health professionals - Musculoskeletal Australia (MSK)

05/Aug/2021

This is the first of a series of blogs that will explore the different groups of health professionals and therapists who’ll help you live well with a musculoskeletal condition. For ease of reading, we’ll be referring to them all as practitioners.

Managing a chronic musculoskeletal condition – or multiple conditions – can be complicated. To help you get the best health outcomes and maintain (or improve) your quality of life, you’ll probably see a variety of different health professionals and therapists.

Who you see and how often will depend on your condition/s, symptoms and how they affect your life.

Physical or manual therapies

These therapies provide a hands-on approach to help relieve your pain and stiffness and improve your mobility, movement and joint function.

They’re often referred to as physical, manual, manipulative or hands-on therapies. The most common are:

Chiropractic – this involves manipulation and manual adjustment of your spine. It’s based on the premise that if your body, especially the spine, is out of alignment, it can affect the health and function of other parts of your body.
Massage – involves rubbing and manipulating the soft tissues of your body, especially your muscles. Massage can improve blood circulation, ease muscle tension and help you feel more relaxed. There are a variety of different types of massage available.
Myotherapy – involves assessing, treating, and managing the pain associated with soft tissue injury and restricted joint movement caused by problems with your muscles and the tissue surrounding your muscles (the fascia).
Occupational therapy – helps you learn better ways to do everyday activities such as bathing, dressing, cooking, working, eating or driving. An occupational therapist can also provide information on aids and equipment to make everyday jobs easier.
Osteopathy – is based on the premise that your body’s wellbeing depends on your bones, muscles and other soft tissues functioning smoothly together and correctly aligned. It uses physical manipulation, massage and stretching.
Physiotherapy – uses physical means (e.g., exercise, massage, heat and cold) as well as education and advice to help keep you moving and functioning as well as possible. Physiotherapists can also show you pain relief techniques and design an individual exercise program for you.
Reflexology – involves pressure applied to specific points of your feet or hands. These points are believed to match up with other parts of your body.

All of these therapies will provide additional support apart from the hands-on treatment. This may include specific exercises for you to do at home, relaxation techniques and pain management strategies. Some practitioners (e.g., chiropractors, physiotherapists and myotherapists) may also use medical devices such as ultrasound, transcutaneous electrical nerve stimulation (TENS) or dry needling alongside their hands-on treatment.

Talk with your GP and/or specialist

Before seeing any new practitioner, it’s best to discuss the treatment with your GP and/or specialist (e.g. rheumatologist). They may have some cautions about a treatment as it relates to your specific health condition/s. For example, they may recommend that you not get a treatment if you’re going through a flare or have active inflammation. Or, if you have fused joints or osteoporosis, they will likely advise against treatments that manipulate or adjust your joints or spine.

On the flip side, they may also provide you with recommendations of practitioners they’ve worked with or who have a particular interest in your condition.

Do your research

When making enquiries about a potential practitioner, ask lots of questions. For example:

How does the treatment work?
What are the possible side effects or risks?
Have you treated other people with my condition or health issues?
Do you need to see any of my recent medical tests (e.g., x-rays)?
How long does it take for this treatment to work?
How will I know if it’s working?
What can I expect during a treatment session?
How often will I need to see you?
How much does it cost?
Can I claim this treatment on my private health insurance?
What are your qualifications?
Do you receive regular training and updates?
Are you a member of the professional association for this treatment/practice?

You can also contact the professional association and check their list of members to ensure the practitioner is registered. Or visit the Australian Health Practitioner Regulation Agency website and search for the practitioner.

What to expect at your first appointment

Regardless of the type of practitioner, you can expect to have a detailed discussion about your musculoskeletal condition and medical history, symptoms and what you hope to get out of the treatment.

Be wary of any practitioner that doesn’t give you this time and attention to understand your situation and your needs. There’s no ‘one-size-fits-all’ when it comes to healthcare.

Keep track of your progress

It can be helpful to keep a daily diary tracking your symptoms so you can see if the therapy is working for you. Write down any changes in your pain levels, fatigue and other symptoms for a period (e.g., a month). Also include any changes to your medications, exercise routine, the amount of sleep you’re getting and anything else that could affect your symptoms. After a month of tracking, you’ll have a clearer picture of whether or not the therapy is working.

And keep your GP and/or specialist informed about how you’re going with the physical therapy.

Be careful

All treatments – from hands-on physical therapies to medications and vaccines – have benefits and risks. You need to weigh these up to make an informed decision as to whether or not the benefits outweigh the risks for you.

And if you have conditions such as osteoporosis or inflammatory arthritis, you should avoid manipulative treatments such as chiropractic and osteopathy.

Contact our free national Help Line

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

More to explore

Better Health Channel
Drugs and complementary therapies (PDF)
Arthritis Ireland
Manipulative therapies
Versus Arthritis
National Center for Complementary and Integrative Health (USA)

Professional associations

Lisa Bywaters

17/Dec/2020

…when it comes to complementary, alternative and ‘natural’ treatments

Many Australians use complementary or alternative treatments to manage their health condition (e.g. arthritis, anxiety) or to improve their overall health and wellbeing. But what are these treatments and what do you need to consider before trying them?

Complementary and alternative treatments include a wide range of therapies, medicines, products or practices that aren’t currently considered to be a conventional or mainstream medical treatment. They include acupuncture, meditation, massage, herbal treatments, yoga, aromatherapy and naturopathy.

The word complementary usually refers to treatments that are used alongside conventional medicine, whereas alternative usually means the treatment is used instead of conventional medicine.

To make things easier (and less wordy), we’ll use the term complementary treatment when referring to all types of complementary or alternative treatments in this article.

Why do we use complementary treatments?

People are attracted to these treatments because they often have a more holistic approach and treat the entire person, rather than just their condition or symptoms. They also appear to be more natural and safer than conventional medicine.

But it’s important to understand that as with any treatment, complementary treatments may cause harm and make you unwell if they’re not taken correctly, if they interact with one of your other medications, or if the practitioner you see isn’t properly trained or qualified. That’s why you should discuss your use, or intended use, or any complementary treatments with your doctor.

Do they work for musculoskeletal conditions?

