Note: I’ve been listening to great music while writing this article. I’ve embedded some links so you can share the love 💛.

Bored with your usual exercise program? Why not follow David Bowie’s advice and “put on your red shoes and dance the blues”?

Dancing is a fun, expressive and social form of exercise. It’s also a great way to meet new people.

There are many dance styles to try – from salsa to hip hop, ballroom or belly dancing. Or you can shake your tail feather around the house when a great song comes on the radio.

Why you should be dancing

If you’re like me, the idea of dancing, especially in public, is terrifying. I’m uncoordinated, clumsy and have never felt comfortable or natural moving to music. My partner is changing that, one ‘box step’ at a time. Not the unco, clumsy part – he’s not a miracle worker 😂. But becoming more comfortable just dancing. You see, he’ll literally dance at the drop of a hat. At home, in his coffee shop, in the supermarket. It makes him happy.

And when he’s happy, I want to join in on that happiness.

So that’s a key reason to dance – happiness 😊.

It’s also a very social activity. Joining a dance class or going to clubs is an opportunity for you and your friends to have a fun, physical outing. And you may make new friends. What’s not to love about that? 💜

Gonna make you sweat (Everybody dance now): Dancing is exercise

The Australian physical activity guidelines recommend that adults be active most days of the week, preferably every day.

That means that each week, adults should do either:

  • 2.5 to 5 hours of moderate intensity physical activity – e.g. a brisk walk, golf, mowing the lawn or swimming. Moderate intensity means you can talk comfortably but not sing.
  • 1.25 to 2.5 hours of vigorous intensity physical activity – e.g. jogging, aerobics, fast cycling, soccer or netball. Vigorous intensity means you can only say a few words without gasping for breath.
  • an equivalent combination of moderate and vigorous activities. (1)

So dancing – at a moderate or vigorous intensity – is a fun and creative way to contribute to your weekly dose of exercise.

Everybody dance: Other health benefits

Chic put it so well in their song, “Dancing helps relieve the pain, soothes your mind, makes you happy again. Listen to those dancing feet. Close your eyes and let go.“ But don’t just take the word of those disco legends… dancing:

  • improves the health of your heart and lungs
  • improves circulation of blood and synovial fluid through joints
  • relieves pain and stiffness
  • reduces fatigue
  • helps you sleep better
  • improves strength, endurance and stamina
  • improves balance, coordination and flexibility
  • helps keep bones strong and prevent falls
  • lowers stress levels and improves your mood
  • helps you maintain a healthy body weight or lose weight when combined with a weight-loss eating plan
  • builds self-confidence
  • improves brain health and cognitive functions
  • nurtures your creative side and allows you to express yourself
  • improves overall health and fitness.

Dance, dance: Getting started

OK, if I’ve sold you on dancing, it’s time to get started. And a good way to do that is to think about the different dancing styles and ask yourself…

  • What style appeals to me?
  • What do I want to get out of dancing? For example, do I want to:
    • meet new people?
    • get fit?
    • improve my balance and coordination?
    • get involved in competitions?
  • Do I want to dance on my own or with a partner?

Thinking about these things can help you choose the style that best meets your needs.

You also need to be conscious of the physical demands of the dance style. For example, if there’s a lot of jumping or moves that put significant pressure on joints, it may not be suitable if you have arthritis in your hips, knees or feet. That being said, there are so many styles to choose from, including:

Once you’ve picked a style, as you would before starting any new exercise program, you need to consider your fitness level and other health issues. If it’s been a while since you’ve been active, talk with your doctor before you start.

Flashdance: What to wear?

Your clothing needs to be comfortable and allow you to move freely. But you don’t want any trailing sleeves and long skirts. They’ll be a trip hazard. So leave your inner Stevie Nicks at home, at least until you’re a more proficient dancer 😁.

As far as shoes go, some dance styles, like tap, require special shoes. But for the most part, when starting out, you can generally wear shoes you already have. Just make sure they’re flexible, comfortable and provide good support. And it’s best to start in low shoes that allow you to move smoothly and safely across the floor.

Other tips for a safe(ty) dance

Dancing is exercise, so start slowly and learn good technique. You should also:

  • Consider getting family or friends involved. It’s fun to explore new experiences, like dance classes or groups with others, especially if you’re a little nervous or find it difficult to get motivated on your own.
  • Warm up before you start. Don’t just ‘lose yourself to dance’. Give your body time to loosen up and get ready for some exertion.
  • Drink enough water and stay hydrated – before, during and after dancing.
  • Take breaks, and rest when you need to. It’s easy to get caught up and overdo it, especially when you’re having a good time. So listen to your body and take regular breaks.
  • If you feel unusual pain, stop that move or dance sequence, and get advice from your dance instructor, physiotherapist or exercise physiologist. You may be overextending a joint or moving in a way that’s not great for your musculoskeletal condition. So safety first.
  • Cool down when you finish.
  • Have a wonderful time!

