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    Lisa Bywaters
    07/Dec/2022
    Health InformationMSK articles

    Are we there yet? Tips for travelling

    Travelling can be an incredible adventure, but it can sometimes cause anxiety and stress if you have a chronic condition. When you’re out of your normal routine, it can be impossible to know how you’ll feel each day and how this may affect your trip.

    Here are some tips and tricks to help you get the most out of your trip and have a fantastic time.

    “I wish I had never gone travelling.” Said no one ever.

    Plan your trip

    Take time to plan your trip carefully. Being proactive before you go away allows you to plan around your condition rather than have your condition disrupt your trip. You know how your condition affects you – using this information when planning will put you in control.

    Give yourself plenty of time to pack and complete any tasks or household chores you need to do well before the day you leave.

    Rest up. Even though you may be going on a holiday for rest and relaxation, try and get some rest before you leave. That way, you’ll have more energy to do and see what you want when you arrive at your destination.

    Make your itinerary realistic. When you’re on holiday, it’s tempting to pack as much as possible into every single day; however, this can often lead to increased pain and fatigue. Plan rest days or less active days and create an itinerary that’s flexible depending on how you feel each day. It’s better to do less and prevent flare-ups than do too much and end up unwell.

    Minimise long journeys where possible. Living in Australia, we know long distances are a part of life, whether travelling overseas or within Australia. However, try to avoid packing your itinerary with long plane, train, car, or bus journeys if you can. Make a list of the key sights you want to see, plan your travel around them and be realistic. If you will be travelling for long periods, plan rest stops and consider layovers to make it more achievable.

    If you’re travelling by plane or train, ask for an aisle seat and take strolls up and down the aisles. This’ll help reduce stiffness, and muscle and joint pain. You can also do leg and foot stretches and other gentle exercises while seated.

    Consider informing the airline of your medical condition. With advance notice, the airline should be able to:

    • provide you with wheelchair assistance and early boarding, if necessary
    • have airline personnel carry your luggage for you and/or lift it into the overhead bin
    • accommodate you with special shuttles and elevator platforms for boarding.

    Talk with the transport operators before you leave. Contact the companies before your journey to see what assistance and services they can provide. This goes for all planes, trains, coaches, ships, boats – basically any form of transport operated by someone else. Let them know if you require help and if you have any mobility aids. Have the specifications of your mobility aids handy in case they need this information. Doing this before you go means the operators can be ready for your arrival and save you any potential stress or inconvenience.

    Booking accommodation. When choosing your accommodation, always consider walking distance to other services, the number of stairs and the availability and location of lifts. Make sure you can drop your luggage off at your hotel if you arrive early – you don’t want to carry heavy bags any longer than necessary! Consider booking accommodation with a heated pool or spa, so you can exercise or relax in warm water to loosen sore muscles and ease painful joints.

    “Oh, the places you’ll go.” — Dr Seuss

    Packing for your trip

    Pack light. Packing can be one of the hardest parts of travelling – what to take, what to leave at home – so if in doubt, leave it out. Lifting heavy bags on and off trains, buses and through airports increases your risk of injury and fatigue. When you travel, you also end up carting your luggage around more than you may realise. So packing light is essential. Check out some of the travel websites, articles, and blogs if you need tips and advice on packing.

    Use lightweight luggage if you have it. If you’re buying new luggage, think lightweight and durable. Look for luggage with good wheels and handles that allow for easy manoeuvrability. A suitcase you can push rather than pull places the load squarely in front of you and means you don’t have to twist your wrists. If you don’t own lightweight luggage, see if you can borrow some from your family or friends.

    Don’t forget to pack any special equipment or aids that help make life more comfortable, such as:

    • supportive pillows
    • lightweight hot/cold packs
    • orthotics, splints or braces.

    Consider wearing a mask and using hand sanitiser when you’re on planes, trains and other public transport. Although many of us have gotten out of this habit, COVID is still around. And nothing spoils a holiday faster than getting sick 🤒. Masking and sanitising are the best strategies to reduce your risk of this occurring.

    Separate your medicine. Keep your medicine in separate pieces of luggage to ensure you don’t lose it all should a piece of luggage become lost or stolen. Only carry enough medicine that you need for your own personal use. Pack in your hand luggage any medicine you may need access to quickly so you can get to it when needed.

    Organise your medicines. Being away from your usual routine can make it easy to forget to take your medicine/s at the appropriate time. If you take medicines every day, consider using a pillbox with separate compartments for each day (but keep the original packaging with you). More information on travelling overseas with medicine and medical devices can be found on the Therapeutic Goods Administration website.

    Check size restrictions on luggage and mobility aids with your travel agent, airline or other transport operators.

    “Once the travel bug bites there is no known antidote, and I know that I shall be happily infected until the end of my life.” Michael Palin

    Medical preparation

    Get advice well in advance. Ensure regular blood tests and doctor visits are done before you leave. Discuss any concerns you have about travelling with your doctor (e.g. whether you need to adjust your medicine schedule if travelling to a different time zone).

