Australian Banking Association has some useful resources on their website, including information about your rights and what your bank can do to help you.

Talk to your utility companies.

Contact your supplier if you can’t afford to pay your gas, electricity, water, and phone bills. But first, check out this information from the National Debt Helpline about how to do this.

Be wary of buy now, pay later schemes, payday loans, and consumer leases.

If you’re under financial stress, these options may seem like a convenient way to pay for things you need. However, they’re also an easy way to get into even more debt. Learn more by reading MoneySmart’s info on the potential problems with payday loans, consumer leases, and buy now, pay later schemes.

Talk with your doctor about GP management plans.

Living with a chronic condition (or multiple conditions) can cost a lot of money. Discuss accessing a GP Management Plan and Team Care Arrangement with your doctor so that you can get coordinated care to manage your health condition. You may be eligible for Medicare rebates for certain allied health services. You can find out more on the Department of Health website.

Talk with your doctor and pharmacist about safety nets.

They exist to help lower the out-of-pocket medical costs for people who, due to their health condition/s, spend a lot of money on Pharmaceutical Benefits Scheme (PBS) medications. Your doctor and pharmacist can give you more information about these safety nets.

Talk with your doctor about 60-day scripts.

From 1 September 2023, eligible people living with chronic conditions can buy 60 days’ supply of some medicines. This will reduce the cost of some medicines for people with stable, chronic conditions. For more info, check out the Consumers Health Forum 60-day scripts website, and talk with your doctor about whether this is an option for you.

Find out about government allowances and benefits.

The Australian Government provides a wide range of allowances and benefits you may be eligible for, including:

The Australian Government’s Services Australia website provides a lot of information about these payments (and others), including information about eligibility criteria.

You can also talk with our nurse on the MSK Help Line if you’re having trouble navigating through these social services schemes. Contact them on 1800 263 265 weekdays or email

Find out about the National Disability Insurance Scheme (NDIS).

The NDIS helps people under 65 with permanent and significant disability get care and support. It pays for reasonable and necessary support that a person needs to live and enjoy their life. The NDIS also provides information and connections to local services to people who aren’t eligible for funding. Find out more about the NDIS.

There’s light at the end of the tunnel.

When you’re in debt or dealing with financial hardship, it can seem like there’s no way out. But there are a lot of organisations and services available to help you. This article has just scraped the surface of them.

There are more for you to explore in the links below.

If you need help with debt or just want to learn how to manage your money better, I’d urge you to look at MoneySmart, National Debt Helpline and The Salvos. They provide excellent, easy-to-understand resources on a wide range of issues relating to money.

Contact our free national Help Line

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

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Your genetics and personalised medicine

You may have heard something about personalised medicine and the tongue twister – pharmacogenomics. But what is it? And might it be beneficial? We take a quick look at this exciting field of research and things to consider before diving in.

Let’s start with the word… it’s a mouthful!

The word “pharmacogenomics” is a combination of pharmacology and genomics:

  • Pharmacology is the study of the uses and effects of medicines.
  • Genomics is the study of all of a person’s genes (their genome), including how genes interact with each other and with your environment.

A (very) little bit of biology 101.

Almost all the cells in your body contain DNA. DNA is the genetic information that helps make people who they are.

DNA is a double helix. You’re probably familiar with the image – it’s shown on practically every crime or detective show. 😉 It looks like a twisted ladder.

Four different chemicals (nucleotides) pair up to make the ladder’s rungs.

Genes are stretches of DNA. They can be long or short. You inherit your genes from your parents – one copy of each gene from each parent. They contain the instructions to build your body and make you uniquely ‘you’.

Where drugs come into the story.

Your genetic makeup affects the way you respond to medicines.

It can affect whether a medicine is effective, whether it has no effect or whether you have a bad reaction or side effect. It can also affect the dosage you may need. For example, some people absorb medicines too quickly, meaning they need a higher dose to experience any benefit; others process them too slowly, leading to side effects.

Knowing this information about your genes has the potential to help your doctor provide more personalised medicine and a more effective treatment plan.

So how do you know how your genes will react to medicines? You can take a test.

Pharmacogenomic tests are available via some GPs and pharmacists and through direct‐to‐consumer services. They’re generally not covered by Medicare, so you’ll have to pay the total cost of about $150-200.