Dance hall days: Finding a place to dance

  • Start at home if you’re nervous about going public with your dance moves. Put some music on, and go for it. Make sure you have plenty of space and there are no slip or trip hazards (e.g. rugs, pets). Other safety issues such as talking with your doc, wearing appropriate clothing and footwear, warming up, cooling down and hydrating still apply.
  • Check out some online groups and classes. There’s so much available online. This has been a positive of the pandemic – an enormous growth in good online resources. You’re sure to find something that suits you. If you’re looking for inspiration, YouTube and TikTok have some great dance content. Just watch them carefully and evaluate them as you would any other online health content. Our article Online exercise – look before you leap provides a list of things to consider before starting any online exercise (including dance).
  • Visit websites of local community houses and clubs as they often provide dance classes as part of their exercise offerings.
  • Dance schools and studios often provide more formal dance training. This may be of particular interest if you want to perfect your dance technique, enter competitions or learn a style unavailable in your local community.
  • Hit a club or pub. And if you’re groaning about a late night (which I do regularly), many venues have afternoon music and dance sessions or dinner dances. You just have to keep an eye on local venues.
  • No Lights, No Lycra. This a place for people to come and dance freely in a friendly, non-threatening, drug and alcohol-free atmosphere. It happens in a dimly lit room with the lights low so people can truly dance without worrying about what they look like. No Lights, No Lycra events happen all over the world. You can find your closest venue here.

Contact our free national Help Line

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

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More dance tunes to get you in the mood!

These songs will have you cutting the sleeves off your jumpers to make leg warmers (à la Flashdance) in no time 😅.


  1. Australian Government, Department of Health and Aged Care. Physical activity guidelines: For adults (18-64 years) 


Do you remember the TV show House? Hugh Laurie played the brilliant but grumpy, antisocial doctor addicted to pain meds who secretly has a heart of gold. Yep, it had all the tropes 😂.

The show created a lupus meme – where a diagnosis of lupus was often mentioned on the show to which House’s reply would always be, ‘it’s not lupus’. And most of the time, he was right.

The meme highlights the fact that lupus is rare, complex, and difficult to diagnose.

And sometimes, it is lupus (as was the case in an episode in season 4).

So what is lupus?

Lupus (systemic lupus erythematosus) is a chronic condition that can cause inflammation and pain in any part of your body. Symptoms vary from person to person and can range from mild to severe.

Anyone can get lupus; however, women are more likely to develop it than men. It’s usually diagnosed in people aged between 15-45.

Certain ethnic groups are also more likely to develop lupus, such as Indigenous Australians, Africans, Hispanics, Asians and Native Americans.


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

Your immune system is designed to identify foreign bodies (e.g. bacteria, viruses) and attack them to keep you healthy. But in the case of lupus, your immune system mistakenly targets healthy tissue.

This causes pain and inflammation in parts of the body such as the skin, joints, and internal organs (e.g. kidneys, heart and lungs).

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


Symptoms can vary greatly between people and may include:

  • skin rashes
  • joint and muscle pain
  • sensitivity to light
  • hair loss
  • fatigue
  • fever
  • mouth ulcers
  • weight changes
  • organ involvement (e.g. kidneys, heart, lungs)
  • pale, blue, or red fingers or toes triggered by cold or stress (Raynaud’s phenomenon)

It’s unlikely that one person will experience all of these symptoms. At times the symptoms you experience as a result of your lupus (e.g. rash, pain, fatigue) will become more intense. This is a flare.

Flares are unpredictable and can seem to come out of nowhere. They’re often triggered by stress or exposure to ultraviolet light.


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

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

  • Your medical history. Your doctor will ask about your symptoms, family history and other health issues.
  • A physical examination – including your joints and skin to look for any signs of change, inflammation and rashes.
  • Blood and urine tests.
  • Tissue biopsies of the skin or kidneys.

Test results also help rule out other conditions that may have similar symptoms.

Your GP should refer you to a rheumatologist if they think you have lupus. Rheumatologists are doctors who specialise in diagnosing and treating problems with joints, muscles, bones and the immune system.


While there’s no cure for lupus, treatments are available to help control disease activity and improve symptoms. They include medicines and self-care.


Medicine can help manage your symptoms and assist in controlling your immune system.

Because people with lupus experience different symptoms, and to varying degrees, there’s no ‘one size fits all’ treatment. You might need to take a combination of medicines.

  • Hydroxychloroquine is very effective at reducing inflammation and reducing flares. It’s the first-line medicine for most people with lupus.
  • Non-steroidal anti-inflammatory drugs or NSAIDs may temporarily relieve pain and inflammation. NSAIDS should be avoided by people with kidney disease.
  • Corticosteroids (or steroids) are used to quickly control or reduce inflammation. They come in different forms: tablets, injections, or a cream to apply to skin rashes.
  • Disease-modifying drugs may be needed to suppress your immune system and control symptoms if you don’t respond to hydroxychloroquine and/or steroids.
  • Biological disease-modifying medicines (biologics and biosimilars) also suppress the immune system. They may be used in more severe cases of lupus that aren’t responding to treatment. These medicines target the specific cells and proteins that cause inflammation and tissue damage rather than suppressing your entire immune system.

