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24/Oct/2023

Medicinal cannabis and you

Marijuana, dope, pot, grass, weed, Mary Jane, doobie, bud, ganja, hashish, hash, wacky tobaccy…they’re just some of the common names for cannabis.

Whatever you call it, it’s been used for medicinal purposes for thousands of years, until it became a banned or controlled substance in most parts of the world.

But for decades there’s been renewed interest in its use in healthcare, with many countries – including Australia in 2016 – decriminalising it for medicinal use.

Last year alone the Therapeutic Goods Administration (TGA) granted over 25,000 applications from doctors to prescribe cannabis, mostly in the form of an oil.

So let’s weed out some of the facts and explore the use of medicinal cannabis for pain and musculoskeletal conditions.

Is it marijuana or cannabis?

It’s both. They’re just different names for the same plant – marijuana is the commonly used name, cannabis is the scientific name. The preferred name for its use in healthcare is medicinal cannabis, to draw the distinction between medicinal use of cannabis and the illegal, recreational use of marijuana.

The tongue twisters – cannabinoids

It’s a tough word to say – far harder than musculoskeletal! – but an important one when we talk about the properties of cannabis. Cannabinoids are the chemicals found in the cannabis plant. They bind onto specific receptors (CB1 and CB2) on the outside of our cells and can affect things like our mood, appetite, memory and pain sensation.

Cannabis has more than 140 cannabinoids. The two major ones are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the cannabinoid linked with the sensation of feeling ‘high’ that’s associated with recreational marijuana use.

Cannabinoids also occur naturally in our body (endocannabinoids) and can also be created artificially (synthetic cannabinoids).

How’s it taken?

Medicinal cannabis, both plant-based and synthetic, comes in many forms including oils, capsules, oral sprays and vapours. Smoking isn’t an approved preparation as it can cause damage to the lungs and airways.

Does it work?

At the moment, evidence for its use to treat pain associated with arthritis and musculoskeletal conditions is lacking.

Cannabis has been illegal for so long that we don’t have the thorough, scientific evidence we need about: side effects, which cannabinoids (e.g. THC, CBD or a combination) may be effective, dosages, the best form to use (e.g. oil, capsules etc), the long-term effects, or the health conditions or symptoms it may be beneficial for. Research is emerging, but we need a lot more.

Because of this lack of research, the Australian Rheumatology Association doesn’t support the use of medicinal cannabis for musculoskeletal conditions. Their concern is that we don’t have enough info to ensure cannabis is safe and effective for people with musculoskeletal conditions.

The Therapeutic Goods Administration (TGA) has also stated that there’s “not enough information to tell whether medicinal cannabis is effective in treating pain associated with arthritis and fibromyalgia”.

Possible side effects

As with any medication – and medicinal cannabis is a medication – it can have side effects. They include: dizziness, confusion, changes in appetite, problems with balance and difficulties concentrating or thinking.

The extent of side effects can vary between people and with the type of medicinal cannabis product being used.

How do I access it?

Unfortunately it’s a complicated process. We aren’t at the stage where a doctor can just write a prescription that you can fill at any chemist. Medicinal cannabis is an unregistered medicine, which means your doctor must be an Authorised Prescriber or must apply for you to have access to it through the TGA’s Special Access Scheme.

But if it’s something you’d like to try, talk with your doctor about whether it’s a possible option for you. Together you can weigh up the risks and benefits for your specific situation.

You need to be aware that medicinal cannabis is not on the Pharmaceutical Benefits Scheme (PBS), so if you can access it, you’ll likely have to pay significant costs.

Another option for gaining access to medicinal cannabis is to consult a doctor at a specialised cannabis clinic. This also comes at a price, however it may be an option if your doctor isn’t an authorised prescriber or they’re not well-informed in the use and prescribing of medicinal cannabis.

Driving and medicinal cannabis

If you’re using medicinal cannabis it’s important that you know exactly what’s in it. If you’re taking a product that you’ve obtained through legal prescribers that only contains CBD, you can drive. However if you’re using a product that has any THC in it, whether on its own or in combination with CBD, you can’t drive. It’s currently a criminal offence to drive with any THC in your system.

Talk with your doctor and/or pharmacist for more information.

Interactions with other medications

As with any substance you ingest, there’s the potential for medicinal cannabis to interact with other medications and supplements you’re taking. So before prescribing medicinal cannabis, your doctor will review your current medications to reduce the risk of any negative effects.

However if while using medicinal cannabis you experience any unusual symptoms, discuss these with your doctor.