These tests usually require a cheek swab, salvia sample or blood sample. The sample is sent to be analysed, and a report is provided. If you have gone through your doctor or pharmacist, they’ll explain the results.

Before you jump.

Before jumping on board and spending your hard-earned dollars on a test, there are some things to consider.

  • Do you need another test? Many people with chronic conditions already have lots of routine tests to manage their condition. This is not only costly but time-consuming. So ask yourself, “Am I experiencing significant problems with my medicines? And does this test have the potential to provide real benefit?” If so, talk with your doctor. It may be alternative medicines or treatments are an option. Or it might be that your doctor thinks a pharmacogenomic test will help. But first, have the conversation. And read Choosing Wisely Australia’s 5 questions to ask your doctor or other healthcare provider before you get any test, treatment, or procedure.
  • The cost. It’s not covered by Medicare, so you’ll have to pay for it yourself.
  • Pharmacogenomic tests aren’t available for all medicines. And not all genes and gene variants are tested. International guidelines have so far identified about 15 genes for which testing can inform the prescribing of 30 different medications with good evidence of clinical benefit.
  • Not all GPs or pharmacists have the experience or training to understand how to best use these tests and understand the results.
  • Your genes aren’t the only player in this game. It’s much more complicated, and many other factors affect how your body reacts to medicines. They include your general overall health, age, other medicines and supplements you’re taking, body size, inflammation, and kidney or liver problems. Your genetics are just one part of the puzzle.
  • Safety of your information. Many direct-to-consumer companies offering these tests are overseas, even if the initial delivery address is within Australia. Australian law protects your privacy rights for services provided in Australia, but these protections don’t apply to overseas services. So ask questions about the company – where’s it located, where’s your data stored, who has access to it.

Pharmacogenomics in practice.

We’ve just touched on the briefest of info about pharmacogenomics, so for more comprehensive information about pharmacogenomics in practice in the real world, read this excellent fact sheet from the NSW Government Centre for Genetics Education.


The field of pharmacogenomics is growing, and it’s an exciting new world. But you also need to weigh up whether this is something that will benefit you now.

Take the time to do your research, ask questions, and talk with your doctor. These tests aren’t going anywhere. In fact, they’ll likely become more comprehensive and more mainstream as time goes on.

Contact our free national Help Line

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

More to explore


  1. A brief guide to genomics, National Human Genome Research Institute
  2. Pharmacogenomics in general practice: The time has come. Australian Journal of General Practice 2019; 48


Budget-friendly tips for staying warm this winter

“Winter is the time for comfort, for good food and warmth, for the touch of a friendly hand
and for a talk beside the fire: it is time for home.” – Edith Sitwell.

I love this quote. It sounds like the perfect lazy Sunday, doesn’t it? 😊💚

Sadly winter is more than just lazy Sundays when you can stay at home, warm on the couch with a loved one. Reality means we need to eventually (and reluctantly) head out of our cosy homes and face the cold, wet winter. And when we’re at home, because of crazy energy prices and rising living costs, we have to make hard decisions about how to spend the household budget. Heating is one of the more significant costs in winter, so many people are forced to reduce it to save money.

For those of us with conditions like  fibromyalgialupusosteoarthritisrheumatoid arthritisback pain, scleroderma, and Raynauds’s phenomenon, this can be a painful problem. We often feel the cold more keenly with increased joint and muscle pain or lack of blood circulation to the extremities.

So, how can you stay warm and keep the costs down this winter? We’ve got some suggestions for you to try.

Dress for the weather.

Let’s start with the basics. You need to dress for the temperature and wear layers. It can sometimes feel cumbersome and bulky, but it’s one of our best defences against the cold. So put on the warm pants and jumper, embrace your inner Wiggle and wear a skivvy, pull on your thick socks and/or tights and appropriate footwear. If you’re still cold, consider adding thermals to your layers.

When you head outdoors, add more layers – including a coat, hat, gloves, and scarf. You can also buy a fantastic range of heated vests, socks, scarves, and gloves. They can be a little pricey, but they may be worth that initial outlay if you’re outdoors a lot. Check online or in-store at outdoor suppliers.

If you’re at home and still feeling the cold, grab a blanket for your legs as you sit at your desk or on the couch. You can use any warm blanket, doona or heated throw. Whatever you choose, just be careful you don’t trip on it when you get up.