All medicines can have side effects. It’s important you discuss these with your doctor and know what to do if you experience any. Your doctor will also monitor your response to the medicines closely. You may need regular blood tests depending on the medicines you’re taking.

You should also inform your doctor of any other medicines or complementary therapies you take. They can potentially affect your lupus medicines.


There are many things you can do to manage your lupus.

  • Learn about your condition. Understanding lupus allows you to make informed decisions about your healthcare and actively manage it.
  • Manage your exposure to ultraviolet (UV) light. UV light, especially sunlight, can cause a flare. This can include skin rashes in sun-exposed areas. Remember to wear 50+ UVA and B sunscreen every day (even if it’s cloudy). You should also cover your skin and wear a hat and sunglasses outdoors. Less commonly, UV light from fluorescent lights, including low-energy light bulbs, may cause rashes in some people with lupus.
  • Stay active. Regular physical activity has many health benefits, including helping you to manage your symptoms. When you start exercising regularly, you should notice an improvement in the quality of your sleep, an increase in energy levels, a reduction in fatigue, and improvements in your overall strength and fitness. Exercise can also help prevent long-term consequences of lupus, such as heart disease and osteoporosis.
  • Learn ways to manage your pain. Pain is one of the most common symptoms of lupus, so it’s crucial to learn ways to manage it effectively. Read our A-Z guide for managing pain for more information.
  • Manage stress. Stress can aggravate your symptoms, so learning to deal with stress is very helpful. Things you can do to manage stress include planning your day and setting priorities, using relaxation techniques, getting a massage or listening to music. And, where possible, avoiding people and situations that cause you stress.
  • Quit smoking. Smoking cigarettes can worsen your lupus symptoms and reduce the effectiveness of particular lupus medicines. It can also affect your bone health and increase inflammation.
  • Ask your GP about your vitamin D, calcium and cholesterol levels. Lupus can affect them all, and you may need to take supplements or medicines to correct any problems.
  • Sleep well. Not getting enough quality sleep can worsen your symptoms; however, getting a good night’s sleep when you have chronic pain can be difficult. If you’re having problems sleeping, talk with your doctor about ways you can address this.
  • Eat a healthy, balanced diet. While there’s no specific diet for lupus, it’s important to have a healthy, balanced diet to maintain general good health and prevent other health problems, such as diabetes and heart disease. Lupus can also cause weight loss or gain depending on how it affects your body and the medicines you take. A healthy balanced diet may help prevent this. Talk with your doctor if you’re concerned about your diet or weight.
  • Pace yourself. Pacing is an effective strategy to help you do the things you want to do by finding the right balance between rest and activity (both physical and mental). This will help reduce your risk of flares and fatigue.
  • Get support from others. Research has shown that people with positive social support cope better with pain. Family, friends, colleagues, and health professionals can help you manage. A peer support group may be another option.


Most women with lupus can have children. However, there’s an increased risk of complications such as premature labour, high blood pressure, blood clots and miscarriage.

For these reasons, it’s essential that you plan your pregnancy carefully.

The healthier you are before you get pregnant, the greater the chance you’ll have a healthy pregnancy and baby. Aim to have your condition under control and be in the best possible health.

Talk with your doctor and specialist before you get pregnant. They may need to change your medicines to ensure a safe pregnancy.


Lupus is an unpredictable condition that can affect any part of your body, including your internal organs. Working closely with your healthcare team, following your treatment plan, and staying informed about lupus is the best thing you can do to reduce your risk of complications.

Contact our free national Help Line

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

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To manage foot and lower limb pain in children

Guest blog written by podiatrist Daniel van Hoof-Harkin, B. Pod (Hons)

When a child starts to complain of pain in their legs or feet for whatever reason – after activity, ‘growing pains’ at night, or joint inflammation caused by a condition like juvenile arthritis (JIA) – often the first thing I’ll look at is their footwear. Specifically, what footwear they wear and when and how they wear them. I’ll then spend time discussing and trying to recommend footwear. That’s because good shoes can be a first-line treatment in relieving pain.

To help you choose the best footwear for your child, here are my suggestions for things to look for.

Getting the right support

To a large extent, you get what you pay for with shoes. Cheaper shoes are usually made with lower quality materials and have less support than more expensive footwear. This is why quality shoes can cost significantly more.

When I look at a pair of shoes for someone in pain, I’m looking primarily at four things:

  • Heel pitch – Also known as drop or offset, it is the difference in height between the heel and forefoot within the shoe. Ideally, shoes should have approximately 10mm, as this helps to reduce the effects of reduced ankle range of motion, or for high arched people whose forefoot sits lower than their heel.
  • Torsional rigid shank – This is the stiffness of a shoe between the heel and the forefoot and helps to stabilise mobile feet, especially on graded surfaces.
  • Heel counter – This is usually a piece of plastic that wraps around the heel in shoes and helps to reduce inversion and eversion of the rearfoot during lower impact activities.
  • Upper fixation – This will normally be achieved with either Velcro or laces, but also aided by the upper of a shoe.