While many people feel that using complementary treatments has been beneficial for their health and wellbeing, there isn’t as much evidence to support its use for musculoskeletal conditions as there is for conventional medicines.

For many complementary treatments there just aren’t enough well-designed randomised controlled trials to show whether or not these therapies are effective. And if they are effective, for which conditions or symptoms.

However some types of complementary treatments show promise and may be helpful for managing your condition. More and more research is now focusing on these treatments. But at the moment the evidence is still lacking so it’s best to take your time, do your research and make sure the treatment is right for you.

Tips for starting a new complementary treatment

Let your doctor know what you’re doing. Keep them informed about any things you’re taking or considering taking (e.g. supplements, homeopathic treatments, herbal medicines) as well as any other therapies you’re trying or considering trying (e.g. acupuncture, yoga).

Continue taking your medications as prescribed. Don’t stop taking any medications without first discussing it with your doctor. Some medications need to be gradually reduced, rather than simply stopped, to avoid side effects.

Think about what you want to get out of the treatment. Are you hoping to control symptoms like pain or fatigue? Sleep better? Reduce or stop taking certain medications? Manage your anxiety? When you have a clear goal from the beginning of your treatment, you can monitor your progress and see if there are any improvements. After starting a new treatment, write down any changes you notice for a month – remember to include any medication changes, changes in your exercise program, the amount of sleep you’re getting and anything else that could affect your symptoms. At the end of the month, you’ll have a clearer picture of whether or not the treatment is working. If it’s not, it may be time to look for an alternative.

Do your research and ask lots of questions. Some treatments may help you manage your condition or symptoms, while others will have no effect. Visit websites such as MedlinePlus and The Cochrane Library to learn more about the treatment. And talk with your doctor and the therapist. Find out if:

there’s any current evidence that the treatment is effective and safe for people with your condition?
the treatment’s been shown to be effective in repeated scientific studies with large numbers of people?
the research used a control group? A control group is a group of people who don’t have a particular treatment compared with a group of similar people who do. This helps to show that any results are due to the treatment and not some other factor.
potential risks, side effects and interactions with other treatments are clearly identified?
you can continue to use your current effective treatments, as well as the complementary treatment?
the treatment’s something you can afford and can access easily?

If you answered no to any of these questions, you should be wary of the treatment. Discuss it with your doctor or specialist before you go any further.

Check the qualifications of the person providing the treatment.

Do they receive regular training and updates?
Have they treated other people with your condition or health issues?
Are they a member of their peak body?
Are they accredited?

Buy Australian. Australian complementary medicines are subject to strict safety and quality regulations. This may not be the case in other countries. In Australia the Therapeutic Goods Administration (TGA) ensures the safety of medicines and other therapeutic treatments.

Call Medicines Line on 1300 MEDICINE (1300 633 424). As well as information on your prescription and over-the-counter medicines, they can also help you find out more about herbal medicine, vitamins and minerals.

After doing your research, if you have any doubts about the treatment, don’t use it.

Talk with your doctor or contact our MSK Help Line weekdays on 1800 263 265 helpline@msk.org.au for information about other treatment options.

Call our Help Line

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

More to explore

Complementary and alternative treatments
Musculoskeletal Australia
Complementary therapy
healthdirect
What are complementary and alternative treatments?
Versus Arthritis (UK)
Complementary medicines explained
National Prescribing Service
National Center for Complementary and Integrative Health (USA)
US Department of Health and Human Services

Lisa Bywaters

22/Oct/2020

And things you can do to manage

Finding and keeping a job when you have a musculoskeletal condition can be difficult. Pain, fatigue, medication side effects, and the unpredictability of your condition can all affect your ability to work.

The extent to which this happens will depend on many things such as the condition you have, e.g. back pain, rheumatoid arthritis, osteoarthritis, gout, how severe it is, how well it’s being managed, and the type of work you do. Physically demanding work, such as building, nursing, and farming, will be impacted by painful joints or restricted movements. And any work that requires you to focus and concentrate, especially for extended periods, will be affected by brain fog, pain, and lack of sleep.

The good news is there are things you can do to help manage these issues. We’ve listed a bunch of strategies here. This is part 1 of our 2 part blog.

Note: we understand that some of these strategies may not be possible for all workplaces or conditions. However the majority of them can be adapted in some way to suit your needs.

Work with your healthcare team to ensure your condition is under control and well managed. This may involve your GP, rheumatologist, physiotherapist, podiatrist and/or occupational therapist. They’ll also help you develop a plan to cope at work when your condition flares.

Evaluate your workspace. Whatever your setting – office, retail, manufacturing, hospitality, transport – there are options for making it more supportive for you. The first step is to talk with an occupational therapist about the issues you’re facing and develop strategies to help you manage them. They may include simple things such as being aware of your posture throughout the day and changing position regularly to reduce pain, strain and fatigue. They may also involve changing your workspace to make it work for you.

For example:

using a standing/sitting desk
rearranging the setup so that items you use most often are close by
sitting on a chair or perch instead of standing for long periods
using a headset on your phone
getting lumbar supports for your chair or car seat
using a trolley to help you move heavy items.

Some of these options may be easy to do without going through your employer, but some changes may need their involvement. If your employer knows about your condition, then you can discuss these changes together. However if you’ve chosen not to disclose your condition, your employer is still obliged to make reasonable adjustments to your workstation or environment to ensure your comfort and safety. Things such as stand up desks, foot rests, wrist rests, height adjustable chair, ergonomic chair are all considered reasonable. For more information read our information on Employment FAQs and visit Safe Work Australia.

Take control of your pain. Chronic pain can affect your ability to do the things you want and need to do, your sleep quality, your concentration, and mood. Basically it sucks. That’s why you need a toolbox of strategies for managing your pain. There’s no one size fits all when it comes to pain management. So having several strategies you know work for you, is essential. They may include gentle exercise, medications, heat and cold, stretches, massage, splints, braces and aids and equipment. It’ll take some trial and error, but it’s well worth the effort to find what works best for you. You can then pull them out of your toolbox when needed, giving you more control over your pain. Your doctor and physiotherapist can also give you tips for managing your pain while at work. For more information and practical tips for dealing with pain, read Managing your pain: An A-Z guide.