Finally

For many people the use of medicinal cannabis could be a long way off. And unlike the way it’s often portrayed in the media, it’s unlikely to be a panacea or magic bullet that will cure all ills.

It also won’t work in isolation – you’ll still need to do all of the other things you do to manage your condition and pain, including exercise, managing your weight, mindfulness, managing stress, pacing etc.

The important thing is to be as educated as you can and be open in your discussions with your doctor.

And be aware that cannabis for non-medicinal purposes is still illegal in Australia.

First written and published by Lisa Bywaters, Dec 2020.

For more detailed information about medical cannabis in Australia watch our webinar

Medicinal cannabis in Australia: Weeding out the facts 
Dr Richard di Natale, outgoing Senator and former leader of the Australian Greens, and Prof Iain McGregor, Lambert Initiative for Cannabinoid Therapeutics, University of Sydney discuss the use of medicinal cannabis in Australia – what it is, available forms, access issues in Australia and the current evidence for use.

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.

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06/Sep/2023

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

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

Let’s start with a look at your spine

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

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

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

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

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

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

So what’s causing the pain?

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

Some common causes of neck pain are:

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

Symptoms

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

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

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

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

Seeing your doctor

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

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

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

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

Dealing with neck pain

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

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

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

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

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

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

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

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

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

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

Treating ongoing neck pain

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

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

(Originally written and published by Lisa Bywaters 2022)

Contact our free national Help Line

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

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18/May/2023

Do you have osteoarthritis in your knees? Does the pain sometimes interfere with your ability to be as quick or mobile as you’d like? If so, you’re not alone – it’s a big club!

Osteoarthritis (OA) is the most common type of arthritis, affecting 1 in 11 Australians. It can develop in any joint but commonly occurs in weight-bearing joints like your knees. And because it’s so common and causes lots of pain and distress, we’re all looking for effective treatments to manage the pain and keep moving.

The good news is there’s strong evidence about the most effective treatments for knee OA, those that aren’t effective, and those that don’t have enough evidence to support their use.

And yet, a recent study has shown an increasing number of people with OA are investigating some less effective treatments such as stem cells, platelet-rich plasma, and Botulinum toxin.

There are likely many reasons for this.

We’ve become much more familiar with searching online for information during the pandemic.

Information about the effectiveness (or not) of treatments isn’t always translated for consumers. And unfortunately, to access much of this information, you need access to journals and databases that are often behind a paywall.

Another problem is that it’s easy for anyone to create a video, blog, or social media post about the latest and greatest treatment without using current evidence. Their reasons for doing so can be many – from sharing personal experiences in the hopes of helping others to purely commercial gain. This info is everywhere online, easily accessible and often looks legitimate.

So you need to weigh any information carefully, be cautious and discuss your options with your doctor.

Here’s a snapshot of what we know works (or doesn’t) for knee OA

Staying active and exercising regularly

You had to know this was coming 😉. Research has repeatedly shown that exercise is key in managing knee OA (and other musculoskeletal conditions). A tailored exercise program developed by a physiotherapist or exercise physiologist can help reduce knee pain and improve knee function. If pain prevents you from exercising, you may find that warm water exercise is a good starting point. Warm water pools offer the comfort of warmth and the buoyancy of the water to ease the load on your joints.

Managing your weight

Being overweight or obese is directly related to the risk of developing knee OA. It’s also likely to speed up how quickly your OA develops or progresses. Evidence shows a relationship between weight loss and relief of symptoms such as pain and stiffness. But weight loss can be a long process for many people. And it’s challenging, especially when pain affects your ability to be as active as you’d like. However, it’s good to know that any weight loss can reduce your pain and increase your ability to exercise. So making small, achievable changes to your eating and exercise habits can bring big results. If you’d like to lose weight to improve your symptoms, your doctor and/or dietitian can assist you in losing weight safely.

Dealing with stress and your emotions

It’s natural to feel stress, anxiety and frustration when living with chronic pain. However, if you’re always fearful or worried about it, it can worsen your pain. That’s because pain isn’t just a physical sensation – it also involves your perceptions, feelings and thoughts.

The worse you think your pain will be, the worse it can feel. It can affect your sleep, and you become less active. These feelings, thoughts and behaviours can become a vicious cycle.

Talking with a family member, close friend, or a health professional about how you’re feeling can get it out in the open so you can start dealing with these feelings and hopefully break this cycle.

Strategies like breathing exercises, cognitive behavioural therapy (CBT), meditation, heat, and gentle activities like tai chi, walking, swimming, and cycling can also help you control your stress and anxiety.

What about medicines?