Most brand-name sneakers will have all of these qualities, which will help support the feet and legs of children, whether they’re walking or running. However, if a shoe lacks any of these qualities, it’ll provide less support for your child’s feet.

For example, Mary Jane style school shoes don’t have as much upper, and only a single strap to secure them. That means they’ll offer less support than a pair of laced shoes.

Mary Jane school shoesLaced school shoes

Orthotics – Yes or no?

Orthotics can often be a controversial subject, but just like any form of therapy, if used correctly, they can make a big difference for a child with leg or foot pain. And there’s evidence that they have a place in managing JIA and hypermobility-related disorders.

But when should they be considered? Sometimes I’ll recommend foot orthotics immediately, and other times I’ll let people know they’re unlikely to help their symptoms. As a general rule of thumb, if your child has good quality footwear and wears them appropriately, but they’re still experiencing ongoing pain, they may require some form of in-shoe support. In this case, visiting a podiatrist for an assessment would be worthwhile.

School shoes vs trainers

A good quality trainer is usually a more comfortable and better option for most active kids. This is because trainers have thicker midsoles that provide a good balance between structure and cushioning, especially when kids play on hard graded surfaces like concrete. School shoes are usually more of a dress shoe, which means they have less cushioning and generally don’t tolerate as much punishment as trainers.
At the end of the day, school shoes are often determined by the uniform requirements of the school, and if dress shoes are required, then fit and comfort when wearing need to be the most important factors.

Alleviating foot pain

When recommending shoes to parents, I’ll often ask how active their child is. I’ll then ask, ‘if you were going to be doing the same things as your child, which shoes would you choose to wear?’ Imagining yourself in your child’s place means you’ll have a better understanding of what’s most appropriate.

The other aspect we don’t often realise is how hard graded surfaces can be on our feet and ankles. If your child is susceptible to experiencing pain, then I’d recommend they wear structured sneakers more often. It’s also important they wear them on outings to places like shopping centres, theme parks, or on days with lots of walking. Less structured footwear like thongs, or ballet flats, should only be used for short outings, where there won’t be much walking involved.

Leg length discrepancy and heel lifts

Differences in the length of legs, or leg length discrepancies, happen more frequently than we think. It’s been reported between 40-70% of the population have a difference in leg length, and one in every 1000 people can have a difference of greater than 20mm.

Leg length discrepancies can be difficult to assess clinically and almost impossible to measure accurately without performing scans to assess bone lengths and joint alignment. Also, kids can often grow asymmetrically, meaning one leg may grow faster than another. However, I often see these leg length differences have disappeared 6 months later.

So I’m usually not too concerned when I come across a leg length discrepancy unless the child has pain I believe is being influenced by it or the leg length difference is such that I see significant postural problems occurring. Once again, if there’s concern about the presence of a leg length discrepancy, it’s worth having it assessed by a health professional, and whether it is indicated to include a heel lift under the shorter leg.

Finding the right fit

Ultimately, the most important thing when it comes to footwear for any child is fit. Given how quickly children can grow, keeping up with their shoe size can become a frequent and sometimes costly exercise. However, it’s vital for growing feet.

Making sure that shoes aren’t too small is essential, as small footwear can cause pain, injury, and difficulty with movement. When checking shoe fit, try and establish their size when they’re standing. This is because feet may become longer when standing, changing the shoe size compared to sitting. It’s also important that the footwear isn’t too big, as this can cause increased movement within the footwear that can affect stability. If shoes are too long, they can also pose a trip hazard to a child.

This advice is, of course, very general, and individual needs will vary. But as a starting point for parents of children with lower limb pain, this advice can be a useful for reducing symptoms.

Contact our free national Help Line

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


In October 2022, the Albanese Government announced that they would invest almost $7 million in stem cell research. The ARISTOCRAT project, led by MSKs Director Emeritus, and orthopaedic surgeon Professor Peter Choong, will allow researchers to develop new therapies to improve the lives of people with conditions like osteoarthritis.

So what does this mean? What are stem cells? And, will they be the miracle treatment we’ve been waiting for?

Let’s take a look.

But first, what’s osteoarthritis?

Osteoarthritis, or OA, is the most common form of arthritis. It most frequently affects the joints in the knees, hips, feet, spine and hands.

OA was once thought to be a natural part of ageing or a lifetime of ‘wear and tear’ on joints. But we now know it’s much more complex than that and may occur due to many factors.

With OA, the cartilage that lines the ends of bones in a joint, enabling them to move smoothly over each other, becomes brittle and breaks down. Because the cartilage no longer has a smooth surface, the joint becomes stiff and painful. Eventually, the cartilage can break down so much that it no longer cushions the two bones.