Along with pain, fatigue is a massive issue for people with musculoskeletal conditions. Fatigue is very different from just being a little tired. It’s overwhelming physical and mental tiredness that makes every activity a struggle. But there are things you can do to manage so that it has less impact on your life and your work. Find out how.

Acknowledge the unpredictability of your condition. It’s a fact that musculoskeletal conditions are unpredictable. You often won’t know you’re about to have a flare until one happens. Apart from increased pain, stiffness, and fatigue, having a flare can be really stressful as you worry about getting things done – at work and at home. Having a plan in place for managing – before a flare occurs – means you can be proactive. This may involve developing a plan with your healthcare team that will help you cope at work, prioritising and pacing your activities so that you get any important, time-dependent tasks done when you’re feeling your best, discussing flexible work arrangements (like working from home) with your employer, or taking time off work or reducing your hours until you can get the flare under control. The important thing is that you’re prepared, with a plan of attack in place, ready to go when needed.

Use your scheduled breaks. It’s easy when you’re feeling under pressure – whether it’s from your employer or pressure you’ve put on yourself – to ignore your lunch or tea breaks and just keep working. But this will only add to your stress, pain and fatigue. You need to take some downtime during your day to eat, drink and give your mind and body a break. If you can, get outdoors and breathe in some fresh air. When you return from your break you’ll feel better, have a clearer head, and be more productive.

For more info and tips check out part 2 of this blog.

Call our Help Line

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

Making the invisible visible

Read the report based on our 2020 National Consumer Survey – Making the invisible visible – in which 66% of people said that their ability to work had been impacted by their condition/s.

Watch our webinar

Watch the recording of our webinar from March 2021, as Jessica Dawson-Field, Employment Associate, Maurice Blackburn Lawyers, takes us through employment law – rights and entitlements.

More to Explore

JobsAccess
Australian Government
JobAccess is the national hub for workplace and employment information for people with disability, employers, and service providers. It provides:

a wide range of info and services to help people with disability find and keep jobs, get promoted to better jobs, upgrade or expand their workplace skills
advice on modifying your work area, talking about your disability, training for your co-workers, negotiating flexible work arrangements and returning to work
the Employment Assistance Fund (EAF) gives financial help to eligible people with disability and mental health conditions and employers to buy work-related modifications, equipment, Auslan services and workplace assistance and support services.
and much more.

Work Assist
Australian Government
Work Assist can help you stay in work if you risk losing your job through illness, injury or disability.

I have a job and arthritis: Now what?
Arthritis Society Canada

Fatigue: Beyond tiredness
National Rheumatoid Arthritis Society (UK)

Sleep and pain
painHEALTH

Managing flares
National Rheumatoid Arthritis Society (UK)

Lisa Bywaters

22/Oct/2020

And things you can do to manage

This blog was so full of info and strategies we had to split it into 2 parts. You can access part 1 here.

But here’s a recap: We know finding and keeping a job when you have a musculoskeletal condition like back pain, rheumatoid arthritis, osteoarthritis and gout can be really tough.

Pain, fatigue, medication side effects and the unpredictability of your condition can all affect your ability to work.

The extent to which this happens will depend on things such as the condition you have, how severe it is, how well it’s being managed, and the type of work you do. Physically demanding work will be impacted by painful joints or restricted movements. And any work that requires you to focus and concentrate, especially for extended periods, will be affected by brain fog, pain, and lack of sleep.

The good news is there are things you can do to help manage these issues. We’ve listed a bunch of strategies here. This is part 2 of our 2 part blog.

Note: we understand that some of these strategies may not be possible for all workplaces or conditions. However the majority of them can be adapted in some way to suit your needs.

Manage your meds. Sometimes medications cause side effects like nausea, headaches, lightheadedness, and drowsiness. This can make it really hard to concentrate at work, and may in fact make it dangerous to perform some work duties such as driving or operating machinery. If you find that your medications are causing issues for you, talk with your doctor about possible alternatives you can use.

You may also need to have a review of your medications if you find your condition’s not under control or you need more help managing pain and other symptoms. Again, talk with your doctor about this.

Get a good night’s sleep. We all go through periods when sleep is elusive. Chronic pain and anxiety are just a couple of things that can affect our ability to get enough quality sleep. But sleep is important for good physical and mental health, and to give us the ‘get up and go’ we need to get to work and work productively. If you’re having issues sleeping, don’t just put up with it. There are lots of things you can do to get the sleep you need.

Take a break. Get up, move and clear your head. We all need to take breaks for our physical and mental wellbeing. So walk to the photocopier or around the block, do some simple stretches, step outside and do some deep breathing or visualisation. Whatever helps you manage your pain, fatigue, and brain fog, do it.

Dealing with time off work. We all need time off from time to time, but for many people with musculoskeletal conditions, it may happen more often than we’d like. Attending healthcare appointments during working hours or having a flare means you may go through your personal leave quite quickly. If this is a concern or problem for you, discuss your options with your healthcare team. Are you able to attend appointments via telehealth or outside of your usual working hours? An occupational therapist or physiotherapist may have some solutions for working during a flare and to reduce the pain and strain on your joints. And if you’ve disclosed your condition to your employer, discuss your concerns with them. Together you should be able to develop a plan to help you balance time off and the work duties you need to complete. One of the silver-linings of the COVID pandemic is that we’ve discovered that many jobs can be done productively from home. So working from home may be an option. As too are aids and equipment that protect your joints and save energy, or even changing the work you do at your workplace. Being proactive and knowing your rights is key to working well with a musculoskeletal condition.

Managing changes to your abilities and functioning. Unfortunately some musculoskeletal conditions will change a person’s ability to do specific tasks. For example, someone with back pain may find sitting for long periods impossible. Or a person with arthritis in their hands may find repetitive work such as typing extremely painful. Talking with an occupational therapist or physiotherapist can help you find potential solutions to these issues. Whether it’s finding new ways to do work tasks, using special equipment and aids to support you and protect your joints, or managing your pain while at work, they’ll tailor a solution to your specific needs.

These are just some of the things you can do to manage your condition and continue to work. Feel free to share the things you do to help you manage at work with a musculoskeletal condition. We’d love to hear from you!