“Winter’s my favourite…The best parts are the coats and sweaters.
Hugging all the warmth back in.” – Abby Slovin.

Shop around.

Don’t assume you’re on the best energy plans for your gas and electricity. Take some time to see if there’s a better deal. If you live in Victoria, visit Victorian Energy Compare. For all other parts of Australia, visit Energy Made Easy.

Deal with draughts.

When the wind’s howling outside, you know it’s trying to find a way indoors 💨. So cover the bottom of your door with a door snake or an old towel, or add some door seals. Pull your curtains and blinds over the windows at night and during miserable days to keep the warmth inside. If you have floorboards, consider putting down rugs (just be careful they don’t become a trip hazard).

If you can safely do so, close or cover air-conditioning vents, exhaust fans, and unused chimneys. However, it’s important to be aware that some gas appliances require a certain amount of ventilation or fresh air, or they can be unsafe. They should also be serviced every two years or sooner if you notice anything unusual. If in doubt, speak with a licenced gas fitter. Energy Safe Victoria has lots of useful info about heating your home with gas and what to look for when searching for a licenced gas fitter.

Sustainability Victoria also has helpful information on draught-proofing your home. You can also watch these handy DIY draught-proofing videos from the City of Port Phillip (Melbourne).

“It was one of those March days when the sun shines hot, and the wind blows cold:
when it is summer in the light and winter in the shade.” – Charles Dickens.

Turn down the temperature.

While it’s tempting to crank the heat up, the most efficient temperature to set your heater to (if you can select the temp) is 18-20 degrees. While that may not sound particularly warm, we’re often outside during the warmer months wearing short sleeves when it’s 18-20 degrees. It’s just a matter of perspective.

And only heat the areas you’re using. If you can turn the heating off in unused parts of your home, do it. Shut the doors and use a draught stopper to prevent the warm air from the rest of the house from escaping into these areas. And turn the heating off when you go to bed or leave home.

Install heavy curtains.

Thick curtains made from heavyweight, tightly woven fabrics can prevent heat from escaping your home. For the best results, curtains should be fitted as close to the window frame as possible, extend below the sill and well over the sides of the window frame, and a pelmet fitted over the top. This acts to seal the window from the rest of the room and prevent heat loss. Curtains will also keep the hot air outside in summer.

Let the sun shine in.

Open your curtains and blinds on sunny days to let the sun shine on your windows. Even with a chilly wind, the sun will bring wonderful warmth into your home.

And remember to close them when the sun starts to go down. As someone who goes for walks when it’s dark in the early morning and evening, I’m always amazed by how many people have their windows uncovered. You can practically see the heat escaping through the glass. So close them to keep the warmth in and the gaze of the sticky-noses (like me) out 😉.

Cool down at night.

You sleep better when your body can cool down, so turn the heater off at night. It’s also safer to sleep with the heater off. You can remove the chill from your bed using a hot water bottle or an electric blanket. Just remember to turn your electric blanket off before sleeping.

Winter-proof your bed.

There’s nothing like slipping into a deliciously warm bed on a cold night, especially if there’s soft flannelette involved! So swap out your lighter, everyday bedding for heavier winter ones. And add layers – a top sheet (if you don’t already use one) and extra blankets. Finally, if you have floorboards in your bedroom, adding a rug under your bed can prevent draughts from making their way to your bed.

Get active.

When the weather allows, go for a brisk walk outdoors, wearing appropriate clothing, and you’ll warm up in no time. Save on pricey petrol and walk to the shop/school/post office instead of driving.

When you’re at home, exercise indoors using an online program, a DVD or an app. Play with the kids. Clean the house. Do anything that gets you moving, and you’ll feel warmer than if you sit in one place for hours.

However, if you’re having a flare or experiencing a lot of pain, be as active as you can within your limits. And use your heat packs to help relieve muscular pain.

Shorten your showers (if you can).

Many of us use our shower to warm up sore joints and muscles so we can get moving. However, hot water uses a lot of energy; even a few extra minutes will add to your bill. If you can, shorten the time you spend in the shower. Aim for four minutes or less. You can use a timer or sing your favourite song. Hunter Water has a great playlist of four-minute(ish) songs to get you inspired.

“There’s no half-singing in the shower;
you’re either a rock star or an opera diva.” – Josh Groban.

Give your heater some space.