    Talk with your doctor about vaccinations, especially if you’re going overseas. This protects your own health, but also some countries, airlines and cruise lines require proof of certain vaccinations before entering or boarding. The Smart Traveller website has more information about vaccinations and overseas travel. Note: Some vaccines should be avoided if you have an autoimmune condition or take medicines that suppress your immune system. Your doctor or rheumatologist can advise you on this.

    Check that your medicines are legal and not restricted or banned where you’re going. You can do this by contacting the relevant consulate or embassy; a list is available on the Smart Traveller website. Carry a letter from your doctor listing your medicines, the dosage and what they’re for, as well as your doctor’s contact details. Keep medicines in their original packaging, or if you’re using a pillbox, keep the packaging with the pillbox.

    For more information about medicines and travelling, read Travelling with medications: A guide by the International Association for Medical Assistance to Travellers.

    Stock up. Make sure you have enough medicines (for your personal use) to last until you return home. You may not be able to get the same medicines elsewhere – especially if you’re overseas.

    Store your biological medicines properly. If you’re taking biological medicines (biologics or biosimilars), they may need to be stored at a specific temperature in a special travel wallet. Seek advice from your rheumatologist and the pharmaceutical company about this. Check with your airline/s to see if they can assist you, for example, with ice for the travel wallet or placing your medicine in the aeroplane’s fridge.
    Make sure your container is clearly labelled with your name and contact information, or attach your boarding pass. And make sure you don’t leave your medicine on the plane!

    Don’t place your medicines in with your checked luggage. The baggage compartment gets extremely cold while the plane is in flight, and your medicine may freeze and be ruined.

    Fridges away from home. Once you’re at your destination, you should be able to use the mini-fridge in your hotel room to store your biologics. You should check that the fridge is adjusted properly to a suitable temperature. Also, in some countries, the power in a hotel room turns off when you leave the room. Ask the hotel staff about this upon arrival.
    Contact the pharmaceutical company that makes your biological meds before you travel. Most have a customer support line and are an excellent source of information on the correct storage of medicines.

    “Once a year, go someplace you’ve never been before.” Dalai Lama

    Travel insurance

    Know what you’re covered for. You can get travel insurance if you have a pre-existing condition such as arthritis, but it’s vital that you understand precisely what your coverage provides and whether it’s adequate for your needs. Different types of travel insurance will have different limitations on what’s covered, so shop around. A medical declaration form may be required in some instances. To learn more, check out our information on travel insurance for people with a chronic illness.

    Coming home

    Rest up. After your trip, take a day or so to unpack and rest before returning to your normal routine. Contact your healthcare team if you have to reschedule any medical appointments or have symptoms that need attention.

    Extra tips and references

    Look after yourself. Even though you’re travelling, you should continue to do the things that help you manage your condition and pain at home, such as regular exercise, eating a healthy diet and getting enough quality sleep. They’ll contribute to good physical and mental health and wellbeing and help you keep pain and fatigue in check.

    Getting around airports. Websites for all Australian international airports and domestic terminals have accessibility information, as do the individual airlines. Check these out before you go.

    Give yourself plenty of time to make flights and connections and deal with your luggage. That way, you’re not rushing, which leads to stress and anxiety. Rushing can also make you push yourself too hard and lead to increased pain and fatigue.

    Choose your meals carefully. Most airport and rest stop food choices are high-fat, high-salt, highly processed foods that promote inflammation. Carry healthy snacks, drink plenty of water, and drink alcohol and caffeine in moderation.

    Check out the blogs of other travellers with special needs. Stories of other people who’ve visited the places you want to go to and who have accessibility needs are often great resources to help you plan your journey.

    Take it easy, and have a great time! Remember, your trip is meant to be fun. Travel can be associated with both physical and mental stress that can be magnified if you have a health condition that causes you pain. So when planning your trip, factor in a plan B – just in case your original plan needs to be altered to allow you time to rest or take it easy. For example, if you’d planned a walking tour of a place you’re visiting, look into alternatives such as hop-on/hop-off bus tours or riding a bike. Build enough flexibility into your holiday to allow for these alterations so that you’re relaxed and not stressed about staying on schedule.

    By planning your trip carefully, being flexible with your schedule, and taking your condition into account, you can have a fantastic holiday.

    So get out there and enjoy yourself!

    “We live in a wonderful world that is full of beauty, charm and adventure. There is no end to the adventures we can have if only we seek them with our eyes open.” Jawaharial Nehru

    Contact our free national Help Line

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

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    christmas-blog-2022.jpg
    Lisa Bywaters
    07/Dec/2022
    Health InformationMSK articles

    Surviving the most wonderful time of the year

    The year’s drawing to a close, and we’re exhausted. It’s been another tough one. 😯 It’s no wonder we’re all in the mood to forget the trials and tribulations of 2022 and eat, drink and be merry! ✨

    But we also need to be mindful and take care. In our excitement to get into the festive spirit 🍸, there’s a very real chance we could end up in a painful heap.