No medicine can affect the underlying disease process of OA. Still, combined with self-care and lifestyle changes, medicines may provide temporary pain relief and help you stay active.

There are a variety of medicines used in the management of knee OA, and each comes with varying degrees of evidence to support their use. They may be taken by mouth as a tablet or capsule (orally), applied directly to the skin in the form of gels and rubs (topical), or injected into the joint (intra-articular). Discuss the benefits and risks with your doctor if you’re interested in the following medicines.

Non-steroidal anti-inflammatory medicines or NSAIDs (e.g. Nurofen, Celebrex, Voltaren). Depending on the dosage and other ingredients, NSAIDs are available over-the-counter or with a prescription. Oral NSAIDs are the preferred first-line drug treatment for OA and have been shown to reduce pain and symptoms in knee OA.

It’s important to note that NSAIDs are designed to be taken at low doses for short periods. Always talk to your doctor before starting NSAIDs, as they can cause harmful side effects, especially in older people.

Paracetamol (e.g. Panadol, Panamax). Research has shown that paracetamol provides only low-level pain relief and, in some cases, no pain relief compared to a placebo in knee OA. However, some people report that it helps reduce their pain so they can be more active. If you can’t take NSAIDs, they may also be an option. Before using paracetamol, talk with your GP to see if it’s appropriate.

Some medicines aren’t effective

Other medicines have been used for OA in the past that we now know aren’t effective and may have harmful side effects.

Opioids. Opioids are powerful pain-relieving medicines. They’re effective at reducing acute pain (or the pain resulting from an injury or surgery), but evidence shows they have little effect on OA pain. Opioids also have many potentially serious side effects. That’s why they’re not recommended in the management of knee OA.

Capsaicin. Capsaicin is the active ingredient in chilli peppers – it makes them ‘hot’. Capsaicin in creams and lotions has been used to help reduce OA pain, and some people report beneficial effects. However, evidence for its effectiveness in knee OA is low, and it’s generally not recommended. It also has side effects when applied, such as a burning sensation, which can take several uses to wear off.

Glucosamine and chondroitin. Studies have found no benefit from taking glucosamine and/or chondroitin for osteoarthritis.

The pointy end of the stick – intra-articular injections

Intra-articular injections are given directly into the knee joint. They include steroids, platelet-rich plasma, stem cells, hyaluronic acid and Botulinum toxin. Let’s look at them a bit more closely.

Corticosteroid injections. If you have persistent knee pain and haven’t had relief from oral medicines or other treatments (e.g. exercise, weight loss), your doctor may suggest a corticosteroid (steroid) injection. However, the duration of pain relief can vary from a few days to a few weeks, and the number of injections you can have is limited due to potential harm. There’s also emerging evidence that long-term use of these injections may cause OA to worsen in the affected joint.

Hyaluronic acid injections. The benefits of hyaluronic acid joint injections (also known as viscosupplementation or hyaluronan injections) are uncertain. Research findings have been inconsistent, and although some people find the treatment helpful, it can be expensive and isn’t generally recommended. The Australian Rheumatology Association states, “emerging evidence indicates that the effect of hyaluronic acid could be smaller than previously reported.”

Platelet-rich plasma (PRP) injections. Platelets are small cell fragments in the blood that help form blood clots to slow or stop bleeding and help wounds heal. PRP is a concentrated version of a person’s platelets injected into the affected joint. An Australian clinical trial led by researchers at the University of Melbourne, University of Sydney and Monash University has found that PRP was no better than a placebo at reducing symptoms in people with knee OA.

Stem cell injections. Despite being commercially available, there’s no evidence for using stem cell injections in treating knee OA. The International Society for Stem Cell Research and the Australian Rheumatology Association do not support using stem cell injections for osteoarthritis.

Botulinum toxin injections. The American College of Rheumatology/Arthritis Foundation Guidelines states that the small number of trials that have looked at the use of botulinum toxin in knee and hip OA ”suggest a lack of efficacy”.(1)

What about surgery?

Surgery may be an option for some people with knee OA when all non-surgical treatment options have failed, and knee pain and reduced function impact their quality of life. In this case, your doctor may refer you to an orthopaedic surgeon to discuss your options.

A total joint replacement of the knee is the most common type of surgery for knee OA. However, having an artificial knee means there will still be some limitations. An artificial knee won’t have the same sideways movement as a natural knee. It won’t bend fully, so getting down and up from kneeling is more likely to be challenging.