Call our Help Line

Making the invisible visible

Read the report based on our 2020 National Consumer Survey – Making the invisible visible – in which 66% of people said that their ability to work had been impacted by their condition/s.

Watch our webinar

Watch the recording of our webinar from March 2021, as Jessica Dawson-Field, Employment Associate, Maurice Blackburn Lawyers, takes us through employment law – rights and entitlements.

More to Explore

JobsAccess
Australian Government
JobAccess is the national hub for workplace and employment information for people with disability, employers and service providers. It provides:

a wide range of info and services to help people with disability find and keep jobs, get promoted to better jobs, upgrade or expand their workplace skills
advice on modifying your work area, talking about your disability, training for your co-workers, negotiating flexible work arrangements and returning to work
the Employment Assistance Fund (EAF) which gives financial help to eligible people with disability and mental health conditions and employers to buy work related modifications, equipment, Auslan services and workplace assistance and support services.
and much more.

Work Assist
Australian Government
Work Assist can help you stay in work if you risk losing your job through illness, injury or disability.

I have a job and arthritis: Now what?
Arthritis Society Canada

Fatigue
National Rheumatoid Arthritis Society (UK)

Sleep and pain
painHEALTH

Managing flares
National Rheumatoid Arthritis Society (UK)

Lisa Bywaters

30/Jul/2020

Looking after your feet

Our feet are amazing ‘feats’ of engineering (sorry, I just couldn’t resist that one).

Each foot has 26 bones, 33 joints, and more than 100 tendons, muscles, and ligaments. They support us through thick and thin – whether we’re walking, running, jumping, dancing, skipping or hopping. We cram them into ill-fitting shoes, torture them in high heels and stub them against the bedside table in the middle of the night (or is that just me?).

As well as the many injuries and calamities that befall our feet, many musculoskeletal conditions, such as osteoarthritis, rheumatoid arthritis and gout can affect the feet.

They’re the unsung heroes of this pandemic as we hit the streets, parks and trails for exercise. Walking has become the exercise of choice for people at the moment. Many of us can’t – or don’t feel safe to – return to gyms or exercises classes. And lots of people are walking instead of catching public transport to avoid being in close contact with others. As a result we’re all walking many more steps than we did pre-COVID.

So we need to stop taking our feet for granted. We need to look after them so we can continue to do the things we want and need to do as pain-free as possible.

So what can we do?

Give your feet the TLC they deserve. It’s really important to look after your feet. Wash and dry them regularly. Inspect them for anything unusual such as cuts, blisters, changes to the nails and skin. By being aware of your feet and any changes that occur, you can seek advice sooner. And if they’re sore after a day of walking, maybe give them a warm soak in the bath, or in a bucket or a foot spa (if you have one) while you watch TV. Then dry them thoroughly and rub a moisturising foot cream into your skin. Take your time and give your feet a nice massage. Better yet, see if you can talk someone else into giving them a massage while you relax on the couch.

Manage your condition. If you have a musculoskeletal condition that affects your feet, it’s important that you work with your doctor and healthcare team to look after your feet and manage your condition effectively. The treatments used for foot conditions will vary from person to person, depending on your condition and how it’s affecting you. And this may change over time as your condition and your feet change.

See a podiatrist. If you have foot pain, or a condition that affects your feet, visit a podiatrist. They’re feet experts and can assess, diagnose and treat foot and lower limb problem, including skin and nail problems, foot and ankle injuries, foot complications related to medical conditions and problems with your gait or walking. Podiatrists can also give you advice on appropriate footwear, and can prescribe custom foot orthotics.

Consider orthotics. Orthotics are corrective insoles that can help alleviate pain by redistributing pressure away from the painful area and support your arches. You can buy off-the-shelf orthotics or you can have orthotics made that are specifically fitted to your feet by a podiatrist.

Fit your feet with appropriate footwear. With our worlds turned upside down due to COVID, and many of us having to stay home, it’s tempting to stay in our slippers all day. There’s something so comforting about warm, fluffy slippers. However our feet and ankles need proper support. Wear the right footwear for whatever you’re doing. Going for a walk? Put on your sneakers. Working at home? Wear your casual shoes/boots that support your feet and keep you warm. And lounging around in the evening? Get those slippers on.

If you’re buying new shoes, make sure they fit properly, support your feet and are comfortable. Look for shoes that are light, flexible at the toe joints and are hard wearing. Shoes made of leather are preferable over synthetic materials as they breathe better. Avoid slip-on shoes and if laces are difficult to fasten due to arthritis in your hands, Velcro or elastic laces may be an option.

Let them breathe. Did you know you have about 250,000 sweat glands in each foot? That’s a lot of sweat! So let your feet breathe to avoid smelly feet and fungal infections. Change your socks and shoes at least once a day. Wear shoes that allow air flow around your feet: leather, canvas, and mesh are good options, avoid nylon and plastic. And avoid wearing the same shoes two days in a row. Give your shoes time (at least a day) to dry and air out. And if the weather’s warm, set your feet free and let them go au naturale. There’s nothing better than walking barefoot on warm grass on a sunny day.

Exercise your feet. I’m not talking about walking here…but other exercises that keep your joints moving. Try non-weight-bearing exercises such as swimming, especially if you have foot pain, as they take the pressure away from the painful areas. You can also do exercises while sitting in a chair. NHS Inform (Scotland) has some foot exercise videos you can try. If you want exercises tailored specifically for you, visit a podiatrist or physiotherapist.

Medications might help. If you’re having a lot of foot pain, speak with your doctor about whether medications may be an option. Depending on the underlying condition causing the problem, your doctor may prescribe a short-term course of pain relievers or anti-inflammatory medications, or they may prescribe other medications, such as a cortisone injection into a joint for rheumatoid arthritis or medication for acute attacks of gout.

Diabetes and feet. Many people with musculoskeletal conditions also have diabetes. So it’s really important if you have diabetes that you take care of your feet every day because of the increased risk of developing nerve damage, ulcers and infections. Talk with doctor about how to look after your feet properly if you have diabetes.

Surgery may be required. For some people, surgery may be needed if other conservative treatments haven’t helped. A referral to an orthopaedic surgeon who specialises in feet is usually required.