    So we’ve made a list (and checked it twice 😉🎄) of tips to help you celebrate without the stress, pain and fatigue. Because all we want for Christmas is family, friends and fun. 😊

    It’s beginning to look a lot like Christmas: Brace yourself for the shopping madness

    • Plan around your pain and fatigue. Wear your most comfortable clothes and shoes, including orthotics if you have/need them. Shopping at this time of the year is almost an extreme sport! So you need to dress for it.
      Grab your walking aid, your shopping list (a foggy brain makes remembering almost impossible) and your shopping buggy/bags.
      Be kind to yourself, as you may feel exhausted for hours/days after your trip. If your battery was already low before you hit the shops, it might take some time to recharge and feel yourself again.
    • Consider wearing a mask and sanitising your hands regularly when you go into the crowded craziness of shopping centres and markets. Although many of us have gotten out of this habit, COVID is still around. Masking and sanitising are the best strategies to reduce your risk of getting sick.
    • Use a trolley or a shopping buggy, even if you only plan to buy a few things. It’ll do the heavy carrying for you, so you can avoid muscle and joint pain.
    • Use your assistive devices, such as walking aids, braces, and orthotics. If you have them, use them. They can make a big difference in how you cope while shopping and how you feel afterwards.
    • Take breaks. Shopping is exhausting and stressful, so take breaks when you need them. Be kind to your body, and don’t push yourself too hard, or you’ll pay for that over the coming hours/days.
    • Shop online. During the past few years, we learned just how many things could be purchased with a few quick mouse clicks (hello, shiny new shoes 😁). So visit your favourite stores online and save yourself some trips to the shopping centre. Just be sure to check the shipping details to ensure your goods arrive on time.
    • Shop local. You don’t need to visit the big shopping centres to find unique gifts or fresh produce. Small, independent local stores often have most of what you need. And many of these businesses have been doing it tough. So share the love and shop local.
    • Be kind to others. Your fellow shopper isn’t the enemy. Be patient, give them space, and be tolerant. The retail staff also deserve our kindness and empathy – they’ve been on the frontline for a long time. And if you feel yourself getting a little hot under the collar, just breathe… and remember we’re all going through tough times.

    Dance of the sugar plum fairy: Festive feasting!

    • Rule #1 – don’t skip meals. It’s a common mistake to make. You’re anticipating a delicious lunch and/or dinner with all your favourite foods, so you skip meals to make space. But this can lead to overeating because you’re so hungry 😫 when you finally do get to eat. It’s also not a great idea to have an empty stomach when taking certain meds or drinking alcohol. So make sure you eat, even if it’s a small meal, to tide you over until you get to the main event.
    • Stay hydrated. The silly season is usually a hot time of the year, and it’s easy to become dehydrated. Especially if you’re drinking alcohol and/or playing backyard cricket, so keep the water flowing.
    • Cook/bake things ahead of time. Many foods we enjoy at our holiday gatherings can be made days and sometimes weeks before the big day. That means you don’t have to work yourself into a cooking frenzy on Christmas Eve and Christmas Day. And you’re more likely to enjoy yourself on the day if everything’s prepped and ready to go.
    • If you’re hosting, ask your guests to bring a plate. This shares the work and the cost and ensures those with special dietary requirements can bring food that accommodates their needs.
    • Slow down and relax. Really take the time to catch up with the important people gathered around the table 🧡 and enjoy sharing a delicious meal 😋.

    Santa baby: Buying gifts

    • Take a leaf out of the big guy’s book 🎅 – write a list and check it twice. Knowing what gifts you’re looking for before you hit the shops will save you time, energy and money.
    • Consider spending less. It’s been a tough year financially for many of us, and things are only getting tougher. So it makes sense to be economical and save some dollars. You don’t want to head into 2023 with massive debts.
    • Make your own gifts. Embrace your inner creative guru and bake, paint, draw, build, knit or sew your presents. Another option is to make your own gift vouchers – for example, 1 hour of babysitting or dog walking.
    • Talk with your people about doing a Kris Kringle or Secret Santa gift exchange 🎁. It’s perfect if you have a lot of people to buy for. And they save money, time, stress and frustrating shopping expeditions.
    • Give gift cards and vouchers. They’re an excellent idea for someone who’s hard to buy for or already has everything. And you can get many of them online – without the hassle of changing out of your pyjamas or leaving the comfort of your couch 😄.
    • Donate to charity. Instead of buying a gift for those who have everything they want or need, consider donating in their name to their favourite charity.
    • When it comes to wrapping, gift bags are easier on sore hands than cutting paper and using sticky tape. They’re also a lifesaver for those of us who are hopeless at wrapping 😉.