Arthroscopy is a surgical technique that involves the insertion of small surgical instruments, including a camera, into the knee. This allows the surgeon to examine the inside of the joint and cut, shave and remove material from the inside of the knee joint. “The Australian Government and most orthopaedic surgeons recommend against using arthroscopy for osteoarthritis of the knee. Research shows that doing an arthroscopy for this condition isn’t effective. Arthroscopy should only be used for knee OA if other treatments fail, such as losing weight, exercising and taking pain relievers.” (2)

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

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References

(1) Kolasinski, S.L., et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis & Rheumatology (2020).
(2) Arthroscopy, Healthdirect


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18/May/2023

Low-level heat wraps:
The gentle solution for managing musculoskeletal pain

By: Dr Peter McCann MRes (c), MAppSc, BAppSc, FASLM, FAICE

Musculoskeletal conditions such as arthritis, back pain, tendonitis, and the pain and stiffness they cause can be debilitating, causing a significant impact on a person’s quality of life.

Fortunately, many treatments are available to help manage these symptoms and improve overall wellbeing. This article will explore one such option – low-level continuous heat wraps and their benefits for people with musculoskeletal conditions.

How do they work?

Low-level continuous heat wraps provide gentle, consistent heat therapy to pain-affected areas. Unlike traditional heat products such as wheat bags or hot water bottles, which can quickly become too hot and uncomfortable, heat wraps use low-level heat, penetrating deep into the affected area without causing discomfort. This helps increase blood flow to the region, reducing inflammation and promoting healing. Heat wraps can help relieve pain and stiffness by reducing inflammation and promoting blood flow, making it easier to move and enjoy your daily activities. Unlike other heat therapy options requiring frequent reheating or readjustment, heat wraps provide continuous heat for up to 10 hours, allowing for long-lasting relief without constant reheating.

What are the benefits?

The benefits of low-level continuous heat wraps for musculoskeletal conditions are numerous. First and foremost, they provide immediate pain relief, making it easier to manage discomfort and carry out daily activities.

Additionally, heat wraps have been shown to increase the range of motion and improve joint function, making it easier to move and engage in physical activity. This is key to promoting recovery from back pain.

Heat wraps keep you mobile, unlike a wheat bag or hot water bottle that requires you to sit or lay down. By reducing inflammation, these wraps can enhance healing, speeding up the recovery process and helping to prevent further injury.

Heat wraps may reduce the need for medication, making it possible to manage symptoms without relying on potentially addictive or harmful drugs.

Finally, heat wraps can significantly improve your quality of life by relieving pain and stiffness, allowing you to focus on the activities and experiences that bring you joy and fulfilment.

What’s the evidence?

The Australian Clinical Care Standard for low back pain recommends using heat wraps as a first-line approach alongside other treatments, such as regular physical activity, to relieve back pain. Heat wraps are Australian Physiotherapy Association and Osteopathy Australia Association endorsed products and are registered medical devices used in major hospitals for pain relief.

How are they used?

Using low-level continuous heat wraps is simple. To begin, remove the wrap from its packaging and gently unfold it. Next, open one or two heat patches. They activate on exposure to air, taking 20 – 30 minutes to warm up.

Insert the patches into the wrap and apply them over the affected area, ensuring it covers the entire region of pain or stiffness.

Finally, secure the wrap using the included Velcro strips, careful not to apply too much pressure. Once in place, the wrap will provide low-level continuous heat therapy, which can be used for up to eight hours.

For best results, using heat wraps regularly as part of a comprehensive treatment plan that includes exercise, medication, and other therapies as needed is recommended.

The ingredients are non-toxic and eco-friendly, so they can be disposed of in the garden as a soil improver.

Are there any precautions?

Users should also be aware of any precautions or warnings associated with using the wraps, such as avoiding use on open wounds or irritated skin and sleeping with the heat wrap on. Before use, read the information provided carefully, or discuss this with your pharmacist.

The wrap-up 😉

In conclusion, low-level continuous heat wraps are safe and effective for managing musculoskeletal conditions such as arthritis, back pain, fibromyalgia and the pain and stiffness they cause.

By providing low-level continuous heat therapy, heat wraps can offer immediate pain relief, increased range of motion, improved joint function, reduced inflammation, enhanced healing, and improved quality of life.

Heat wraps can be used alongside other treatments to create a comprehensive care plan. I encourage readers to try these heat wraps and experience the benefits firsthand.

Talk with your doctor, pharmacist, physiotherapist or exercise physiologist for more information.

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

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23/Apr/2023

How to keep up (or start) walking for health and pleasure when it’s cold outdoors

It’s not quite winter yet, but it sure feels like it!

And if you’re like me and love to get outdoors and walk, it can be a little tough staying motivated when it’s cold, wet and wintery. But there are things you can do to boost your motivation, stay active and even come to relish the experience of walking in colder weather.