There are currently no treatments, including medicines, that can affect the underlying disease process of OA. Instead, symptoms (e.g. pain and stiffness) are managed using exercise, weight management and medicines that provide temporary relief.

The lack of targeted treatments to prevent OA from worsening or reversing the damage it causes makes the promise of new and innovative treatments, such as stem cells, very exciting.

So what are stem cells?

Cells are the basic building blocks of all living things. They provide structure for the body, take in nutrients from food, convert those nutrients into energy, and carry out specialised functions. Cells also contain the body’s hereditary material and can make copies of themselves. We have many different types of cells, such as nerve, bone, fat, blood, and stem cells.

Stem cells differ from other cells in the body in three ways:

  1.  they can divide and renew themselves over a long time
  2.  they’re unspecialised, so they can’t do specific functions in the body
  3.  they can become specialised cells, such as muscle cells, blood cells, and brain cells.

There are many types of stem cells. However, the type of stem cell most often promoted as a treatment for osteoarthritis is the mesenchymal stem cell or stromal cell. They’re generally referred to as MSCs (because no one can say mesenchymal 😉). These cells can be obtained from many parts of the body, including bone marrow and fat.

MSCs can become bone cells (osteoblasts), cartilage cells (chondrocytes), muscle cells (myocytes), or fat cells (adipocytes). They can also release substances that may alter how the immune system responds to injury and encourage other cells to grow.

This has led scientists and doctors to explore whether MSCs can restore function to damaged joints and tendons.

EuroStemCell has an interesting article that explains MSCs – what they are, what researchers are investigating when it comes to MSCs, and the challenges they face.

More research is needed

For most conditions, stem cell treatments are still considered experimental. They have yet to prove safe or effective in clinical trials for osteoarthritis.

While there’s a lot of excitement about the future, we need more research to understand how to best obtain, handle and administer stem cells or the cells made from them.

We need to know some of these answers to ensure that new stem cell treatments don’t cause more harm than good.

We also need more information about potential side effects and the long-term safety of stem cell treatments.

Be wary

Unfortunately, despite the lack of reliable evidence that stem cell treatments work and are safe to use, they’re actively promoted for osteoarthritis and many other health conditions by clinics in Australia and overseas.

Some clinics use cells obtained from the person on the same day they’re collected, while others may grow the person’s or donor cells in the lab over several weeks before returning them to the person. It’s important to know that even when the cells are taken from a person and returned to the same person, there’s still risk involved. Even though they’re your own cells, the fact that they’ve been removed means there’s the risk that they may have become contaminated.

Most clinics charge substantial fees (thousands of dollars). They encourage multiple treatments and may imply they’re doing research but aren’t usually part of a registered clinical trial. They also often use celebrity patients’ testimonials or endorsements to support their claims of success.

That’s why participating in a clinical trial is currently the safest way to access stem cell treatments. Researchers must follow strict rules to ensure that participants are safe. Each clinical trial also follows a careful study plan or protocol that describes what the researchers will do.

Before joining a clinical trial, you’ll be told what to expect as a participant and all the things that might happen. For example, someone from the research team will explain possible side effects or other risks of the treatment. You’ll also have a chance to ask questions about the trial. In most cases, you won’t be required to pay any costs involved in participating in a clinical trial. There may be out-of-pocket expenses, such as travel, which may be reimbursed to you.

Ask questions

If you’re considering trying a stem cell treatment, you need to be well-informed – so ask lots of questions. For example:

  • Is this treatment part of a registered clinical trial listed on the Australian New Zealand Clinical Trial Registry (ANZCTR),, or elsewhere?
  • Was ethics review and approval obtained, and by whom?
    Note – All clinical research projects in Australia must be approved by a Human Research Ethics Committee (HREC), which checks that the research conforms to the National Statement on Ethical Conduct in Human Research requirements.
  • Does the doctor, or any of the researchers involved, have any conflicts of interest, including financial?
  • What are the total costs of the treatment, and how much will I be expected to pay? Remember, if you’re taking part in a clinical trial, no costs should be involved.
  • Will you use my own cells, or are they from a donor or other source?
  • How does this treatment compare to other treatments?
  • Is there any scientific evidence (not testimonials or anecdotes) that the treatment improves my health condition?
  • What are the potential side effects or risks involved?
  • How many treatments are required?
  • How long do you monitor the effects of my treatment?

Stem cell treatments are still considered experimental for osteoarthritis, so don’t be embarrassed to ask lots of questions. Learn as much as possible about the treatment and how it might affect you. You should also have a chat with doctor or specialist about your intentions and get their input.

Stem cells and cell therapy are an exciting new frontier in medicine, but it’s still early days. So watch this space.

And watch our video, Stem cells and muscle, bone and joint health: Hope, hype and reality, presented by Professor Megan Munsie, Deputy Director – Centre for Stem Cell Systems, The University of Melbourne; Head – Education, Ethics, Law & Community Awareness Unit, Stem Cells Australia.