    Deck the halls: Decorating

    • Get the family involved. Put on some music and have fun with it. Decorating your home and your tree is all about the joy of the festive season, being together and the love of shiny tinsel 😊.
    • Keep it simple. Remember, what you put up has to be packed away. So if that thought fills you with dread, choose the ‘less is more’ option. Or plan to do it over a period of days, rather than all in one go.
    • Save your back when decorating the tree by putting your baubles and tinsel on a table or bench. That way, you’re not constantly bending over to pick them up.
    • Use a step ladder rather than overstretching. And if you have any balance issues, ask someone else to do the high stuff.
    • Remember, things don’t have to be ‘perfect’. That’s too much pressure. Things should be happy and festive, so fling some tinsel over the banister, a wreath on the door, and presents under the tree. Job done! 🎄

    Rockin’ around the Christmas tree: Hosting gatherings

    • Keep it COVID-safe. As we know, COVID’s still around, as are many other bugs and germs. So it’s important to have plenty of soap and hand sanitiser available.
      If you feel unwell, get tested, stay home, or cancel your gathering. That last one will be incredibly tough, as we’re so used to soldiering on through our aches, pains and fatigue, but if you think there’s even the smallest chance you have COVID, get tested and keep everyone safe by isolating until you know you don’t have the virus.
      And ask your guests to do the same. Again, it’s a tough thing to do, but no one wants to get sick. Especially at this time of the year, when we’re already run down and are just looking forward to a break.
    • Keep it simple. As with decorating, keep your celebrations simple. Seriously after the year we’ve had, any celebration will be epic!
    • Take a seat. Get off your feet and rest when you need to.
    • Be medicine-wise.
      • Over-the-counter and prescription medicine may help you manage pain and inflammation so you can enjoy your day. If you’re not sure what will work best for you, talk with your doctor or pharmacist.
      • Watch the alcohol. Many medicines don’t mix well with alcohol, so find out if drinking while taking your meds is okay. If you can drink, avoid drinking to excess. Try mixing a small amount of bubbles with orange juice or soda water with white wine. Or choose zero-alcohol drinks and mocktails.
    • Give yourself a break when it comes to cleaning and packing up. Get the family and your guests involved – even if it’s simple things like folding up chairs or bringing dishes to the kitchen. And ask yourself – do you really need to do everything immediately? As long as you put away any perishables and get rid of rubbish, everything else can be done the next day after you’ve had a rest.

    Have yourself a merry little Christmas: Taking care of you

    • Manage stress. Christmas and the holidays can be stressful, but you need to manage your stress as best you can or risk having a flare. So pull out your best stress management strategies and use them as often as you need to.
    • Pace yourself. When you’re hosting an event, it’s easy to get carried away and be constantly on the move. Gatherings can be a marathon, so pace yourself so you don’t run out of steam before the end. The same goes if you’re visiting others. Travelling to and from your home to theirs, being a witty conversationalist 😉 and just interacting with others can be exhausting.
    • Get some sleep, and rest when you need it. With so many events and gatherings happening at this time of year, it’s easy for our sleep to be disrupted. And we have enough problems with sleep at the best of times! Try as much as possible to stick to your sleep schedule and take rest breaks or naps when needed.
    • Stay active. Regular exercise is essential all year round for managing a musculoskeletal condition and chronic pain. It’s also important to help offset some of the extra kilojoules you may be consuming at this time of year. And it’ll help you deal with excess stress and sleep issues.
    • Listen to some tunes. Music helps to reduce anxiety, fear, depression, pain-related distress and blood pressure. And it’s an easy, cost-effective and enjoyable way to relieve pain🎵. Happy holidays everyone! From all of us at Musculoskeletal Australia, we wish you a happy, fun, safe and pain-free festive season. 🎄🎁🥗🍹

    Contact our free national Help Line

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

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    osteoporosis.jpg
    Lisa Bywaters
    16/Nov/2022
    Health InformationMSK articles

    Osteoporosis: The unseen problem of fragile bones

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

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

    So what is osteoporosis?

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

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

    Your bones

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

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

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

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

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

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

    Causes of osteoporosis

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

    Risk factors you can’t change:

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

    Risk factors you can change:

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

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

    Symptoms of osteoporosis

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

    Diagnosing osteoporosis

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

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

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

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

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

    Treating osteoporosis

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

    Calcium

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

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

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

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

    Vitamin D

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

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

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

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

    Exercise

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

    The types of exercise that benefit bone health include:

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

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

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

    Medicines

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

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

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

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

    Other medicines:

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

    What else can I do to manage my condition?

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

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

    Contact our free national Help Line

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

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    road-trip.jpg
    Lisa Bywaters
    16/Nov/2022
    Health InformationMSK articles

    11 tips for safe, comfortable and happy road tripping

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

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

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

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

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

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

    1. Talk with your doctor before you hit the road

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

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

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

    This brings us to the next tip…

    2. Know how your medicines affect you

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

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

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

    3. Wear comfy clothes

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

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

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

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

    4. Plan your trip

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

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

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

    5. Get comfortable in the car

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

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

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

    6. Take breaks and notice the world around you

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

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

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

    7. Stay hydrated and eat well

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

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

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

    8. Manage your fatigue

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

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

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

    9. Check out aids and gadgets

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

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

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

    10. Use heat and cold treatments

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

    11. And have fun!

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

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

    Contact our free national Help Line

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

    More to explore

    CONTINUE READING
    falls.jpg
    Lisa Bywaters
    16/Nov/2022
    Health InformationMSK articles

    Staying on your feet

    Tips for preventing falls

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

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

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

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

    Let’s start with some facts

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

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

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

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

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

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

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

    What causes people to fall?