But, I hear you ask, why would any sane person want to get off their warm, cosy couch, put aside the remote control and brave the elements??? Because exercise doesn’t take a break for the colder months 😐 and we need to engage in regular, consistent exercise year round.

And while it can be challenging at times, we all know how much better we feel after we hit the pool, go for a walk, or take part in an exercise class. Being active every day helps us manage our pain, get better quality sleep, and improve our mood. It also helps us manage our other health conditions. And it gets us out of the house so we can connect with others – our friends, teammates, gym buddies, and other people walking their dogs in the park.

Knowing all of that doesn’t make it easy though, so here are some strategies to help you get out there.

Timing is everything

Plan to go walk when your body has had a chance to loosen up. Do some stretches, or have a warm shower to relax your muscles and joints so you can walk more easily and with less pain. The Arthritis Foundation has some basic stretches you can use before you head out the door.

Dress for the weather

Your usual exercise gear may not cut it when it comes to walking in colder weather. You need to think layers. The clothes closest to your skin should draw moisture away from the skin (known as wicking) so your skin doesn’t stay damp. It should also dry quickly. Look on the labels for mention of wicking or polypropylene. Avoid cotton. When cotton clothes get wet, they stay wet, making you colder.

Next, add an insulating layer of fleece or wool to keep you warm. And finally, add a layer that will resist wind and rain. The beauty of layers is that you can take them off and put them back on if/when needed.

Choose bright colours so you’ll be seen through the fog and rain, even on the greyest days 👕👚🦺. And at the risk of losing my Melbournian status 😉, there’s something lovely about ditching the black clothes and wearing bright colours on a gloomy day.

There’s no such thing as bad weather, just the wrong clothing, so get yourself a sexy raincoat and live a little.“ Billy Connolly

Now accessorise!

I’m not talking bling here, 💎💍 though; like adding colour, bling can definitely brighten your day 😊. But I’m referring to appropriate socks and footwear. It’s best to wear walking shoes that are waterproof or dry quickly. And they need good traction – it can get very slippery out there! If you’ve got old shoes from last winter, check the soles to ensure they’re still ok.

It’s important to know that the walking shoes you wear in warmer months are unlikely to be suitable for walking in colder months. The tops of these shoes are generally a lightweight mesh that lets air in to keep your feet cool. Not what you need on a cold walk!

You also need to protect your extremities (this is a must if you have Raynaud’s). Wear gloves or mittens, a hat that covers your ears, a scarf, sunglasses and sunscreen. Even in the colder months, your skin can be damaged by the sun’s rays.

Oh, and depending on the length of the walk you’re planning, you might want to take a lightweight backpack or bag for your water bottle and to store any of the layers you remove.

Get a walking buddy

Having a buddy to walk with can be fun and boost your motivation on cold days. This could be your partner, kids, family, friend, neighbour, pet 🐕🐈, or a walking group.

Or go on your own

Sometimes you just need some time to yourself.

Be aware of the walking surfaces

Slips, trips and falls are enemies of anyone with a musculoskeletal condition. So we need to take care out there. Uneven surfaces, moss, wet leaves or mud on footpaths and trails, and slick tiles at the shopping centre can all be dangerous. So keep an eye on the surfaces. And check out this info from MyHealth.Alberta.ca for some tips to lower your risk of falling.

Explore new areas

Whenever you can, take the time to explore new walking paths, rail trails, parks, or neighbourhoods. It’s amazing what you discover when you go beyond your own backyard.

Always check BOM 💣

Visit the Bureau of Meteorology (BOM) or your weather channel of choice, and get the weather and rain forecast. This will help you dress appropriately and may also affect your timing. If you like walking in the rain, you may decide to head out regardless. But if you’re not a fan, the radar will give you an idea of when to go (just don’t forget your umbrella – just in case).

Take your phone

It’s handy for listening to music, podcasts, and audiobooks and taking pics of the things you discover on your walk. It’s also essential for safety. Unfortunately, accidents can happen to us all, so stay safe and take your phone in case you need help. Or so you can call someone to pick you up if the weather becomes nasty!! 🚗🚓🚕

Add some mindfulness to your walk

Much of the pleasure of walking outdoors comes from enjoying the beauty of the changing seasons. So on your next walk, focus on your surroundings and how you feel. Try using the 5, 4, 3, 2, 1 method. For example:

  • What are 5 things you can see – e.g. the stripes on your gloves, the different hues of autumn leaves, a dog chasing a ball, fluffy clouds, ducks enjoying rain puddles.
  • What are 4 things you can physically feel: e.g. your feet on the ground, your partner’s hand, the wind on your face, the way your stride lengthens as you get into your rhythm.
  • What are 3 things you can hear: e.g. leaves crunching under your feet, children laughing, thunder in the distance.
  • What are 2 things you can smell: e.g. cut grass, rain coming.
  • What is 1 thing you can taste: e.g. your coffee traveller. ☕

Walk indoors

If you’re not a fan of exercising in cold and wet weather or you’re worried about slippery wet surfaces, walk indoors. Do laps of your home, hire/buy a treadmill, or walk briskly in your local shopping centre, gym or community centre.