Contact our free national Help Line

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

More to explore

Common foot problems
Royal College of Podiatry (UK)
Australian Podiatry Association
Exercises for foot problems
NHS Inform (Scotland)

Lisa Bywaters

16/Jul/2020

For many of us, massage is an important tool for managing the aches, pains and muscular tension associated with having a musculoskeletal condition. It complements the other things we do to manage our condition such as exercise, medication and mindfulness.

What is massage?

Massage is a hands-on therapy that involves rubbing and manipulating the soft tissues of your body, especially your muscles. There are many different types of massage including relaxation, shiatsu, sports, deep tissue, hot rock and remedial.

Massage can improve circulation, ease muscle tension and help you feel more relaxed. A massage can also help relieve stress and help you sleep.

In this blog our focus is remedial massage and self-massage.

What’s a remedial massage?

Remedial massage treats muscles that are knotted, tense, stiff or damaged. (1) In consultation with the client, a remedial therapist will assess and identify which areas of the body require treatment, and use a range of massage-based techniques to optimise muscle function.

Remedial massage helps loosen tight muscles and ease your pain and stiffness. And for many people with musculoskeletal conditions such as arthritis or back pain, this type of massage is essential to keep you moving.

Seeing a remedial massage therapist

A qualified remedial massage therapist is trained to “assess and treat muscles, tendons, ligaments and connective tissue and treat injuries and soreness”.(2)

Seeing a massage therapist regularly can help prevent a build-up of muscle tension caused by chronic pain, inactivity and injury. They can also help you manage your pain, maintain joint flexibility and function, and provide you with exercises and stretches to do between visits.

Questions to ask a massage therapist

Before seeing a therapist, you should do your homework and find out as much as possible. Ask questions such as:

What type of massage do you provide?
What are your qualifications?
Are you accredited with the peak massage body in Australia?
Have you successfully treated people with my condition?
Do I need to take all my clothes off?
How long are the massage sessions?
What is the cost?
Can I claim this on my health insurance?

When you see the therapist you should:

Be open with them and communicate your needs and any health issues – whether they’re ongoing or new.
Make sure you’re comfortable before they start massaging. They may have placed your arms in a position that aggravates a neck or back condition, or have you lie in a way that causes pain or discomfort. If this occurs, explain to the therapist that the position doesn’t work for you. They can then make changes to ensure you’re comfortable and that you get the most benefit from the massage.
Ask for extra support if you need it. If you need a pillow or cushion to support your neck, knees or back, let them know so they can accommodate you.
Let your massage therapist know if the pressure is too hard, too soft or if anything hurts. Don’t suffer in silence.
Ask yourself whether it matters if you see a male or female therapist. Massage therapists are professionals who want to help you. They’ve seen people of all shapes and sizes and will use towels and sheets to cover you. However you do need to be relaxed during a massage, and if you feel uncomfortable or self-conscious you won’t fully relax. So if you think this will be an issue for you, ask for a massage therapist that suits your needs.
Try not to feel embarrassed if you fall asleep or pass wind during your massage. It happens – especially when your body relaxes.

After your massage

You may feel a little sore or tender after your remedial massage. This may last up to a day. The massage has worked and stretched your muscles, much like exercise does. If you’re not used to this or it’s been a while since your last massage, you may feel some pain. A warm shower or heat pack can help alleviate this.
Do some gentle stretches, as you would after exercising. This helps you maintain some of the benefits of your massage – such as increased flexibility and reduced muscle tension.

Giving yourself a massage

You can relieve many of your own aches and pains by giving yourself a massage. You may even find that you do this unconsciously – when you’re sitting at the computer and you rub your neck, when you have a headache and you gently rub your temples, or when you’re applying a heat rub to your sore knee.

It’s a simple easy way to relieve pain and tension. The good thing about self-massage is you can do it almost anywhere and it’s free! Try it next time you feel tense and sore.

Self-massage tips

Warm up first – ease some of your muscle tension with a warm shower or by applying a heat pack (warm not hot) to the painful area.
Use smooth, firm strokes. You’ll feel the difference between strokes that are relieving muscle tension, and those that are adding to it. Adjust the pressure, from hard to gentle, based on your pain.
Add some massage oil (or lotion) – it can help your hands move smoothly over the skin. This isn’t essential, but can add to the soothing feeling of the massage.
Don’t massage over bony areas. This can be painful and may cause an injury.
Try using massage aids – such as a foam roller, massage balls or other massage aids; e.g. use a tennis ball or a golf ball to massage the soles of the feet. Simply place the ball on the floor, place your bare foot on top of it and gently roll the ball along the length of your foot. If you’re unsteady on your feet, sit down while you do this. You can also use the shower to provide a massage, especially on your neck, shoulders and back.
Massage regularly – this’ll help prevent muscle pain and tension building up.

Get help with self-massage

Sometimes you need help when you’re giving yourself a massage. Reaching a sore spot in the middle of your back is tough. Or being able to apply firm, consistent strokes to your neck and shoulders may be impossible if you have a musculoskeletal condition that affects those areas. So ask for help. From your partner, a close friend or even the kids. Just be sure to clearly explain what you need.

You can remain fully clothed and have them massage those areas over your clothes. Combined with using a heat pack, a home massage can provide some relief from your pain.

Massage during COVID

Many of us are finding our muscular aches and pains are worse at the moment and the need for a massage is even greater. Working from home and not having access to a proper desk or chair, trying to home school kids, not being as physically active as we’d like, and general stress about what’s happening in the world can all add to our pain levels and muscle tension. A massage – whether by a qualified therapist or a self-massage can help.

The good news for people locked down due to stage 3 restrictions, is you can still access remedial massage therapists. Yay!

Remedial massage and other allied health services like podiatry, mental health counselling and physiotherapy are essential to support health and wellbeing. So they’re not a restricted at this time. So wherever you are in Australia, you can get a remedial massage if you choose to.

Just make sure you don’t see a massage therapist if you’re feeling unwell. If you feel at all sick, get tested for COVID-19 and stay home. Find out more about COVID symptoms on the Australian Government website or call the National Coronavirus Helpline on 1800 020 080.

Take care, stay safe and give massage a go.