    Health issues

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

    The environment

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

    Reducing your risk

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

    Exercise regularly

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

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

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

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

    Look after your health

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

    Move around safely

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

    Choose your clothing and footwear carefully

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

    Reduce the hazards in your home

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

    What to do if you fall

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

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

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

    If you can get up:

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

    If you can’t get up:

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

    Services to help keep you safe

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

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

    Contact our free national Help Line

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

    More to explore

    References

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

    CONTINUE READING
    question.jpg
    Lisa Bywaters
    13/Oct/2022
    Health InformationMSK articles

    Can I avoid getting arthritis?

    We get asked this question a lot! But unfortunately, it’s not a simple ‘yes’ or ‘no’ answer.

    Arthritis is a general term used to describe over 150 different conditions. The more accurate name for them is musculoskeletal conditions, as they affect the muscles, bones and/or joints.

    They include osteoarthritis, back pain, rheumatoid arthritis, fibromyalgia, gout, polymyalgia rheumatica, lupus, osteoporosis and ankylosing spondylitis.

    Around 7 million Australians live with a musculoskeletal condition, including kids. So can you avoid becoming one of them?

    Maybe? Not really? It depends? 🙄

    Because there are many different types of musculoskeletal conditions, the answer depends on various factors.

    For conditions like rheumatoid arthritis, juvenile arthritis, ankylosing spondylitis, and lupus, we don’t really know their cause. Without knowing the cause, it’s hard to prevent something from occurring.

    What we do know is that they’re autoimmune conditions. That means they occur due to a malfunctioning immune system. Instead of attacking germs and other foreign bodies, the immune system targets joints and healthy tissue, causing ongoing inflammation and pain. We don’t know why this happens, but scientists believe that a complex mix of genes and environmental factors is involved.

    At this stage, we can’t change a person’s genetics to prevent them from developing an autoimmune type of arthritis, or conditions like osteoporosis and Paget’s disease, which are also linked to genetics. Many musculoskeletal conditions also become more common as you get older and are more common in women.

    Other health issues, such as diabetes, kidney disease, coeliac disease, and even other musculoskeletal conditions 😫, can also increase your risk of developing a musculoskeletal condition. For example, chronic kidney disease can increase your chance of developing gout, and rheumatoid arthritis increases your risk of developing osteoporosis and fibromyalgia.

    So that’s the bad news.

    The good news is there are things you can do to reduce your risk of developing a musculoskeletal condition. Or, if you develop one, reduce its impact and severity.

    Maintain a healthy weight

    Excess body weight puts more pressure on your joints and increases the stress on cartilage, especially in weight-bearing joints like your hips, knees, and back. For every kilo of excess weight you carry, an additional load of 4kgs is put on your knee joints.

    In addition to putting added stress on joints, fat releases molecules that increase inflammation throughout your body, including your joints. Being at a healthy weight reduces this risk.

    Being overweight or obese is strongly linked to developing osteoarthritis (OA), most often in the knees. Hand OA is also more common in people who are overweight.

    Back pain and inflammatory conditions such as gout, rheumatoid arthritis, and psoriatic arthritis have also been linked to being overweight.

    If you have a musculoskeletal condition, maintaining a healthy weight, or losing weight if you’re overweight, can decrease your pain, allow you to become more active, and decrease your risk of developing other health problems like heart disease and diabetes.

    Quit smoking

    As well as the obvious links to cancer and lung disease, smoking’s linked to back pain, neck pain, rheumatoid arthritis and osteoporosis. Smoking also causes fatigue and slower healing, which can make pain worse. And it can make some medications less effective.

    So quitting smoking has many health benefits. Within weeks of quitting, you’ll breathe easier and have more energy, making it easier to exercise and do your day-to-day activities. Find out more about the impact of smoking and ways to quit for good.

    Stay active and exercise regularly

    Regular exercise is vital for overall good health and keeps you fit, independent and mobile. Being active helps keep your muscles, bones and joints strong so that you can keep moving. It reduces your risk of developing other conditions such as osteoporosis, heart disease, diabetes and some forms of cancer. It boosts your mood, benefits your mental health, helps with weight control and improves sleep.

    Having strong muscles is also essential to reduce your risk of falls.

    Look after your mental health

    Mental health conditions can increase the likelihood of developing some musculoskeletal conditions. For example, people with depression are at greater risk of developing chronic back pain. And living with a painful musculoskeletal condition can have a significant impact on mental health.

    If you’re living with anxiety, depression, or another mental health condition and feel that you’re not coping well, it’s important to seek help as soon as possible. This will ensure you don’t prolong your illness and worsen your symptoms. It becomes harder and harder to climb out of a depressive episode the longer you wait. Similarly, the longer you put off seeking help for anxiety, the more anxious you may become about taking that first step.

    There are many different types of treatment options available for mental health conditions. The important thing is to find the right treatment and health professional that works for you. With the proper treatment and support, they can be managed effectively.