Anything that blocks a heater will prevent the warm air from flowing around the room uninterrupted. So move clotheshorses and other obstructions away from the heat source.

Hot air rises, so if you have ceiling fans, flick the reverse or winter mode switch and turn the fan on low. This will pull the cooler air towards the ceiling and push the warmer air down to you.

And to stay safe, fire authorities say you should keep clothing and other fabrics at least one metre from your heater. Never place them on heaters.

Snuggle up.

Get comfy on the couch with your partner, kids, and pets. Grab a warm blanket or doona, share your body heat, and enjoy being together.

“People don’t notice whether it’s winter or summer when they’re happy.” – Anton Chekhov.

Use heat packs and hot water bottles.

If you’re feeling stiff and sore, heat packs or hot water bottles can provide temporary pain relief and help you get moving. But you need to be careful when using them.

If you’re using a heat pack or wheat bag, let it cool completely before you reheat it. Don’t sleep with your wheat bag or smother it behind you in your chair or bed. This can cause it to overheat and catch fire. Always carefully follow the manufacturer’s instructions and never overheat them in the microwave.

If you’re using a hot water bottle, use hot water from the tap, not boiling water. Wrap it in a cloth or use a cover so it doesn’t come into contact with your skin.

Always examine your hot water bottles and heat packs before use, and toss them out if you notice signs of wear or damage. And always check their temperature before use to ensure they’re not too hot.

Warm up from the inside out.

Many delicious winter recipes bring comfort and warmth on the most miserable days. So crack open the cookbooks and get cooking! Or go online for inspiration for yummy, warming curries, soups and stews. We’ve got some great recipes to get you started! Can’t be bothered cooking? Simple. Grab a cup of hot chocolate, tea or coffee. It’ll warm your insides and your hands. Perfect! ☕🍵

“Winter blues are cured every time with a potato gratin paired with a roast chicken.” – Alexandra Guarnaschelli.

Choose energy-efficient heaters and hot water systems.

If you’re in the market for a new heater or hot water system, make sure you’re buying one that’s energy-efficient and best suits your needs. Read Canstar’s guide to energy-efficient heaters and Choice’s article on buying the best hot water system for more info.


Insulation keeps your home warm in winter and cool in summer by preventing heat from escaping or entering your home. This keeps your home at a more consistent temperature and reduces the need to crank up your heating or cooling.

If your home isn’t properly insulated, this is something you can do that’ll have long-term benefits. There’s a substantial upfront cost, but it may be an option for some households. Find out more about insulation, including the different types available and how to install it, from the Australian Government’s website, Your home.

Billing and payment help.

If you’re struggling to pay your energy bills, also has some information about support for Australian households, including info on potential rebates that may be available.

We’ve also put together lots of info to help you if you’re struggling with financial stress.

Contact our free national Help Line

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

More to explore


Hate going to the dentist? You’re not alone. Many of us become anxious or worried about visiting the dentist.

But for people with a musculoskeletal condition, taking care of their teeth and gums – including the dreaded visit to the dentist – can also be painful.

We’ve got some tips to help make this a little easier.

But first, why should we care about oral health?

Looking after the health of your mouth, teeth, gums, and the structures that support them helps you keep your teeth healthy and intact for longer as you age. This is important because it makes you feel more confident and comfortable when speaking, smiling, eating, and laughing.

Poor oral health is also linked to diabetes, heart disease, stroke and respiratory conditions. And in some studies, gum disease has been linked to rheumatoid arthritis.

So oral health is important. Got it. 👍

Musculoskeletal conditions and oral health.

There are various reasons why people with musculoskeletal conditions may have difficulties with their oral health, such as:

Pain. Pain can affect your ability to open your mouth for the time it takes to clean and floss your teeth or to keep your mouth open during a check-up. It can also affect your ability to hold and use a toothbrush or dental floss.

Dry mouth. Whether it’s due to a health condition such as Sjogren’s syndrome or taking certain medicines, having a dry mouth reduces the amount of saliva in your mouth. And that’s a problem because saliva washes away food remnants, neutralises the acids in your mouth, helps prevents bad breath, tooth decay and gum disease, and protects your teeth’s enamel.

Being immunosuppressed or having a weakened immune system due to your condition or medicines can increase your risk of infections, including oral thrush and mouth ulcers.