Stay hydrated

Even though you may not be sweating as much as you would be on a hot day, your body is still losing water through your sweat and breathing. Take a water bottle with you and drink when you need to.

Set yourself a goal

If you’re still finding it hard to get motivated, set yourself a goal. It may be the ability to walk a certain distance without being out of breath or taking part in an upcoming fun run/walk. Choose something that matters to you, then create a SMART goal – that is, it’s Specific, Measurable, Achievable, Realistic and has a Timeframe. Read more about goal setting.

“Sunshine is delicious, rain is refreshing, wind braces us up, snow is exhilarating; there is really no such thing as bad weather, only different kinds of good weather.” John Ruskin

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 Monday to Thursday between 9am-5pm on 1800 263 265 or email (helpline@msk.org.au) or via Messenger.

More to explore


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23/Mar/2023

Chronic (or persistent) pain is a common and complex problem affecting 1 in 5 Australians aged 45 and over.(1)

Dealing with chronic pain can be challenging. But there are many things you can do and resources available to help you manage. The first step starts with seeing your doctor.

Here are five reasons you should see your doctor about your pain.

1. You want to take control

Talk with your doctor about pain management programs if you want to learn about managing your pain more effectively. These programs are available in person and online.

Pain management programs aim to reduce the impact that pain has on your life. They treat you as a whole person and don’t focus solely on your pain. That means they address everything from exercise to mood, stress, goal setting, sleep, managing your activities, returning to work, and more.

By attending a pain management program, you’ll learn from doctors, physiotherapists, occupational therapists, nurses, and psychologists. They’ll provide information, advice and support to help you take control of your pain.

Talk with your doctor about whether a pain management program would be helpful.

2. You’re not coping with your pain

It’s important to talk with your doctor if you feel like you’re not coping, especially if:

  • you’re taking more of your medicines than prescribed
  • you’re mixing your medicines with other drugs, including alcohol
  • you’re drinking excessive amounts of alcohol
  • you’re having problems sleeping due to pain
  • you’ve been feeling very low for more than a few weeks
  • you’ve been missing work because of pain
  • you’re more worried, frustrated and irritable than usual.

Your doctor understands that living with pain is difficult. They can work with you to find the right pathway to help. They can also refer you to other health professionals, including physical and/or mental health specialists.

3. You’re struggling at work

If you’re not coping with your work responsibilities or just getting to and from work has become difficult because of your pain, discuss this with your doctor.

Evidence shows that working improves general health and wellbeing for most people and reduces psychological distress.

That’s why finding ways to stay at work, even with chronic pain, is important. Your doctor can give you information and support to do this. They can also refer you to other healthcare professionals – e.g. physiotherapists, occupational therapists and specialist doctors (occupational physicians) – to help you stay at work.

And check out our resource WorkWise for info and tips to help you at work.

4. You’ve decided to stop taking your regular medicine for pain

You should talk openly with your doctor if you’re considering stopping any medicines. Some may need to be reduced gradually to avoid potential side effects. Your doctor will advise you on this.

5. You’ve noticed significant changes to your symptoms

It’s also important to be aware of other health changes that may occur. They can appear for various reasons, many unrelated to your pain.

However, if you’ve been experiencing any of the following symptoms, talk with your doctor:

  • a sudden increase in the intensity of your pain
  • sudden loss of muscle power in your legs or arms
  • sudden change in your ability to empty or control your bladder or bowel
  • a lack of sensation anywhere in your body
  • sudden onset of pins and needles or numbness in either hands or feet
  • sudden onset of poor balance or a lack of coordination
  • unexplained and ongoing loss of weight
  • sweats at night time
  • moderate or severe pain at night or at rest
  • new pain in your abdomen, chest or head which doesn’t go away.

These ‘red flags’ tell your doctor that something has changed. Changes in pain and other signs and symptoms are treated with caution. Your doctor will investigate potential causes to understand what’s happening and how/if to treat it.