    Get enough calcium and vitamin D

    Calcium and vitamin D are essential to building strong, dense bones when you’re young and keeping them strong and healthy as you age.

    Getting enough calcium each day will reduce your risk of bone loss, low bone density, and osteoporosis.

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

    Vitamin D is also essential for strong bones, muscles and overall health. The sun is the best natural source of vitamin D, but it can be found in some foods.
    If you’re unable to get enough calcium or vitamin D through your diet or safe sun exposure, talk about calcium and/or vitamin D supplements with your doctor.

    Protect your joints

    Joint injuries increase your risk of getting OA. People who’ve injured a joint, perhaps while playing a sport, are more likely to eventually develop arthritis in that joint. So it’s important to protect against injury by:

    • maintaining good muscle strength
    • warming up and cooling down whenever you exercise or play sport
    • using larger, stronger joints or parts of the body for activities, for example, carrying heavy shopping bags on your forearms, rather than the small joints in your fingers
    • using proper technique when exercising, for example, when using weights at the gym or when playing sports, especially those that involve repetitive motions such as tennis or golf
    • maintaining a healthy weight
    • avoiding staying in one position for extended periods
    • seeking medical care quickly if you injure a joint.

    Drink alcohol in moderation

    Excessive alcohol consumption contributes to bone loss and weakened bones, increasing your risk of osteoporosis. For people with gout, drinking too much alcohol, especially beer, can increase your risk of a painful attack.

    It can also affect your sleep, interact with medicines, and affect your mental health. To find out more about the risks of drinking too much alcohol and how you can reduce your alcohol intake, read ‘Should I take a break from booze?’.

    Manage stress

    While stress on its own is unlikely to cause someone to develop a musculoskeletal condition, chronic stress or a stressful event may be a contributing factor, especially with conditions such as fibromyalgia and back pain.

    It can also cause issues with sleep, mood, increase pain, and make you more prone to flares if you have a musculoskeletal condition. It can then become a cycle of stress, poor sleep, pain and more stress. And this can be a difficult cycle to break.

    But there are things you can do to deal with stress. Try relaxation techniques such as meditation, breathing exercises and visualisation, and avoid caffeine, alcohol and cigarettes.

    Talk to someone – whether it’s a family member, friend or mental health professional, about what’s stressing you out so you can deal with it.

    Talk with your doctor

    If you’ve been experiencing joint or muscle pain, it’s important that you discuss your symptoms with your doctor. Getting a diagnosis as soon as possible means that treatment can start quickly, reducing the risk of joint damage and other complications.

    Final word

    While at this moment in time, we can’t absolutely 100% prevent ourselves from getting a musculoskeletal condition, the good news is that early diagnosis and treatment will give you the best outcomes.

    Treatments for many of these conditions have come a long way in recent years, and most people live busy, active lives with musculoskeletal conditions. 😊

    Call our Help Line

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

    More to explore

    CONTINUE READING
    osteoarthritis-blog.jpg
    Lisa Bywaters
    13/Oct/2022
    Health InformationMSK articles

    Osteoarthritis: It’s not ‘just’ arthritis

    Osteoarthritis is the most common form of arthritis. And because of this, I think it’s often dismissed, and its effects underestimated.

    I mean, how often have you heard people say, ‘it’s just wear and tear’, ‘we’ll all get it eventually’, or my personal favourite ‘it’s just a bit of arthritis’ 😤? These offhand comments trivialise the considerable pain and disability that osteoarthritis (OA) causes many Australians.

    If you have OA or know someone who does, you know it can significantly impact every aspect of life. Symptoms such as persistent pain, fatigue, stiff and swollen joints, weakened muscles, anxiety, depression, and sleep problems can affect a person’s ability to be as involved in social, community and work activities as they might like.

    So, no, it’s not ‘just’ arthritis.

    Let’s look at what it is.

    What is osteoarthritis?

    As we know, OA is the most common form of arthritis. It’s most likely to develop in people over 45, but it can also occur in younger people. It frequently affects weight-bearing joints, such as the knees, hips, feet, and spine. The joints of the hands, including the thumbs, are also commonly affected.

    While it was once thought to be an inevitable part of ageing, resulting from a lifetime of wear and tear on joints, we now know it’s a complex condition and may occur due to many factors.

    Osteoarthritis and your joints osteoarthritis

    To understand how OA affects your body, it’s helpful to know a little about your joints.

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

    Covering the ends of your bones is a thin layer of tissue called cartilage. It provides a slippery cushion that absorbs shocks, helps your joints move smoothly and prevents bones from rubbing against each other.

    Around most of your joints is a tough capsule that holds your bones in place. The inside of the capsule is lined with synovial membrane, which produces synovial fluid. This fluid lubricates and nourishes the cartilage and other structures in the joint.

    With OA, the cartilage becomes brittle and breaks down. Some pieces of cartilage may even break away and float in the synovial fluid. Because the cartilage no longer has a smooth surface, the joint becomes stiff and painful to move.