Taking care of your oral health.

Get brushing.

While it sounds obvious, you need to clean your teeth, tongue and gums twice a day for at least two minutes for good oral health. But according to the Oral Health Tracker, only about half of us do this 😮.

And yes – I did say brush your tongue. Gently brushing your tongue removes any bacteria, other microbes or bits of food lurking there.

For more info, check out the Australian Dental Association’s brushing basics.

Oh – and if you need some help knowing if you’ve brushed for two minutes, or to make it fun for the kids, check out Spotify and YouTube for music to brush your teeth by. There’re plenty of playlists and songs out there! 🎶🎵 Or get creative and make your own. 😉🎵🎶

Choose your tools.

Toothbrushes. I don’t know why, but I always thought using a hard toothbrush and giving my mouth a good old scrub was the way to clean teeth. Turns out, a softer brush is the best choice. And you shouldn’t use too much pressure when brushing; it’s bad for your teeth and gums and can aggravate your joint pain. Brushing too hard also wears down the bristles of your toothbrush faster.

If the handle of your toothbrush is difficult to hold, you can make it thicker and easier to grip by adding some thick rubber or foam tubing to the handle. You can pick this up at the hardware store.

An electric toothbrush is another option, especially if pain or dexterity affects your ability to brush. Electric toothbrushes also generally have a bigger handle that may be easier for some people to grip; however, they’re also a bit heavier than a standard toothbrush, so you’ll need to consider that.

Whether you use a standard or electric toothbrush, you need to change the brush regularly. That’s generally every three months or sooner if you notice the bristles falling out or pointing in the wrong direction.

Toothpaste. There are so many varieties of toothpaste available it can be hard to choose one! The good news is that a Choice article reports that ‘most toothpastes contain essentially the same ingredients’ and do the same thing – remove plaque and prevent tooth decay and cavities. So choose the toothpaste you like.

But if you have a dry mouth or sensitive teeth and gums, talk with your dentist about the best toothpaste for you.

Dental floss. Flossing is essential to teeth cleaning as it helps remove food particles and microbes from between your teeth. Not flossing increases your risk of developing tooth decay and gum disease. However, according to the Australian Dental Association, many of us forget to floss our teeth, with only one in four people saying they floss daily 😐.

But using dental floss can be a challenge if you have sore hands. Talk to your dentist about other options, such as dental floss picks (not toothpicks), interdental brushes, water flossers and electric flossers.

Mouthwash. Most people don’t need mouthwash, especially if you’re cleaning and flossing regularly and properly.

Many types of mouthwash kill the bacteria in your mouth, both good and bad. They can also mask bad breath, which may indicate an infection or other problem. And they can be irritating if you have a sensitive mouth.

But mouthwash may be helpful if you have a dry mouth, as certain types can help stimulate saliva.

So what to do? Have a chat with your dentist about whether or not a mouthwash is appropriate for you.

Check yourself out. 😁

The best way to stay on top of any problems is to regularly check your teeth and gums for changes. That way, if you notice any bleeding, inflammation, signs of infection, or other issues, you can see your doctor or dentist and get on top of it quickly.

See your dentist regularly.

You should see your dentist every 6-12 months to ensure good oral health. Or sooner if you have toothache, damage to your teeth and gums, or pain or sensitivity when eating or drinking. When combined with regular brushing and flossing, seeing your dentist regularly will reduce your risk of needing more invasive and costly procedures in the future.

If you have problems keeping your mouth open for long periods and/or lying in the chair while having a check-up, discuss this with your dentist. There are options to make this less painful, such as:

  • Using pain-relieving medicines or heat/cold packs before and after your visit.
  • Taking breaks. Have an agreed signal with your dentist – for example, raising your hand – if you need to move, close your mouth, or relax your jaw.
  • Distraction, for example, put on some headphones and listen to music, a podcast or a book.
  • Using your supports, for example, a cushion or blanket that helps you relax and get comfortable.
  • Visiting your dentist more frequently but for shorter visits, so you don’t have to spend so much time in one sitting. Though this can become costly, so talk with your dentist about your options.

Your dentist may also suggest using a mouth prop. Mouth props are rubbery, flexible tools that dentists can place between your teeth to help reduce muscle fatigue caused by keeping your mouth open wide.

Eat well.