Contact our free national Help Line

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

More to explore

Remedial massage
Healthdirect
Find a massage therapist
Healthdirect
Massage therapy guide
Healthdirect
Benefits of massage
Arthritis Foundation (USA)
What is remedial massage?
Massage & Myotherapy Australia

Lisa Bywaters

25/Jun/2020

Living with a chronic musculoskeletal condition costs us physically, mentally and emotionally. But what many people don’t understand are the substantial financial costs associated with having chronic conditions. They’re expensive.

Healthcare costs

These are the most obvious. Medications, lots of trips to your doctor, your specialist/s, allied health professionals, tests, exercise classes, surgery, orthotics….they all add up. A lot!

People who don’t have a chronic condition may assume that a lot of this is covered by government subsidies, GP Management Plans, health insurance, the Pharmaceutical Benefits Scheme, with a little sprinkling of magical fairy dust to cover the rest. Depending on a person’s situation some of this may be covered. But much isn’t.

There’s significant cost in seeing allied health professionals such as physiotherapists, podiatrists, occupational therapists, hand therapists, dietitians and psychologists. While GP Management Plans assist with the cost, there’s mostly only five visits provided and these are used up very quickly. There may also be a gap payment over the Medicare Rebate. And there are also often considerable out of pocket expenses to see a specialist privately or longer waits when you see them publicly.

This can put a significant strain on a person’s finances.

Employment

Living with a chronic musculoskeletal condition is varied and episodic. That means you often don’t know how you’ll wake up. Your pain and stiffness may have been under control and manageable for some time, but then one day you wake up feeling crap. Your joints are swollen, it hurts to move, and you’re soooo exhausted. This makes it difficult to get up and move around, let alone get to work and put in a full day, as well as all the other things you have going on – family, friends, studying, chores, and a social life.

This may lead to time off work, and using up all your sick and personal leave. But if the situation (or workplace) becomes unmanageable it may result in someone having to permanently reduce their hours, change jobs, become unemployed or retire early.

Any of these things will obviously affect your everyday finances. However it can also affect your future finances as superannuation is impacted by reduced or lost income.

Wow. This became really depressing really quickly.

The good news is there are services to help you if you need to change careers, or need financial assistance while you re-evaluate what you can or can’t do. We’ve added a bunch of these to the More to Explore section below.

And while we know none of these services are perfect, they can provide you with many of the tools and resources to help you through this tough time.

Hidden costs

Lost employment and medical costs – check. They’re probably the most visible costs. But there are many hidden costs. We’ve listed just a few.

Home and car modifications – so that you can continue to do the things you want and need to do as easily and pain-free as possible you may need to make changes to your home and/or car. They may be simple and relatively inexpensive – e.g. adding a swivel seat to your car to help you get in and out, or more complicated and pricey – e.g. installing a chair lift to help you get up and down the stairs in your home. An occupational therapist can help you work out what modifications will assist you, and can also advise you of any available schemes or assistance programs you may be eligible for.
As well as changes to your home or car, you may also need to buy various gizmos and gadgets that: protect your joints (e.g. tap turners, pick-up reachers), help you manage your pain (e.g. heat packs) and generally make life a little easier (e.g ergonomic mouse for your computer, walking aids). Again these can range in price.
Getting out and about if you’re in pain, or dealing with serious brain fog, can be tricky if you don’t feel up to driving. It’s only made worse with the COVID pandemic, when many of us feel vulnerable catching public transport. So you might have to resort to catching a taxi or using a rideshare company. But over time this does add up. You may be eligible for a taxi subsidy – each state/territory has their own scheme – so it’s worth checking to see if you can access this.
Food, glorious food. Let’s face it there are many times you feel flattened by your condition and cooking is the last thing you want to do. And now with the convenience of delivery apps, you can get almost anything delivered to your door. Unless like me you live in an outer suburb in which case it’s fish n’ chips, pizza or burgers – yum, but not the healthiest options. These deliveries can be a lifesaver, but the cost can also very quickly add up.
Events and holidays. This’s a tough one. Because of the nature of chronic conditions and often not knowing how you’ll feel from day to day, you can pay for future events and then have to cancel or change at the last minute. Like tickets to a concert (remember those??) – you often buy them so far in advance and you’re excited for literally months! And then the night comes and you know you can’t go – you’re too tired, too sore, too whatever. So you have to forfeit your ticket, or give it away to a friend. Or you’re on holiday, but you end up having to pay to make changes because you’ve had a flare and you need an earlier flight home, or you need to catch more taxis than you’d planned to, or you need to buy a pillow because the one at your hotel is a rock. It’s the crazy, unpredictable stuff like this that’s hard to plan for and adds to financial stress.

Pandemic pain

And then came COVID.

Many of us are having to manage to do more on less, with fewer hours, less pay, or no pay. It’s the unpredictability of this pandemic that adds to financial stress, especially if things were already tight before COVID came along.

The best thing to do if you’re feeling anxious about your financial situation is to be proactive and sort it out ASAP. Ignoring the problem won’t make it go away, and may make the situation worse. Choice has written a useful article that provides lots of handy info and tips: Making the right financial moves during the COVID-19 coronavirus outbreak.

And check out the More to Explore section below for more resources to help you.

Contact our free national Help Line

More to explore

Access for People with Disability
Australian Government, JobAccess
This site helps people with disability find and keep jobs, get promoted to better jobs, upgrade or expand their workplace skills, and more.
Best practice guide: The right to request flexible working arrangements
FairWork Ombudsman
Career Transition Assistance
Australian Government, jobactive
Designed to help mature-age job seekers to build their confidence and skills to become more competitive in their local labour market.
Centrelink Entitlements
Chronic Illness Alliance
Eight tips for looking after your mental health through unemployment
Beyond Blue
Employment Assistance Fund
Australian Government, JobAccess
Government Assistance
Pain Australia
Job in Jeopardy Assistance
Australian Government, Services Australia
Making the right financial moves during the COVID-19 coronavirus outbreak
Choice, 7 April 2020
Payments for people living with an illness, injury or disability
Australian Government, Services Australia
Types of care
Australian Government, My Aged Care
This is a federal government scheme for older Australians needing assistance to live independently in their own homes. You can get assistance with everyday tasks and home modifications.
Your guide to Australian careers
Australian Government, Job Outlook
This site helps you make decisions about study and training, your first job, or the next step in your career. Includes physical and other demands of jobs.