Contact our free national Help Line

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

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Peak bodies
Research registries


Did you know that there’s a link between certain bacteria and a type of arthritis? It’s strange but true. Find out how a case of food poisoning, or a sexually transmitted infection, can sometimes cause arthritis.

Reactive arthritis (ReA) is a relatively uncommon form of arthritis that occurs as a ‘reaction’ to a bacterial infection in another part of your body.

Usually, when you have an infection, your immune system fights the foreign body (e.g. the bacteria) and then settles down. However, with reactive arthritis, the immune system stays active after the infection has cleared and targets healthy parts of the body, causing pain and inflammation.

Although it’s caused by bacteria, it’s not contagious. However, the bacteria can be passed on to others through sexual activity or contaminated food.

The types of bacteria that cause reactive arthritis are:

  • salmonella, shigella, yersinia or campylobacter bacteria – they cause food poisoning and bowel infections
  • chlamydia bacteria causes genital infections (though some people may not have any symptoms) and is spread through sexual contact.

Most people who become infected with these bacteria won’t develop reactive arthritis. So the big question is why some people develop arthritis and others don’t 🤔.

Researchers believe that your genes may play a role. You’re more likely to develop reactive arthritis If you have the gene HLA-B27. However, lots of people have this gene and never develop reactive arthritis.

Reactive arthritis can occur at any age, but it tends to affect people aged between 20 and 50.

The good news is that for the majority of people, their condition disappears within 6 months. However, some people experience symptoms for a longer period.


The symptoms of reactive arthritis develop some weeks after the infection and may include:

  • pain, swelling or stiffness in a joint (arthritis), most commonly the knees, feet and ankles
  • pain in the lower back and buttocks
  • pain and inflammation of tendons, such as the Achilles tendon at the back of your heel
  • pain and redness in your eyes – some people may develop conjunctivitis (inflammation of the outer layer of the eye) or uveitis (inflammation of the middle layer of the eye)
  • extreme tiredness, or fatigue
  • rash on the palms of your hands or soles of your feet
  • mouth ulcers
  • diarrhoea.

The good news is most people won’t experience all of these symptoms.

Diagnosing ReA

There’s no specific test for diagnosing reactive arthritis, so your doctor will use a combination of tests to confirm your diagnosis. They may include:

  • discussing your medical history – e.g. your current symptoms, as well as any recent illness, infections or other health problems
  • a physical examination of your joints, spine, eyes and skin to check for inflammation and other changes (e.g. changes to joint movement, rashes)
  • lab tests – e.g. blood, urine or stool (poo) samples may be taken to check for the presence of infection, look for signs of inflammation and to rule out other conditions
  • swabs of your throat, penis or vagina to check for signs of infection
  • x-rays – may be used to look for signs of arthritis
  • arthrocentesis – a sample of fluid is taken from your joint and tested in a lab (this is done to rule out conditions such as gout that may cause similar symptoms).

Treating ReA

Treatment aims to manage the symptoms until you get better and may include:

  • Antibiotics to treat the infection. Antibiotics don’t treat the symptoms of reactive arthritis, just the bacterial infection. If you developed reactive arthritis due to a sexually transmitted infection, your sexual partner/s will also need antibiotics.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) are the main medicine used to treat reactive arthritis because they quickly reduce joint inflammation and pain. But they do have the risk of side effects, so you’ll be given the lowest effective dose for as short a time as possible to reduce this risk.
  • Corticosteroids may be necessary if you have severe joint pain and inflammation. They can be taken as tablets or injected directly into a joint, muscle or other soft tissue.
  • Disease-modifying anti-rheumatic drugs (DMARDs) may be given if your condition doesn’t respond well to other treatments. DMARDs suppress your overactive immune system. They help relieve pain and inflammation and reduce or prevent joint damage. It can take several weeks to months before you begin to notice any effect, so you may also need to take other medicines to help control pain and inflammation until then.
  • Eye drops to treat conjunctivitis or steroid eye drops to treat uveitis.
  • Physiotherapy can help keep affected joints mobile and strengthen the surrounding ligaments, tendons and muscles.

Uveitis requires specialist treatment. If you develop uveitis, your doctor may refer you to an ophthalmologist, a specialist who deals with eye diseases.

Your doctor may also refer you to a rheumatologist, a specialist who treats problems with joints, muscles, bones and the immune system.


As well as following the treatment plan your healthcare team has given you, there are many things you can do to manage your reactive arthritis.

Become more informed about your condition. Understanding reactive arthritis allows you to make informed decisions about your healthcare and actively manage it.

Stay physically active. We know that regular physical activity has many health benefits. But it can also help you manage the symptoms of your condition. When you start exercising regularly, you should notice an improvement in your pain levels, the quality of your sleep and an increase in energy levels. However, when your joints are very swollen or painful, avoid strenuous activity or straining the joint. Gentle exercise or movement is best and will help prevent the joint from becoming stiff.

Pace yourself. Pacing is an effective strategy to help you do the things you want to do by finding the right balance between rest and activity (both physical and mental). This will help reduce your risk of flares and fatigue.