A healthy diet with a variety of nutritious foods and plenty of water is best for your oral health and general wellbeing. You should also limit your intake of foods high in sugar and snacks between meals.

Quit smoking.

Smoking and vaping increase your risk of gum disease.

Contact our free national Help Line

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

More to explore


Every year on 29 June, people mark World Scleroderma Day. This year, many landmarks around Australia shone gold like sunflowers in June to support people living with scleroderma.

What’s the connection between scleroderma and sunflowers? 🌻 🌻 🌻 And what exactly is scleroderma?

According to Scleroderma Australia, just as sunflowers follow the sun for warmth, people with scleroderma find the warmer weather more comfortable. That’s why sunflowers have become a hopeful symbol representing scleroderma in many parts of the world, including Australia.

“I want to be like a sunflower; so that even on the darkest days I will stand tall and find the sunlight.” – Unknown

Scleroderma is a chronic (or long-term) condition that affects your connective tissue. The word scleroderma literally means ‘hard skin’; as you’ll see, it’s an apt name for this condition.

Connective tissue is the cells and fibres that hold together the millions of cells of your body. It ‘connects’, or supports and holds together your joints, muscles, internal organs, skin and other body tissues. Types of connective tissue include bone, cartilage, fat, blood, and lymphatic tissue.

The connective tissue of people with scleroderma has too much collagen, which causes it to become hard and tight.

Anyone can develop scleroderma, but it’s more common between the ages of 30 and 60 and is more common in females.

There’s no cure for scleroderma, but it can be managed effectively.

We don’t know the cause.

Scleroderma is an autoimmune disease. That means it occurs as a result of a faulty immune system.

Your immune system is designed to identify foreign bodies (e.g. bacteria, viruses) and attack them to keep you healthy. But in the case of scleroderma, your immune system mistakenly targets healthy tissue. This triggers connective tissue cells, especially a cell type called fibroblasts, to make too much collagen and other proteins. This leads to the hardening and scarring of the skin and other tissues.

We don’t know why this happens. Scientists believe a complex mix of genes and environmental factors may be involved.

There are different types of scleroderma.

There are two broad classifications of scleroderma based on the amount of skin and other organs affected.

Localised scleroderma mainly affects the skin. It can affect both adults and children. There are two types of localised scleroderma, morphea and linear. Both have distinctive signs and symptoms. Localised scleroderma can sometimes restrict normal joint movement due to the hardening of the skin over the joint.

Systemic scleroderma (or systemic sclerosis) affects internal organs like the heart, lungs, kidneys, and skin. Systemic means it affects several organs and tissues, or the entire body, rather than a single organ or body part. Sclerosis means abnormal hardening of body tissue.

Systemic scleroderma can also be broken into sub-types depending on the symptoms. They are limited scleroderma and diffuse scleroderma.

Symptoms vary.

The symptoms of scleroderma vary from person to person and will depend on the type you have.

Symptoms can include:

  • thickening and hardening of the skin
  • skin dryness and ulcers
  • sudden constriction of the blood vessels, resulting in pale, blue, or red fingers or toes (Raynaud’s phenomenon)
  • stiffness and pain in the muscles and/or joints.

If some of your internal organs are involved, you may experience:

  • digestive issues, such as heartburn, bloating, constipation, stomach pain
  • lungs problems, such as shortness of breath
  • heart problems, such as chest pain
  • kidney problems may lead to high blood pressure.

While these symptoms sound very scary, your doctor and specialist/s will monitor your condition and symptoms to prevent/treat complications.

“Keep your face to the sunshine and you cannot see the shadow. It’s what sunflowers do.” – Helen Keller

It can be difficult to diagnose.

Scleroderma can be a difficult condition to diagnose. Symptoms vary significantly from one person to another and are similar to those of other conditions. They can also change or fluctuate. So, it may take some time to get a definitive diagnosis of scleroderma.

No single test can diagnose scleroderma, so your doctor will use a combination of tests to confirm your diagnosis. They may include:

  •  Your medical history.
  •  A physical examination.
  •  Blood and urine tests.

There’s no cure, but there are effective treatments.

While there’s currently no cure for scleroderma, medicines can help ease your symptoms. Your doctor will develop a treatment plan based on your symptoms. You’ll generally start on the lowest possible dosage and, if necessary, slowly increase the dose until your symptoms are under control. All medicines have side effects, so you should discuss these with your doctor.

