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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

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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

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State and territory resources


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03/Mar/2022

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.

Symptoms

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.

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 (helpline@msk.org.au) or via Messenger.

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03/Mar/2022

Are you like me and automatically select the same items when buying groceries? That specific yoghurt, brand of orange juice, yummy cheese 😉?

There’s nothing wrong with that. We’re creatures of habit and know what we like. Also, we often want to shop as quickly as possible and get it over with 😄.

But every now and again, it’s a good idea to compare that yoghurt, orange juice, cheese or whatever, to other similar items available.

The ingredients list and nutrition labels can help you do this. They pack a lot of useful info into a tiny space. By reading this information you can see if the product you buy really is the best or healthiest choice for you.

For example, if you have high blood pressure, making sure the product you buy is low in salt is important. If you’re trying to lose weight, comparing the kilojoules, fats and sugars in different brands of foods will help you make a better choice. Or if you have an allergy or intolerance to an ingredient or food additive, you can avoid buying a product that contains that item.

In Australia, all manufactured food must provide nutrition and safety information on their labels.

This includes:

  • the name of the product and an accurate description of what it is
  • the brand’s name
  • an ingredients list (in order from largest to smallest by weight)
  • nutritional information (e.g. energy, fat, protein, sugars and salt)
  • use-by or best-before date
  • manufacturer details
  • weight
  • food allergy information
  • list of food additives
  • directions for use and storage
  • country in which the food was produced.

Obviously you’re not going to take the time to look at every one of these items every time you shop! But it’s helpful to look at the ingredients list and nutrition panel when looking at new products, and occasionally compare your trusty favourite with other similar items.

Ingredients list

All ingredients must be listed in order by weight, from largest to smallest. They also need to show the percentage of the key ingredient if it’s mentioned in the description. For example, a tomato pasta sauce may say 80% tomatoes, peanut butter 90% peanuts, raspberry yoghurt 10% raspberries etc. Other brands may have more or less tomatoes, peanuts or raspberries, so knowing the percentage is useful when comparing products.

Sometimes what’s known as compound ingredients are used in foods. They’re ingredients that are themselves made up of two or more ingredients. For example, in some food items (e.g. Tim Tams 🤤), milk chocolate is used. So all of the ingredients in milk chocolate – sugar, milk solids, cocoa butter, cocoa mass, vegetable oil, flavour – must be listed in the ingredient list, along with the other ingredients. However, if a compound ingredient makes up less than 5% of the final food, it doesn’t need to be listed unless it’s an additive or allergen.

Nutrition information panels

These panels provide the nutrient details, as well as serving sizes and number of servings per package. Some labels also display % daily intake. This helps you choose foods that are lower in fat, sugar and salt.

The nutrients listed are:

  • energy (kilojoules or calories)
  • protein
  • fat
  • saturated fat
  • carbohydrate
  • sugars – includes added and natural sugars (e.g. fructose in fruit)
  • sodium (salt).

Some nutrition panels may include other nutrients such as fibre, potassium, calcium or iron. For example, a manufacturer may add calcium to the panel if they state on their yoghurt packaging that it’s a good source of calcium.

Nutrients are displayed in a standard format showing the average amount per serve and per 100g (or 100mL if liquid).

This means you can look at the 100g column on two different brands of cheeses and compare the nutrients, helping you make the healthiest choice.

This diagram from Eatforhealth.gov.au provides a simple visualisation of what to look for in a nutrition panel.

As far as serving size, this is the average serving according to the manufacturer. For example, a packet of crispbread lists the servings per packet as approximately 18, and the serving size as 7g (1 piece). If you eat more or less than the suggested serving size, you’ll need to factor in the difference in the energy, fat, sugar etc that you’re consuming.

Health star ratings

You may have seen these on the packages of some foods. They bring together all of the info from the nutrition panel, and give the food a rating out of 5, with 5 being the healthiest. These are a guide to help you very quickly compare similar products.