    Eventually, the cartilage can break down so much that it no longer cushions the two bones. Your body tries to repair this damage by creating extra bone. These are bone spurs (or osteophytes). Bone spurs don’t always cause symptoms but can sometimes cause pain and restrict joint movement.

    OA causes and risk factors

    Many things can increase your chances of developing OA, including:

    • your age – people over 45 are more at risk
    • being overweight or obese
    • your genetics – the genes you inherit can play a role in developing OA
    • other conditions – such as rheumatoid arthritis and gout, can cause damage to your joints and lead to OA
    • gender – 3 in 5 people who have OA are women
    • repetitive movements associated with your job or occupation (e.g. constant kneeling, squatting, lifting heavy loads)
    • significant injury, surgery, damage or overuse of a joint.

    Signs and symptoms

    The symptoms of OA can vary from person to person. Some of the more common symptoms include:

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

    These symptoms can sometimes worsen, especially when you feel stressed, upset, overdo things, or don’t get enough sleep. This is called a flare or flare-up.

    Diagnosing OA

    If you’ve been experiencing joint pain, it’s essential you discuss your symptoms with your doctor. Getting a diagnosis as soon as possible means that treatment can start quickly. This will give you the best possible outcomes.

    To diagnose your condition, your doctor will do some exams or tests. They may include:

    • Your medical history. Your doctor will ask you about your symptoms, family history and other health issues.
    • Physical examination. Your doctor will look for swelling in and around the joint and test your joint’s range of movement. They’ll also feel and listen for grinding, rubbing or creaking in the joint.

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

    Treating OA

    There’s no cure for osteoarthritis; however, your symptoms can be effectively managed with exercise, weight management, medicines, and self-care.

    Exercise

    Because of the old ‘wear and tear’ myth, many people are worried that exercising joints with OA will cause more joint damage. But regular exercise can actually help reduce some of your symptoms (e.g. pain, stiffness) and improve your joint mobility and strength. It will also move synovial fluid through the joint, providing essential nutrients and removing waste.

    Exercises that move your joints through their range of movement will also help maintain joint flexibility; this is often lost due to OA. Strengthening the muscles around your joints is also important. The stronger they are, the more weight they can take. This will help support and protect your joints.

    An exercise program that promotes muscle strength, joint flexibility, improved balance and coordination, and general fitness will give you the best results. Start exercising slowly and gradually increase the time and intensity of your exercise sessions over weeks and months. A physiotherapist or exercise physiologist can help you work out an exercise program that’s right for you.

    Weight management

    Being overweight or obese increases your risk of developing OA and the severity of your condition. The additional weight also increases pressure on your joints, especially your weight-bearing joints (e.g. hips, knees, feet), which is likely to cause further pain and damage.

    The amount of overall fat you carry is also significant because fat releases molecules that contribute to low but persistent levels of inflammation across your whole body. This, in turn, increases the level of inflammation in the joints affected by OA.

    For these reasons, maintaining a healthy weight is essential if you have OA. Your doctor or dietitian can advise you on safe weight-loss strategies if you need to lose weight.

    Weight loss can be a long process for many people. It’s challenging, especially when pain affects your ability to be as active as you’d like. But it’s good to know that any weight loss can reduce your pain and increase your ability to exercise. So making small, achievable changes to your eating and exercise habits can bring big results. It just takes time, commitment, and support.

    Medicines

    No medicines can affect the underlying disease process of OA, but combined with exercise, weight management, and self-care, medicines may provide temporary pain relief and help you stay active.

    The most commonly used medicines for OA are:

    • Non-steroidal anti-inflammatory medicines or NSAIDs (e.g. ibuprofen). These medicines are available over-the-counter and with a prescription, depending on their dosage and other ingredients. They come in tablet/capsule form (oral NSAIDs) or as a gel or rub applied directly to the skin (topical). It’s important to note that oral NSAIDs are designed to be taken at low doses for short periods. Always talk with your doctor before starting NSAIDs, as they can have side effects.
    • Paracetamol. Research has shown that paracetamol provides only low-level pain relief for osteoarthritis. However, some people report that it helps reduce their pain so they can be more active. For this reason, it’s worth discussing a trial of paracetamol with your GP to see if it‘s appropriate for you.
    • Corticosteroid (steroid) injections may be helpful for people who haven’t found relief from other treatments (e.g. exercise, weight loss) or other medicines. Corticosteroid injections into a joint can provide short-term pain relief; however, the number of injections you can have each year is limited due to potential harm.

    Note: Opioids are powerful pain-relieving medicines that effectively reduce acute pain (or the pain resulting from an injury or surgery). In the past, they were prescribed to treat pain associated with conditions like osteoarthritis; however, there’s strong evidence that they have little effect on OA pain. Opioids also have many potentially serious side effects. That’s why they’re not recommended in the management of OA. Read the Choosing Wisely Australia resource ‘5 Questions to ask about using opioids for back pain or osteoarthritis’ for more info.