Lisa Bywaters

04/Jun/2020

The opium poppy is such a pretty, delicate looking flower. And humans have been actively growing them and enjoying their medicinal benefits since at least 3,400 B.C. The Sumerians referred to it as Hul Gil or the “joy plant.”

It’s from these delicate plants we get opioids, a group of medications with which we have a long and complex relationship. They can provide great pain relief, but can also cause great harm.

That’s why on 1 June 2020 the Australian Government introduced some changes which affect how we use and access opioids. So let’s look at what opioids are, how they work, and why these changes have been brought in.

What are opioids?

Opioids are pain relieving medications that come in a variety of formulations, dosages and strengths. They include: tramadol, codeine, morphine, oxycodone and fentanyl. You need a prescription from your doctor to buy any medications containing opioids.

Opioids may be:

natural – created using the milky substance found inside the pods of the opium poppy, or
synthetic – created in a lab to have a chemical structure similar to natural opioids.

How do they work?

Opioids attach to opioid receptors in brain cells and dull our perception of pain. The pain isn’t gone, nor is the cause of the pain. It’s simply been dampened so that we can function with less discomfort. They also cause the brain to release the hormone dopamine, which can make us feel happy or relaxed.

Opioids are used to treat severe pain associated with cancer or for acute pain – e.g. following surgery.

They’ve also been used for many years to help people with severe, persistent non-cancer pain, like the pain associated with musculoskeletal conditions. However their long-term benefit is controversial for persistent pain or chronic pain. This is mainly due to the large body of evidence that shows that opioids have a limited effect on this type of pain. In addition they can also have serious side effects particularly with long term use, including breathing difficulties, addiction, overdose and death.

We also know that our body adapts to opioids when we use them long-term. We have to increase the dosage to get the same effect, and an increased dose brings an increased risk of harm.

Every day in Australia there are nearly 150 hospitalisations and 14 emergency department admissions due to opioid use, and three people die from drug-induced deaths involving opioids. (1)

Because of these alarming statistics the Australian government has been changing the way we access opioids. Last year we saw all opioids, even the lowest dose available, requiring a prescription from your doctor. You can no longer buy them over-the-counter.

The latest changes are a continuation of this plan to reduce the harm that opioids can do, and ensure that we use them cautiously and safely.

What’s changing?

From 1 June 2020 changes include:

smaller medication packs containing fewer opioids will be provided for short-term opioid use – for example after surgery or an injury,
improvements in medication information so people are better informed about the potential risks of opioids and how to reduce them, and doctors are following best-practise when prescribing opioids,
updating prescribing ‘indications’ (or when they’re used) to ensure opioids are only prescribed where the benefits outweigh the risks. (2)

Can I still use them for my musculoskeletal pain?

If you’re using opioids to manage the pain associated with your musculoskeletal condition, continue taking them as prescribed and talk to your doctor.

We do know some people experience pain relief using opioids for persistent pain, so if they’re proving to be clinically effective for managing your pain, your doctor will be able to continue to prescribe them. However these new changes will require your doctor to weigh the risks and benefits of these medications, and to explore possible alternatives with you, including enrolling in a pain management program. Also, where opioid use exceeds twelve months or is expected to exceed this time, a second opinion will be required to renew ongoing prescriptions.

Opioids aren’t a magic bullet and should be used in conjunction with other pain management therapies such as physiotherapy, exercise, weight management, cognitive behavioural therapy and mindfulness.

What now?

Living with persistent pain is exhausting. And the possibility of changing your medication can be stressful, especially if you feel like you’re managing your condition and your pain effectively. If you’re worried about these changes, talk with your doctor. Be honest about how you feel, but also be open to the possibility of trying new things to manage your pain. The aim is to keep your pain at a level that allows you to live your life and do the things you want and need to do. Opioids may be part of that, or they may be something that you’ll be able to phase out. It’s something that you and your doctor will need to discuss so that you get the best and safest outcomes.

Contact our free national Help Line

More to explore

Prescription opioids: What changes are being made and why
Therapeutic Goods Administration, 29 May 2020
Prescription opioids: Information for consumers, patients and carers
Therapeutic Goods Administration, 29 May 2020
What are opioids?
Alcohol and Drug Foundation, 28 January 2020
Smaller pack sizes from today: could new opioid restrictions stop leftover medicines causing harm?
The Conversation, 1 June 2020
Opioid medicines and chronic non-cancer pain
National Prescribing Service, 2 October 2019
Managing your pain: An A-Z guide
Musculoskeletal Australia

References

(1) Prescription opioids: What changes are being made and why
Therapeutic Goods Administration, 29 May 2020

(2) Prescription opioids: Information for consumers, patients and carers
Therapeutic Goods Administration, 29 May 2020

Lisa Bywaters

21/May/2020

For many of us our pain is always there – sometimes in the background and at other times it’s very much in the front of our minds. It’s a constant – just like taxes. Even with a pandemic causing so much chaos and uncertainty, our pain persists, it’s always there.

And quite frankly it’s a pain in the arse. It hurts. It’s exhausting. And it’s invisible.

The Australian Institute of Health and Welfare last week released their latest report Chronic pain in Australia. It highlights that 1 in 5 of us lives with chronic pain. So next time you’re standing in a physically distant queue at the shops or taking a walk around the park – consider the fact that 1 in 5 of the people see you around you is also living with pain. It’s a massive problem, but there are things we can all do to manage our pain effectively.

Know your pain and yourself

It’s so important when you live with a chronic condition that you understand it. Learn as much about your condition as you can so that you can take an active role in managing it, including the pain associated with it. For example, what makes your pain better? What makes it worse? Do you tend to overdo things when you’re feeling great and end up paying for it over the next couple of days with increased pain? Or when you’re experiencing a flare and your pain is worse – do you get anxious, and everything becomes negative and too hard?

Knowing these things – really understanding how your pain affects you physically, emotionally and behaviourally – will help you manage your pain and your condition better, even in this time of crazy COVID.

Tackle the big three – exercise, eat, sleep, repeat

I don’t know about you, but I’m finding my exercise, diet and sleep have all taken a hit due to the pandemic and iso. Not being able to get to the gym, changes to work and my normal routine and stress has really impacted how and when I’m eating, sleeping and exercising. And not in a positive way.