Medicines may include:

  • Topical corticosteroid (steroid) creams that you apply to your skin.
  • Anti-inflammatory medicines to help manage pain and control inflammation.
  • Corticosteroids taken as a tablet, injection, or into the vein (intravenous or IV) act quickly to control or reduce inflammation and may be used in the short term. They aren’t used for long periods as they’re associated with serious side effects.
  • Medicines that suppress your overactive immune system and control symptoms. These medicines may also be in the form of topical creams, tablets, injections, or IV infusions.

As well as seeing your GP, you’ll likely see a skin specialist (dermatologist) and a specialist in joint and muscle conditions (rheumatologist). Other healthcare providers, like respiratory physicians and gastroenterologists, may be involved in your ongoing treatment.

There are things you can do to manage your condition.

Learn about scleroderma. Knowing as much as possible about your condition means that you can make informed decisions about your healthcare and actively manage it.

Lifestyle changes. Avoid exposure to cold temperatures, dress warmly and don’t smoke. This will help you manage Raynaud’s phenomenon.

Stay active with regular exercise. Exercise will reduce tightness and help keep your joints moving, especially those areas affected by scleroderma, such as the hands and wrists. Exercise will also strengthen your muscles and improve overall health. Talk with a physiotherapist or exercise physiologist about an exercise program tailored to your condition and symptoms.

See a hand therapist. They’re qualified physiotherapists or occupational therapists with extensive knowledge and skill in understanding and treating problems with the fingers, wrists, elbows and shoulders. They can help you keep your hands and wrists flexible and moving well.

Aids and equipment. Scleroderma can make some actions difficult, for example, using door handles or getting dressed. An occupational therapist can advise on aids and other gadgets that may help and provide additional solutions to make life easier.

Eat well. Eating a balanced diet can help provide you with better energy levels, help to maintain your weight, and give you a greater sense of wellbeing.

Get support from others. Research has shown that people with positive social support cope better with pain and chronic conditions. Family, friends, colleagues, and health professionals can help you manage. A peer support group may be another option. Contact Scleroderma Australia for details on support options in your state or territory.

“Someone was sitting in front of a sunflower, watching the sunflower, a cup of sun, and so I tried it too.
It was wonderful; I felt the whole universe in the sunflower. That was my experience. Sunflower meditation.
A wonderful confidence appeared. You can see the whole universe in a flower.“ – Shunryu Suzuki

Contact our free national Help Line

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

More to explore


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

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

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

So what is Paget’s disease?

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

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

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

Bones and Paget’s disease

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

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

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

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

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

Causes, symptoms and diagnosis

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

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

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

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

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


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

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


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

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

Stay active.

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

Enjoy a healthy, well-balanced diet.

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

Learn new ways to manage pain.

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


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

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

Contact our free national Help Line

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

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We all know regular exercise is essential for good health. It can improve the fitness of your heart and lungs, sleep quality, energy levels and mental wellbeing. And it can reduce your risk of developing conditions such as diabetes.

Exercise is also vital for the health of your bones.

Like muscle, bone is living tissue that responds to exercise by becoming stronger. People who exercise regularly have stronger bones and higher bone density than those who don’t. This reduces the risk of developing osteoporosis.

Exercise also increases your balance, coordination and flexibility, which improves your ability to prevent trips and falls. DYK, falls are Australia’s largest contributor to injuries that require a stay in hospital and are a leading cause of injury deaths? More than half of the hospitalisations were due to broken bones (fractures).(1)

Bones need exercise.

To understand why exercise is important for bone health, it helps to know how bones work.

Throughout your life, your bones are constantly changing. This is called ‘remodelling’. Bone cells called osteoblasts build new bone, while other bone cells (osteoclasts) break down and remove old bone. This process is controlled by hormones such as calcitonin, parathyroid hormone, oestrogen (in women), testosterone (in men), and vitamin D.

From birth to about 25, you build more bone than you lose. Your bones are not only getting bigger as you grow, but they’re also developing their density. This determines how strong they are.

From about 25 to 50, your bones break down and rebuild at about the same rate. 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, you break down more bone than you rebuild. While this means everyone will experience some bone loss as they age, it doesn’t mean everyone will develop osteoporosis.