Nutrition claims

Remember the milk ad from many years ago, when a man asks for milk at a corner store? The lady behind the counter rattles off the following: ‘Low fat, no fat, full cream, high calcium, high protein, soy, light, skim, omega-3, high calcium with vitamin d and folate or extra dollop?’ They’re just some of the nutrition claims that we see on the packaging of many food products. Like reduced fat, baked not fried, light/lite, salt reduced, all-natural, no added sugar etc. They can make it hard to understand which is the best, healthiest product for you.

Nutrition Australia (QLD) has a great article that can help you understand some of the more commonly used claims on packaging. Check out Reading food labels like a pro.

Understanding food labels can be a little tricky at first, but with a bit of practice (and a magnifying glass 😄) you’ll soon be able to decipher what it all means and make healthy food choices. And it’s important to remember that you don’t eat separate pieces of food in isolation. They’re all part of your daily/weekly meal plan. That means there’s room for the sometimes foods we all enjoy, as long as you consume them in moderation, and you’re aware of what’s in them.

Finally – remember there’s always help available. If you want to know more about choosing healthy food or need advice on diet in general, talk with your doctor and/or a dietitian.

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 (helpline@msk.org.au) or via Messenger.

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10/Feb/2022

“The secret of great style is to feel good in what you wear.” Ines de La Fressange

Hands up if you wake up some days and the thought of getting out of bed, let alone dressed, seems impossible?

Painful muscles and joints, fatigue, difficulty with buttons and zippers, not being able to reach behind your back or over your head, sensitive skin and continence issues can make getting dressed a challenge. However, because staying in your pajamas all day is rarely an option 😣, you need some practical strategies to take the stress out of getting ready for the day.

So how can you tackle getting dressed so that you feel comfortable and put together, even if you’re in pain and exhausted?

Make a plan

I know it’s not particularly glamorous or cool, but planning can be your best friend when you live with a chronic condition that can be so unpredictable.

Decide what clothes and accessories you want to wear the night before. Or be a super-planner and do this on the weekend, for the week ahead. Take into account your activities and the weather. Then have them arranged in your cupboard so you can simply reach for the items you need for the day.

Choose your clothes carefully

When buying new clothes, choose those with quality fabrics that are soft and stretchy.

Loose clothes are perfect on days when you’re in pain, or your skin is sensitive. If twisting or reaching behind you is difficult, buy clothes that fasten at the front or side. Or ones that have no fastenings at all.

Avoid clothes that require ironing if you can…unless you find ironing relaxing (I know that person 😉). But seriously, who can be bothered ironing when you’re already tired? For clothes that do crease in the wash, hang them up on a hanger as soon as you take them out of the wash so that most of the wrinkles drop out. You can also hang them in your bathroom while you shower so that the steam removes any stubborn wrinkles.

Buy clothes that you can dress up and dress down as the occasion warrants. For example, plain black t-shirts can be as casual as you want for hanging out at home with a pair of leggings/loose jeans and sneakers. But by simply adding a light jacket, some accessories, and changing your shoes to low wedges/loafers, you’re ready for lunch with friends. No muss, no fuss.

Add layers. Many people with chronic pain are sensitive to fluctuations in temperature. Because you can rarely control the temperature of the places you visit, layering your clothes can be a lifesaver. You can remove/add layers as needed.

Use dressing aids. If you have difficulties with fastenings (e.g. zippers, buttons, shoelaces) or putting clothes over your head or shoes on your feet, there are gadgets to make life easier. They include zipper hooks, dressing sticks, buttonhooks, shoehorns, elastic shoelaces, and so much more. Check out our online store for some of these items. An occupational therapist can also give you tips for getting dressed as well as other available aids that are available to help you.

Have a go-to outfit that makes you happy. We all need a pick-me-up now and again, and often what we wear can do that. Have a favourite outfit or two ready to go for when you need a boost or some extra confidence to face the world 😍.

Don’t forget your accessories

Shoes: When buying new shoes, make sure they fit your foot properly, including any bunions, hammertoes and other structural changes to your foot. Choose shoes with a good, supportive sole, and decent grip to avoid slips and trips. Avoid wearing high heels or very flat shoes every day. If you wear orthotics, ensure they’ll fit in your new shoes. And if you have painful feet and you’re having trouble managing, talk with a podiatrist. They can give you information to help you look after your feet, including advice on your footwear.