Eat a healthy, balanced diet to improve your energy levels, help maintain your weight, and give you a greater sense of wellbeing. And ensure you handle and store your food safely to avoid any contamination.

Learn ways to manage your pain. Pain is a common symptom of reactive arthritis, so it’s important you learn ways to manage it effectively. Read our A-Z guide for managing pain for more information.

Practise good hygiene and safe sex.

Preventing ReA

You can reduce your risk of getting reactive arthritis by avoiding sexually transmitted infections and food-borne bacteria. So:

  • Wear a condom during sex with new partners.
  • Wash your hands regularly or use hand sanitiser if you don’t have access to water and soap (we’re experts at this now!) 😉
  • Make sure your food is prepared and stored correctly.

Contact our free national Help Line

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

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Travelling into the city for medical appointments – either from the ‘burbs or a more rural or regional area – can often be stressful, time-consuming, costly and difficult. Planning your journey, becoming familiar with different types of transport, and potential forms of assistance can make it easier.

We’ve got some info, tips and tricks to help you get to your appointments safely and calmly – no matter what transport you use.

I’m travelling by car…

If you’re travelling to your appointment by car – either as the driver or passenger – it’s important to plan and be prepared.

Get comfortable in the car
If you’re the driver, make sure you can reach and operate all of the controls, pedals, steering wheel etc. comfortably, and you have good visibility through your windows and mirrors. Whether you’re the driver or passenger, remember to pack your supports (e.g. lumbar cushion), water, and any other necessities you need for a road trip.

Take breaks
Avoid driving for more than an hour without a break. Stop, get out of your car, and stretch or massage tight muscles. 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.

Know your route
Have a map or set your GPS to your destination. It’s easy to get confused or take a wrong turn if you’re anxious or worried about an appointment.

Be prepared for public works and road closures
Nothing can disrupt your trip and add to your stress like road works, especially when you weren’t expecting them 😤.

Allow extra time in your journey so that you don’t feel rushed or stressed if you encounter any public works and have to change your route. If you don’t experience any delays, you can use the extra time before your appointment to grab a coffee, read a book or just relax.

You also need to be mindful of damage to our road networks caused by storms and floods. Before you head out, check the traffic websites in your state/territory for information about roadworks, road closures and other traffic alerts.

Be aware of any tollways you may need to go on. If you have an electronic tag, the toll will automatically be added to your account. If you don’t have a tag, you’ll need to purchase a pass before you set out on your journey or pay soon after you use the tollway.

Is there parking at the medical centre or hospital you’re going to? If you’re not sure, call them before you leave. If there’s parking available, is it free or do you have to pay a fee to use it? And if so, do you need coins, or can you pay with your debit/credit card?

I’m travelling by public transport…

When travelling by public transport, many factors, like cancellations and delays, are out of your control. So being proactive and prepared will give you some control over your trip.

Plan your trip
Your state/territory government website has tools to help you find the best way to get from point A to point B (and back).

Simply enter the place you’re departing from (e.g. Wodonga) and where you’re going to (e.g. Royal Melbourne Hospital). You then choose the time you want to depart or arrive by and your journey date. You’ll be given several journey options to choose from. It’s a good idea to plan to arrive much earlier than your appointment so that if something does go wrong (a cancelled train or you get a little lost 😐), you have time up your sleeve. You won’t be rushing or worrying about running late.

Mobility aids
The experience of travelling with mobility aids will vary between trains, trams, cabs, ferries, buses and coaches, as each form of transport is different. It will also depend on the mobility aid – scooter, wheelchair, walker, crutches etc. – as they can vary significantly in size and space required to safely transport them. Before you set out on your journey, contact the relevant operator and let them know you’re travelling with a mobility aid. This gives you a chance to provide them with the details of your mobility aid and ask any questions.

I need help to get to my appointment…

Sometimes travelling by car or public transport isn’t an option, or you may need extra help.

Community transport
Community transport services are run by not-for-profit organisations and some local councils. The service is often operated by volunteers who take people to medical appointments, shopping centres and social outings if they can’t use other transport. Eligibility requirements and costs vary from place to place and with different operators. Search online for ‘community transport’ or contact your local council to find out about options in your area.

Subsidised taxi fares
All states and territories have subsidised taxi schemes for people with disability and health issues. They all vary in the concessions offered and eligibility criteria. Contact your relevant government department to determine if you’re eligible to participate in this scheme.

Patient transport assistance schemes
If you need financial support with travel and/or accommodation to receive your medical treatment or care because the services are unavailable locally, patient travel assistance schemes may be an option. These services are generally available for people who travel large distances or interstate to access necessary health care. Again, they vary in the support provided and eligibility criteria.

Red Cross Patient Transport Service
If public transport isn’t an option for you, the Red Cross operates a transport service for medical appointments. Cars are driven by volunteers, not medical staff, so you may need a carer if you’re unwell.