Women commonly experience a period of rapid bone loss after menopause. This is due to a drop in oestrogen levels. It’s estimated that the average woman loses up to 10% of her bone mass in the first five years after menopause.(2)

For good bone health, exercise is vital for everyone – from the very young to the very old.

A combination of different exercises is best for bone health.

Different exercises challenge and strengthen your bones and muscles in different ways, so you should include the following in your exercise plan:

Weight-bearing exercises or activities where your body carries its own weight. These exercises put stress on your bones, making them stronger and denser. It also strengthens the muscles around your bones, providing support and reducing the risk of fractures. Weight-bearing exercises include brisk walking, climbing stairs, tennis, and netball.

High-impact exercises such as jogging, running, jumping, and skipping rope. They’re also weight-bearing exercises, but they place greater stress on the bones of the spine and legs as your feet hit the ground. This can provide more bone-strengthening benefits; however, these exercises aren’t suitable for everyone.

Resistance training, also known as strength training, uses resistance or weights to strengthen your muscles by working them harder than you do in everyday life. The strong muscle contractions required to move a heavy weight place stress on the bone where the muscle attaches. When bone feels this strain repeatedly, it responds by becoming stronger. Resistance training uses equipment like free weights (e.g. dumbbells), gym machines, elastic resistance bands or your body weight (e.g. push-ups, squats).

Balance and flexibility exercises such as tai chi and yoga improve balance and mobility and can reduce your risk of falling. This is important for preventing fractures.

Before beginning an exercise program, speak with your health professional. Not all types of exercise are suitable for everyone. This is especially important if you have other health conditions, including osteoporosis. A physiotherapist or exercise physiologist can assist you with a safe exercise program that targets your specific needs and reduces your risk of injury.

Exercise must be regular and ongoing.

You need to exercise regularly to have a significant benefit, so you should choose activities you enjoy. This will make it easier to exercise consistently.

Australian physical activity and exercise guidelines recommend that all adults be active most days, preferably every day, for 30 minutes or more. This includes at least two sessions of strength training every week. However, when you’re just beginning, this can seem daunting.

That’s why it’s good to know you don’t have to do all your exercise in one session. For example, a 30-minute brisk walk can be broken up across your day into shorter, more achievable sessions, such as three 10-minute or six 5-minute walks.

You can do other things to make exercise a regular, ongoing activity.

Exercise with a group or a partner. This can improve your motivation to exercise and provides an opportunity for socialising with others.

Exercise SMART and set goals. A clear goal can motivate you to stay on track with your exercise program. But they must be realistic and specific to your abilities, needs, and health issue So, ensure your goal is SMARTSpecific, Measurable, Achievable, Realistic and has a Timeframe.

For example, a good SMART goal for resistance training for stronger bones and muscles could be: “I will perform resistance exercises, such as lifting weights or using resistance bands, for 30 minutes, twice a week, for the next three months.”

This goal is Specific (focuses on resistance training), Measurable (30 minutes, twice a week), Achievable (realistic for most people), Relevant (aimed at improving bone and muscle strength), and has a Timeframe (three months).

Constantly evaluate your goals, adjust them as needed and reward yourself for your successes.

Add variety. Vary where you exercise and the type of exercise you do. Include recreational activities such as bushwalking or dancing. This will help keep your mind fresh and your motivation high. Find activities that are enjoyable to you so that you’ll be motivated to continue doing them.

Exercise within your capabilities. Often, people drop out of exercise programs because they exercise at a level beyond their current capabilities. Ensuring your exercise program suits your current abilities will decrease your risk of injury and increase your enjoyment and motivation to continue your exercise program.

Challenge yourself. Increase the intensity of your exercise as your fitness improves. It’ll make your exercise more interesting and also has greater health benefits.

Stop if you have pain. Don’t continue exercising if you experience pain or severe discomfort. Talk with your fitness professional for advice to ensure you’re not doing an exercise incorrectly.

Bone health doesn’t happen in a vacuum.

As well as exercise, you need to also to eat a nutritious diet with calcium-rich foods, get sufficient sun exposure for vitamin D, take medicines or supplements as prescribed by your doctor, quit smoking, and moderate your use of alcohol, caffeine, and salt intake, as they can impact bone density.

Contact our free national Help Line

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

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(1) Falls. Australian Institute of Health and Welfare.
(2) Osteoporosis, Australasian Menopause Society

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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