Bags and backpacks: We carry a lot of stuff with us every day – phones, purses/wallets, computers, medication, keys, masks, water, hand sanitiser, snacks, work/school gear – so bags and backpacks that can help you cart this around, without aggravating your condition, are a must. Bags with thick straps that spread the weight across a wider area, rather than bags with thin straps, will cause less pain and strain. Avoid large bags, where the temptation can be to throw everything in them. Instead, choose a bag that suits what you need to carry, and avoid adding anything that isn’t necessary for your outing. Have a couple of bags and backpacks that’ll accommodate what you need to carry, whether it’s a casual outing or work-related, and your outfit. That way, you can mix and match as necessary.

Hats and caps: Don’t forget your head! Hats and caps protect your head and face from the heat and UV rays, as well as the cold bite of winter. Again, have a couple you can choose from to suit your outing and the elements.

Now add bling: I find that even when I’m wearing my most casual, comfy outfit, I can dress it up, and by doing so, feel better, just by adding some earrings, a cool watch or another piece of jewellery. It may sound superficial, but personally, anything that lifts my mood when I’m feeling low or in pain is just as necessary to me as my medication or meditation 😊.

Be a thrifty shopper

Living with a chronic condition can be costly, so saving money where you can is important. Op shops, clothing exchanges and online noticeboards can help you save money when it comes to sourcing new clothes and accessories. I’m an avid op shopper, and I find many unique, good quality and fun items at great prices. I also feel better about recycling clothes rather than buying a cheap item from a chain store that won’t last the season. And don’t forget you can also sell or donate the quality clothes you no longer wear to these networks.

Develop your own style

Throw the season’s fashions out the window! Wear clothes that make you happy, comfortable and project your own personality and style. I’ve said it many times – the world would be incredibly dull if we were all the same. And that goes for what we wear. So embrace your inner fashionista and create a style that’s uniquely you.

“When you don’t dress like everybody else, you don’t have to think like everybody else.” – Iris Apfel

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 (helpline@msk.org.au) or via Messenger.

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10/Feb/2022

It’s hard to believe that we’ll soon be into our 3rd year of this pandemic 😷. We’ve made sourdough bread, gotten ‘used’ to masks, embraced jigsaws and telehealth, changed the way we work, go to school and socialise. We’ve missed out on many important events – big and small – as our world changed so dramatically.

It’s been really hard, and it’s taken a toll on our physical, mental and emotional health.

One aspect of ourselves that has suffered is our resilience. Resilience is our ability to cope and adapt to changes and challenges that the world throws at us. As this pandemic continues, we’re constantly tired, anxious, and stressed, with no end in sight. And this is really testing our resilience. Add to this a chronic, painful musculoskeletal condition, and everything seems amplified 😫.

For example, this morning, I was driving to the chemist to buy more masks. Someone cut me off in traffic. In the past, I would’ve muttered to myself and continued on my way. But today, I flashed my lights, tooted my horn and yelled. I yelled! Madness 😣. And at that moment, I realised that the only person negatively impacted by the situation was me. The other driver was long gone, but I could feel my heart pumping and the adrenaline coursing through my veins. It’s clear that my resilience is at an all-time low at the moment. I’ve known this for some time but haven’t done anything about it. But it’s now time.

So if you’re like me and know that your resilience isn’t what it used to be, and that you’re not handling stress and challenges as well as you once did, what can you do about it? How can you rebuild your resilience in a world that’s still so topsy-turvy, and you have no idea what’s around the corner?

Accept that you’ll have to face change, stress and challenges. Our lives are messy. And nothing is ever smooth sailing. However, by accepting that change is always happening – both good and bad – you can mentally prepare yourself for it. You can learn from how you’ve reacted in the past and how situations have affected you. You can use this information to prepare for future events and challenges. But the first step is to accept that things will happen. Change is constant. You can choose to deal with it in a positive, proactive way, or you can choose to let it negatively affect you. Acceptance isn’t always easy and will take time and reflection, but it is possible. And if you need help, it’s available. Read our article on support for mental and emotional wellbeing for more info about the types of professionals who can help you.