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

More to explore

Reference

(1) Chronic pain in Australia, Australian Institute of Health and Welfare, 2020.


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13/Oct/2022

Tips to help you sweep away winter

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

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

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

Planning, prioritising and pacing

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

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

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

Take breaks

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

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

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

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

Get the right tools for the jobs

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

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

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

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

Choose your battles

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

Let the cleaning products do the hard work

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

Beware of dust and toxic smells

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

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

Recycle old socks

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

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

Use your dishwasher for more than dishes

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

Consider reorganising your pantry, laundry or kitchen

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

Get some wheels

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

Repackage it

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

Alternate your cleaning activities

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

Get the family involved

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

De-clutter

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

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

Hire someone

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

Distract yourself with music, podcasts and audiobooks

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

Give your medicine cabinet a spring clean too

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

Things don’t have to be perfect…

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

Call our Help Line

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

More to explore


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31/Aug/2022

Always laugh when you can. It is cheap medicine. – Lord Byron

I think there’s a reason we respond so positively to the memes, social media posts and jokes that poke fun at pain, chronic illness and the trials and tribulations that come from living with both.

Having a foggy brain isn’t particularly funny, being unable to sleep isn’t a joke, and pain – wow, that’s probably the un-funniest thing you can think of 😣. But we all tend to laugh at and share the well-crafted meme or post that pokes fun at these things because we identify with the truth behind them. And with the best ones, you can tell it’s been created by someone who knows what it’s like to live with pain and illness. You recognise a fellow traveller.

Laughter and humour are such powerful forces. Just think about the last time you had one of those huge, spontaneous belly laughs with family or friends. Something was said, a joke was told, or you all saw something ridiculous. You snort, giggle, and guffaw. Your eyes water, you gasp for breath, and your belly starts to hurt. When you look at each other, you laugh some more. When you finally do stop laughing, you feel euphoric. Everything seems better, and you feel happier 😊.

However, when you’re in the grips of pain, laughing is probably the last thing you feel like doing. But laughter can actually help you deal with your pain better. A good joke, a funny movie, or just seeing something silly can distract you from your pain and make you feel better, at least for a while.
Laughter also causes your brain to release some feel-good chemicals that boost your mood and make you feel more optimistic. They include endorphins, serotonin and dopamine. Endorphins are your body’s natural pain reliever; releasing them into the body temporarily reduces your feelings of pain. Serotonin produces feelings of calmness and happiness. And dopamine is part of your brain’s reward system and gives you a sense of pleasure. It also helps reduce feelings of anxiety.

Other health benefits of a good giggle

As well as helping you cope with your pain and the stress of living with chronic health issues, laughter has many other health benefits. Laughing regularly:

LOL ideas

To bring on the laughs, giggles, chortles, snickers, cackles and guffaws, give these ideas a go:

  • Watch/stream a funny movie or sitcom – check out these lists from Flickchart and Rolling Stone for their top picks.
  • Listen to a funny podcast – this list from Time Out will get you started if you need ideas.
  • Run through a sprinkler on a hot day.
  • Talk with a friend and reminisce about a funny experience you had together.
  • Watch cat / dog / panda videos (you’re welcome!). 😹
  • Grab the kids, friends, partner or housemates and play. Anything! … Keep a balloon off the floor. Throw a frisbee. Charades. Pub quizzes. Truth or dare. Never have I ever. The floor is lava…
  • Have a pillow fight.
  • Think about the funniest joke you ever heard or your best (worst) dad jokes.
  • Jump on a trampoline.
  • Take silly selfies and send them to your bestie.
  • Grab a microphone (or a hairbrush) and sing out loud!
  • Join a laughter club. Simply google ‘laughter clubs’ for your state or territory.
Laughter serves as a blocking agent. Like a bulletproof vest, it may help protect you against the ravages of negative emotions that can assault you in disease. – Norman Cousins

Sadly it’s not all fun and games

It’s important to remember that laughter and humour are temporary distractions from pain. They’re great, and we should definitely cram as much into our day as possible. Just for the sheer joy of it 🤡.

But when you have a chronic illness and persistent pain, a balanced treatment approach should include self-care, appropriate medications and medical care, a healthy lifestyle, exercise, mindfulness and, yes, laughter.

Laughter may not be the best medicine (as the old saying goes), but it’s pretty close to perfect.

So, make sure you take a dose (or better yet – several!) every day!