    Self-care

    There are many other things you can do to reduce the impact of your symptoms, including:

    • Learning about your condition. Understanding OA and how it affects you means you can make informed decisions about your healthcare and actively manage it.
    • Learning ways to manage your pain. Pain is the most common symptom of osteoarthritis, so it’s crucial to learn to manage it effectively. Read our A-Z guide for managing pain for more information.
    • Working closely with your healthcare team. The best way to live well with OA is by working closely with the people in your healthcare team (e.g. GP, physio) and keeping them informed about how you’re doing and alerting them to any changes.
    • Protecting your joints. Supports such as walking aids, specialised cooking utensils, ergonomic computer equipment and long-handled shoehorns can reduce joint strain and make life easier. An occupational therapist can advise you on aids, equipment and home modifications. You can also check out our range of aids in our online shop.
    • Taping, knee braces and orthotics may be helpful if you have OA in your knees or feet. A physiotherapist or podiatrist can advise you on these.
    • Improving sleep quality. Not getting enough quality sleep can worsen your symptoms; however, getting a good night’s sleep when you have osteoarthritis and chronic pain can be challenging. If you’re having problems sleeping, talk with your doctor about ways you can address this.
    • Managing stress. Stress can also aggravate your symptoms, so learning to deal with stress is extremely helpful. Things you can do to manage stress include planning your day and setting priorities, using relaxation techniques such as going for a walk, getting a massage or listening to music, and, where possible, avoiding people and situations that cause you stress.
    • Eating a healthy, balanced diet. While there’s no specific diet for OA, it’s important to have a healthy, balanced diet to maintain general health and prevent weight gain and other medical problems, such as diabetes and heart disease.

    Surgery

    In most cases, surgery isn’t required for people with osteoarthritis. However, surgery may be an option if all non-surgical treatment options have been unsuccessful and you’re still experiencing significant pain and loss of function.

    The most common surgery for osteoarthritis is a joint replacement. When considering surgery, you should be informed about what it involves, the rehabilitation process, and its potential benefits and risks.

    Note: An arthroscopy isn’t recommended to treat knee OA. Evidence shows it’s not effective in improving OA knee pain or function.

    Contact our free national Help Line

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

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    cleaning.jpg
    Lisa Bywaters
    13/Oct/2022
    Health InformationMSK articles

    Spring cleaning the easy way

    Tips to help you sweep away winter

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

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

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

    Planning, prioritising and pacing

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

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

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

    Take breaks

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

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

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

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

    Get the right tools for the jobs

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

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

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

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

    Choose your battles

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

    Let the cleaning products do the hard work

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

    Beware of dust and toxic smells

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

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

    Recycle old socks

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

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

    Use your dishwasher for more than dishes

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

    Consider reorganising your pantry, laundry or kitchen

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

    Get some wheels

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

    Repackage it

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

    Alternate your cleaning activities

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

    Get the family involved

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

    De-clutter

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

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

    Hire someone

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

    Distract yourself with music, podcasts and audiobooks

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

    Give your medicine cabinet a spring clean too

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

    Things don’t have to be perfect…

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

    Call our Help Line

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

    More to explore

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    JIA-blog-Sep-2022.jpg
    Lisa Bywaters
    20/Sep/2022
    Health InformationMSK articles

    Kids get arthritis too

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

    What is juvenile idiopathic arthritis (JIA)?

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

    What causes JIA?

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

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

    The job of your immune system is to look out for and attack foreign bodies – like bacteria and viruses – that can make you sick. However, in the case of JIA, the immune system mistakenly targets healthy tissue in and around the joints, causing ongoing inflammation and pain. We don’t know why this happens, but scientists believe that a complex mix of genes and environmental factors is involved.

    Types of JIA

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

    Oligoarthritis JIA

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

    Polyarthritis JIA

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

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

    Enthesitis-related JIA

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

    Psoriatic JIA

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

    Systemic JIA

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

    Undifferentiated JIA

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

    What are the signs that my child may have JIA?

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

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

    Less common symptoms include:

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

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

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

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

    What is uveitis?

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

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

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

    How is JIA diagnosed?

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

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

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

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

    How is JIA treated?

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

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

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

    Medicines

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

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

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

    What can we do to control symptoms?

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

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

    Contact our free national Help Line

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

    MSK Kids

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

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    gardening.jpg
    Lisa Bywaters
    20/Sep/2022
    Health InformationMSK articles

    Weed ‘em and reap

    Tips to help you in the garden

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

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

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

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

    Lettuce do our best: Pacing

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

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

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

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

    Just dill with it: Warming up is important

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

    Cactus makes perfect! Good posture and technique

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

    Do you have the thyme? Know your limits

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

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

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

    If bush comes to shove: Love local

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

    Pot it like it’s hot: Contain your garden

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

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

    What a re-leaf! Raised and vertical gardens

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

    Say aloe to my little friend: Tools and gadgets

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

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

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

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

    Water you doing today? Staying hydrated

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

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

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

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

    Time to turnip the heat: Loosen those tired muscles

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

    Need some encourage-mint? See an OT

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

    Don’t moss around, get out there!

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

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

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

     

    Contact our free national Help Line

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

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