Make time for your people and your relationships. It’s tempting when you’re feeling low, in pain or like you just can’t take any more drama, to disconnect from others. However, when you’re on your own, it’s easy for your mind to get stuck on a merry-go-round of negative thoughts. They go round and round as you think about different ways you could have handled past events or as you worry about the unknown future. Staying in touch with the people who care for you can distract you from this rumination and help you focus on what’s actually happening in the world around you. They can also be a supportive ear and listen as you explain what’s affecting you and how you’re dealing (or not) with these things. They can also be a valuable source of advice if you choose to ask for it.

Write it down. Putting pen to paper and writing down the things that are causing you stress, or to feel anxious or powerless, is a useful strategy to help you see the nuances of the problem. Take the time to think about all sides of the issue and how it affects you. You can then process it more clearly, allowing you to do some critical thinking and problem-solving. Read this article, ‘5 ways journaling can build your resilience’ for more info about journaling.

Keep up your self-care. Again, it’s easy to let things slide when we’re not feeling on top of things. You may stop exercising, go to bed later or sleep in more often, eat comfort foods that give you a quick rush but don’t give you the nutrition you need, or rely on alcohol and other drugs to pick you up. But these behaviours will negatively affect your physical and mental health if you don’t get on top of them. So it’s important that you make a conscious commitment to continue your self-care, especially because your resilience is low. Because self-care practices such as sticking to a daily routine, eating a healthy diet, exercising regularly, getting good quality sleep and getting out into nature, will make you feel healthier and more able to cope with life’s challenges. They’ll also help you deal with pain and other symptoms of your musculoskeletal condition.

Focus on what you can control, no matter how small. You can’t control what’s happening with the pandemic, apart from following the health advice you receive from the government and your healthcare team. This lack of control can sometimes make you feel powerless. But you can control things closer to you, like how often you access social media or how much ‘doomscrolling’ you’re doing. You can choose to give your mental health a break from negative news and socials. You’re giving yourself power – over your actions and the effect they have on you – which will help build your resilience.

Think about how you can positively deal with challenges you’re currently dealing with. For example, if you’re working from home and feel isolated from your colleagues and the world in general, how can you manage this? Or, if you’re feeling financial stress because you’re not getting as much work as you once did, what options are available to help you? By problem-solving and coming up with a range of potential solutions, you can start to feel more in control. And if it all seems to overwhelming, you can always break big challenges down into smaller actions. If we look at the financial stress example, the first step might be to read our information on financial support. The next step might be to list who you need to contact to get help – e.g. your bank, utility companies etc. The third step might be to contact them, and so on. The point is, by breaking it down, and moving through a series of steps, you’re dealing with whatever issue or obstacle is causing you stress. You’re taking control of the situation.

Think of the things that make you happy or grateful. Every day, before getting out of bed or before you go to sleep, think of three things that make you feel happy or grateful. It can be anything you like – the sound of your child laughing, the sight of dogs playing in the park, the scent of freshly mown lawn, the warmth of your partner’s hand as you go for an evening stroll etc. Taking time to think of these things will make you feel more optimistic because there’s so much good around us. We just have to take the time to be aware of it.

Learn from the past. What things have helped you through a hard time in the past? Can you use that strategy/behaviour/resource now? It’s important to remember that you’ve gotten through tough times before, and you will again. It can just be a little hard to see that when you’re still going through it. But as they say, this too shall pass.

Get help. Sometimes you can try really hard, but you just can’t seem to get on top of things by yourself. That’s ok. We’re living through very difficult times, and we all need help from time to time. Talk to trusted family or friends about how you’re feeling. They can help you work through many of the above strategies if you’re struggling. Or it may be time to speak with a mental health professional to get some support that’s specifically tailored to you and your own specific circumstances.

We’ve all been rocked by these extraordinary times, and many of us are finding it difficult to find our footing again. We feel out of control and powerless by so much of what’s going on around us. However, by building our resilience, we’re more able to cope with these challenges and feelings and bounce back more quickly. It takes time and commitment to build your resilience, but it can be done. One step at a time.

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 (helpline@msk.org.au) or via Messenger.

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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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