A good laugh heals a lot of hurts. – Madeleine L’Engle

Contact our free national Help Line

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

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Photo by MI PHAM on Unsplash


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10/Aug/2022

Creams, sprays, liniments, ointments, patches, rubs & gels

If you open most medicine cabinets or bathroom cupboards, you’ll more than likely find a tube or jar of a pain-relieving rub. With varying degrees of smelliness!!😱

Many of us turn to these products when we wake up with a stiff neck or overdo it in the garden. The soothing ointments, creams, sprays, liniments, patches, rubs and gels that we apply directly to our skin (topically).

But what are they? How do they work? Are they effective? And are they safe?

First, there’s a vast array of topical products available in many forms and using different ingredients. Many are available to buy over-the-counter from your chemist or supermarket. However, some require a prescription.

Let’s look at some of the more common varieties.

Counterirritants

These products use ingredients such as menthol, methyl salicylate, eucalyptus oil and camphor. They’re called counterirritants because they create a burning, cooling or ‘tingling’ sensation in the area where they’re applied that distracts you from your pain.

Medicated products

Many topical products contain non-steroidal anti-inflammatory drugs (or NSAIDs) such as ibuprofen, diclofenac or piroxicam. NSAIDs block the action of specific enzymes (cyclooxygenase or COX) that are involved in inflammation.

Topical NSAIDs may be an option for you if you can’t take oral NSAIDs due to other health issues (e.g. high blood pressure) or the risk of complications (e.g. stomach problems), as less medication is absorbed into the bloodstream.

If you’re using a topical NSAID, you should avoid taking NSAIDs orally (pills or tablets) unless you’ve discussed this with your doctor. Although the amount of medicine that enters your body through the skin is less than when taking them orally, there’s still the risk of getting too much when using both forms.

Corticosteroids, or steroids, simulate the naturally occurring hormone cortisol. One of the many functions of cortisol is to suppress or reduce inflammation. Steroid creams come in varying strengths. They rarely have serious side effects if used correctly, so it’s essential that you follow the instructions carefully. If you have any concerns, discuss these with your doctor or pharmacist.

Capsaicin

Capsaicin is the substance found in chilli peppers that gives them their heat and spicy kick, making your mouth tingle and burn. Applied to the skin as a cream, it works by interfering with the pain signals between your nerve endings and brain.

Benefits of using topicals

Most topicals, when used correctly, provide quick, temporary pain relief and have fewer potential side effects than oral pain-relieving medicines.

They may be a good option if you only have pain in a few joints or muscles, as they work in the immediate area you apply it to, rather than affecting your whole body.

Topicals also provide the soothing benefit of a mini-massage when you apply them to your skin. Seriously, how good does it feel when you rub the cream into your sore neck, and you feel the muscles loosening? Or when you apply a warm gel to your stiff, aching knee? Bliss. 😊

Another benefit of topicals is that they’re very portable; you can have some at home, in your drawer at work, in your handbag or gym locker, and use them as needed.

Do they work?

Many people swear by these products for quick pain relief. And there’s solid evidence that they can provide pain relief for acute pain, such as strains and sprains. However, research shows only modest benefits for chronic pain. But, if you feel better when using these products, and you’ve discussed it with your doctor, they’re safe to use and are better tolerated than oral medicines.

Potential side effects

Topicals, both medicated and non-medicated varieties, can cause side effects. They include skin irritation, redness, rash, or a burning, stinging or itchy sensation in the area it’s been applied.

Very rarely, some people may experience nausea, breathlessness, indigestion or an allergic reaction to the topical. If you experience any of these symptoms, stop using the topical and talk with your doctor or pharmacist for advice.

Cautions

As with any medication, there are things you need to be aware of to prevent any problems from occurring:

  • Taking oral and topical medicines containing the same ingredients (e.g. NSAIDs) at the same time may increase the risk of side effects. Talk with your doctor about this risk.
  • Always read the consumer medicine information carefully and follow the instructions. Take note of how to apply the topical, how often and how much. Don’t go overboard and slather it on. You can get too much of a good thing!!
  • Wash your hands thoroughly after applying.
  • Be careful to avoid contact with your eyes or other sensitive areas 😖.
  • Don’t use these products on wounds or damaged skin.
  • Don’t use with heat packs as this may cause burns.
  • Only use one topical medicine at a time.
  • Check the use-by-date and discard any out-of-date products.

Contact our free national Help Line

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

More to explore


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03/Mar/2022

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

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

Let’s start with a look at your spine

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

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

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

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

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

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

So what’s causing the pain?

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

Some common causes of neck pain are:

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

Symptoms

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

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

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

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

Seeing your doctor

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

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

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

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

Dealing with neck pain

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

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

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

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

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

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

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

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

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

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

Treating ongoing neck pain

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

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

Contact our free national Help Line

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

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