This has had a very noticeable effect on my pain levels. If you’re experiencing this too, acknowledging it is the first step to changing things. So I can’t get to the gym – there are other ways to be active. So my routine has changed and as a result so has my diet. I can manage that. Stress and pain is impacting my sleep? I’ve managed that before – I can do it again.

It’s all about finding the right mindset. This is a strange, new normal we’re living in. And it’s going to change and evolve as we continue through 2020. We have no roadmap for what’s been, and what’s to come – so we need to do the best we can to change and adapt to the constantly shifting landscape.

Get help

OK, that all sounded sooooo easy, right?? Nope.

We may be able to change and adapt to some things but there will be times when we need to ask for help. From our family and friends, from our doctor, physio, psychologist. Whether it’s medications or physiotherapy to directly manage the pain, or asking a family member to carry the heavy laundry basket to the clothesline, or talking with a friend about your frustrations – whatever it is, there’s help available. You just need to acknowledge the fact that you need it and reach out. And remember the nurses on our Help Line are just a call or email away.

Use your mind

It’s a powerful tool. You can use it for distraction, mindfulness, relaxation, visualisation and guided imagery. None of these things will take your pain away completely, but they can provide temporary relief while you do a painful task, try to fall asleep, or wait for your pain medication to kick in.

‘P’ yourself – plan, prioritise and pace

We’re often our own worst enemy. We do too much when we’re feeling great, and end up feeling rubbish for hours/days afterwards. Something ‘simple’ we can do to prevent this from happening time and again is to plan, prioritise and pace ourselves. First plan – what do you need to do today? Write it down. Now prioritise. How much of those zillion things do you really need to do? Often things we see as hugely important aren’t. And do you need to do them yourself? Can someone else do it? Now pace yourself. It’s not a race – so be generous with your time, spread your jobs over the day and build in space for rest breaks.

Look after your mental health

Living with persistent pain can sometimes be a roller-coaster of emotions. It’s perfectly natural that from time to time to feel sad, worried, angry, anxious, depressed or frustrated. Add a pandemic, and it’s no wonder many of us are feeling as if our worlds have turned upside down and inside out. It’s important that you acknowledge these feelings. You may want to write in a journal, talk with a family member or close friend or talk with a counsellor or psychologist. Don’t ignore these feelings or keep them bottled up.

Your GP can refer you to a psychologist if needed on a GP Mental Health Management Plan. At the moment because of COVID-19 you can arrange to speak to a psychologist via telehealth (over the phone or a video call).

Be kind

To yourself and to others. It’s an unprecedented, really strange time and we’re all doing the best we can. So be kind to yourself – you’ll experience ups and downs, stumbling blocks, and barriers that get in your way. And some days you’ll need to work really hard just to keep moving. So give yourself a break. And remember 1 in 5 people are living with invisible chronic pain. And even more people are dealing with all kinds of stuff we can’t even imagine. So be kind to the people you encounter. It makes us all feel so much better than the alternative.

More to explore

Our nurse Clare discusses some simple things you can do to manage pain while at home in isolation, including pacing activities, exercise, getting a good night’s sleep and heat and cold packs.

We also have some great blogs to give you more tips and info about managing pain:

Lisa Bywaters

13/May/2020

Thanks to one of our MSK Kids parents who has written this blog for us. They have chosen to remain anonymous.

When our world changed rapidly at the end of March due to COVID-19 social distancing regulations and remote learning, I was amazed that my child wasn’t freaking out about all the changes taking place. I put it down to her wonderful teachers and the fact that she has dealt with a major event in her life already, a chronic health condition and immunosuppressive treatment. Here are some of the ways my child has had the dress rehearsal to COVID-19, and so have we as parents.

Experienced at social distancing

When you have an immune suppressed child you have already had to cancel play dates, sleepovers and extra-curricular activities. Your child has already stopped sport at some stage, and has probably missed important days at school or with friends. You have already been fearful of every cough and sneeze in the classroom and you know the times of the year when chicken pox cases increase.

We’ve been using hand sanitiser already

Ask any parent who has spent time with a child in hospital, and chances are they know the smell of Microshield® very well (the brand of hand sanitiser in most Australian hospitals). We’ve been used to having good hand washing habits and know the importance of alcohol-based agents to clean hands. You probably already had a decent amount of hand sanitizer at home before COVID-19, as well as alcohol-based wipes (especially if you have to administer subcutaneous injections).

We know and appreciate our healthcare workers

It didn’t take this pandemic for us to appreciate our wonderful healthcare workers. We’ve known this for years through our regular interactions with doctors, nurses and allied health workers. Hopefully everyone else now recognises the importance of good health in our lives and our amazing healthcare workers.

Newer Posts

Older Posts

Physical or manual therapies

Talk with your GP and/or specialist

Do your research

What to expect at your first appointment

Keep track of your progress

Be careful

Contact our free national Help Line

More to explore

Professional associations

…when it comes to complementary, alternative and ‘natural’ treatments

Why do we use complementary treatments?

Do they work for musculoskeletal conditions?

Tips for starting a new complementary treatment

Call our Help Line

More to explore

And things you can do to manage

Call our Help Line

Making the invisible visible

Watch our webinar

More to Explore

And things you can do to manage

Call our Help Line

Making the invisible visible

Watch our webinar

More to Explore

Looking after your feet

So what can we do?

Contact our free national Help Line

More to explore

What is massage?

What’s a remedial massage?

Seeing a remedial massage therapist

Questions to ask a massage therapist

When you see the therapist you should:

After your massage

Giving yourself a massage

Self-massage tips

Get help with self-massage

Massage during COVID

Contact our free national Help Line

More to explore

Healthcare costs

Employment

Hidden costs

Pandemic pain

Contact our free national Help Line

More to explore

What are opioids?

How do they work?

What’s changing?

Can I still use them for my musculoskeletal pain?

What now?

Contact our free national Help Line

More to explore

References

Know your pain and yourself

Tackle the big three – exercise, eat, sleep, repeat

Get help

Use your mind

‘P’ yourself – plan, prioritise and pace

Look after your mental health

Be kind

More to explore

Useful Links

Key Conditions

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