Angel Flight Australia
This volunteer-run charity operates non-emergency flights to help rural and remote Australians get to medical appointments in other parts of the country. All flights are free, and people are transported to medical facilities across Australia. Find out more.

Contact our free national Help Line

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

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If you’ve ever had bursitis, you know how painful it can be. I had the displeasure of experiencing it several years ago when I slipped in the bathroom and fell heavily. Unfortunately, my shoulder took the full brunt of the fall 😫. I honestly thought I’d broken a bone; it was so painful! But after seeing my doctor, it turns out I had bursitis. And so began several weeks of ice packs, rest and gentle exercise. The good news is that my shoulder recovered completely. But I realised that although I’d heard of bursitis, I didn’t know what this common, painful condition was.

So let’s look at bursitis – what it is, what causes it (apart from falls 😉) and what are the treatment options.

What is bursitis?

Simply put, bursitis is the inflammation of a bursa. A bursa (plural bursae) is a small fluid-filled sac that cushions your bones and soft tissues (muscles, tendons and skin) in and around your joint.

They reduce friction between moving parts (e.g. between a bone and a tendon), enabling them to move smoothly over each other.

When a bursa becomes irritated or inflamed, it fills up with excess fluid. This causes pain and restricts movement.

What causes bursitis?

Bursitis can develop quickly (acute bursitis) or more slowly (chronic bursitis). Common causes include:

  • injury, e.g. having a fall and landing hard on your shoulder or hip
  • overusing a joint, especially if the movements are repetitive, e.g. typing, playing tennis
  • prolonged pressure, e.g. kneeling for long periods while laying carpet or scrubbing floors
  • joint stress, e.g. from being overweight or having an uneven walk (gait)
  • other health conditions, e.g. rheumatoid arthritis, gout, diabetes
  • infection, e.g. if a joint is injured and bacteria enter the bursa.

What are the symptoms of bursitis?

The signs and symptoms of bursitis include:

  • pain, especially when moving the joint
  • joint stiffness and swelling
  • restricted movement of the joint
  • warmth and reddening of the skin in the affected area.

The joints most commonly affected are the shoulder, elbow, hip, knee and heel.

How is it diagnosed?

If you have a painful, swollen joint or you’re finding it difficult to move a joint, it’s important that you discuss your symptoms with your doctor. Getting a diagnosis as soon as possible means that treatment can begin immediately.

To diagnose your condition, your doctor will:

  • Take your medical history and ask about your symptoms, recent injuries, the work you do, and other health issues.
  • Do a physical examination and look for redness and swelling in and around the joint, and test your joint’s range of movement.

If your doctor thinks your bursa is infected, they may remove a sample of fluid from your bursa. This will be examined under a microscope for signs of infection.

Scans such as x-rays and ultrasounds are usually unnecessary; however, your doctor may send you for a scan to rule out the possibility of another condition.

How is bursitis treated?

Some people can manage the pain, inflammation and stiffness of bursitis with self-care, such as cold packs, rest and gentle exercise. However, other people will require medical treatment to manage.

In this case, your doctor may recommend using over-the-counter non-steroidal anti-inflammatories (NSAIDs). They can be taken as a tablet (orally) or applied directly to the skin (topically) as a cream or gel. In cases of severe pain, your doctor may prescribe stronger anti-inflammatory medicines or inject a corticosteroid into the bursa.

You may also see a physiotherapist or exercise physiologist who can recommend exercises to help your joints move more easily and prevent bursitis from occurring again.

If your bursitis is caused by an infection, your doctor will prescribe antibiotics to treat the infection. In some cases, a needle is inserted into the bursa to remove the infected fluid. This may happen several times until the infection has cleared.

If the bursitis was triggered by a particular form of overuse, it‘s important to avoid that activity or modify how you perform it. An occupational therapist or physiotherapist can help you find solutions to this problem.

What can I do to control my symptoms?

You can do many things to relieve your pain and inflammation.

  • Protect and rest the joint to help the bursa recover. Your doctor or physiotherapist will advise you on how to rest the joint and for how long. This could include using cushions or pads when sitting or kneeling for long periods, using a sling or walking stick, modifying your activities etc.
  • Ice packs can help soothe red, inflamed joints, and heat packs and rubs can relax tense, painful muscles.
  • Maintain a healthy weight to reduce the pressure and stress on weight-bearing joints such as hips and knees.
  • Continue to stay active as much as you can while following any instructions provided by your healthcare team to protect your bursa.
  • Your doctor, physiotherapist and/or occupational therapist can offer other suggestions and strategies to reduce your risk of developing bursitis again.

Contact our free national Help Line

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

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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 painmusculoskeletal condition, treatment options, mental health issuestelehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email ( or via Messenger.

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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 painmusculoskeletal condition, treatment options, mental health issuestelehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email ( or via Messenger.

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We 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.


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.


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.


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 painmusculoskeletal condition, treatment options, mental health issuestelehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email ( or via Messenger.

More to explore


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

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