This year’s theme is: Get informed. Get supported. Check out the Rattle Ya Bones Day web page on how you can get involved!
Let’s take advantage of the warmer days and and look at how we can sweep away the winter cobwebs and make ourselves sparkle this spring!
(Originally written and published by Lisa Bywaters 2020).
If you have questions about things like managing your pain, 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.
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 spineIt 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.
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:
The symptoms you experience will depend on what’s causing your neck pain but may include:
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’.
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.
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 cold – they 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 away – massage 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.
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:
(Originally written and published by Lisa Bywaters 2022)
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.
Do you take better care of the person you are caring for than yourself?
If the answer is yes, you will benefit from this workshop. We will explore why your health and well-being are important, and give you strategies to help better care for yourself.
The workshop is open to all families and carers, especially those who find it difficult to care for themselves.
TOPICS WILL INCLUDE:
Our presenter: Sally Camilleri – Carer and Community Educator
Sally’s academic experience encompasses welfare studies, anthropology, and education. She has many years’ experiences as an educator and facilitator of learning that builds on a career in direct service delivery, community development and project management with people with a disability, women who experience disadvantage and Carers. This includes implementing financial literacy programs with refugee and migrant women, to build capacity to engage with our complex financial systems. Having worked with Carers Victoria for over four years, Sally has built a complex understanding of the carer perspective.
I’ve never really thought about my shoulders. They’re just there. Useful for hanging a handbag on or supporting a heat pack for my neck. I only really notice them when, graceful person that I am 😉, I bash one on a door frame.
That was until a few years ago when I slipped in the bathroom and fell hard on my arm, with my shoulder in an unnatural position. I was suddenly very keenly aware of my shoulder! I honestly thought I’d broken it. Fortunately, scans revealed nothing had broken, but I had injured the soft tissues.
However, it was during that time I learned about shoulders. I know, I know, the crazy fun times never end for me 😂. But in my defence, I was stuck on the couch for a few days with my arm in a sling and an ice pack on constant rotation. So I didn’t really have a lot going on.
And what I learned was fascinating.
And since shoulder pain is incredibly common, I thought I’d share what I learned with you. Because if you haven’t had shoulder pain, you probably know someone who has. So buckle up, and let’s learn about shoulders, shoulder pain and how to treat it.
DYK, the shoulder has not one, but four joints???
This makes them complex, flexible structures with a large range of movement. Unfortunately, this flexibility can also put the shoulder at risk of injury and dislocation, especially through contact sports and falls.
Your shoulder is made up of three bones: the shoulder blade (scapula), collarbone (clavicle), and upper arm bone (humerus).
The main joint is the glenohumeral joint. This is where your humerus connects with your scapula. Like the hip, it’s a ball and socket joint. The top of your humerus is shaped like a ball and fits inside the socket or cup-shaped indentation in your shoulder blade. However, this socket is shallow, giving your shoulder great flexibility but also making it less stable.
The other joints are:
Soft tissues surround the glenohumeral joint to form a capsule. This keeps the head of the arm bone in place in the joint socket. The joint capsule is lined with a synovial membrane that produces synovial fluid to lubricate and nourish the joint. Tendons, ligaments, bursa, and muscles also support the joints and bones in your shoulder to stabilise it and allow it to move freely. The bones, joints and soft tissue work together to make your shoulders incredibly mobile, so you can do all kinds of things like throw a ball, hug a friend, brush your hair, and scratch your back.
Shoulder pain may come on quickly, e.g. if you injure yourself, or it can occur more gradually. It can be mild pain or, as I experienced, very painful 😥.
There are many causes of shoulder pain, not all due to problems with the shoulder joints or associated structures. They include:
Note: if you feel shoulder pain radiating down your arm or you’re experiencing a tight feeling across the chest and shortness of breath, dial 000 immediately.
Unsurprisingly, the main symptom of shoulder pain is pain! Other symptoms include:
If you have shoulder pain that’s causing you distress or affecting your ability to do your daily activities, you should see your doctor. Your doctor will:
From this, they can work out the likelihood of particular structures in the shoulder being involved.
Sometimes they’ll suggest that scans are needed. They may include X-rays, ultrasounds, computed tomography (CT), or magnetic resonance imaging (MRI). The type of scan/s required will depend on the suspected cause of your shoulder pain. However, it’s important to know that many scans show changes to your shoulder that will likely represent the normal passage of time (even by age 45), not damage to your shoulder.
Treating shoulder pain begins with understanding the cause of the problem. What works for one shoulder issue may not work for another. Your doctor will create a treatment plan based on your diagnosis.
The following are some commonly used treatments for shoulder pain.
For most people, shoulder pain will improve over time with appropriate, conservative treatment. However, in some cases, surgery may be required.
When considering surgery, you should be informed about what it involves, the rehabilitation process, and its potential benefits and risks.
Most people with shoulder pain will find it gets better over time. But there are things you can do to proactively prevent future problems.
Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265, email (helpline@msk.org.au) or via Messenger.
“Winter is the time for comfort, for good food and warmth, for the touch of a friendly hand
and for a talk beside the fire: it is time for home.” – Edith Sitwell.
I love this quote. It sounds like the perfect lazy Sunday, doesn’t it? 😊💚
Sadly winter is more than just lazy Sundays when you can stay at home, warm on the couch with a loved one. Reality means we need to eventually (and reluctantly) head out of our cosy homes and face the cold, wet winter. And when we’re at home, because of crazy energy prices and rising living costs, we have to make hard decisions about how to spend the household budget. Heating is one of the more significant costs in winter, so many people are forced to reduce it to save money.
For those of us with conditions like fibromyalgia, lupus, osteoarthritis, rheumatoid arthritis, back pain, scleroderma, and Raynauds’s phenomenon, this can be a painful problem. We often feel the cold more keenly with increased joint and muscle pain or lack of blood circulation to the extremities.
So, how can you stay warm and keep the costs down this winter? We’ve got some suggestions for you to try.
Let’s start with the basics. You need to dress for the temperature and wear layers. It can sometimes feel cumbersome and bulky, but it’s one of our best defences against the cold. So put on the warm pants and jumper, embrace your inner Wiggle and wear a skivvy, pull on your thick socks and/or tights and appropriate footwear. If you’re still cold, consider adding thermals to your layers.
When you head outdoors, add more layers – including a coat, hat, gloves, and scarf. You can also buy a fantastic range of heated vests, socks, scarves, and gloves. They can be a little pricey, but they may be worth that initial outlay if you’re outdoors a lot. Check online or in-store at outdoor suppliers.
If you’re at home and still feeling the cold, grab a blanket for your legs as you sit at your desk or on the couch. You can use any warm blanket, doona or heated throw. Whatever you choose, just be careful you don’t trip on it when you get up.
“Winter’s my favourite…The best parts are the coats and sweaters.
Hugging all the warmth back in.” – Abby Slovin.
Don’t assume you’re on the best energy plans for your gas and electricity. Take some time to see if there’s a better deal. If you live in Victoria, visit Victorian Energy Compare. For all other parts of Australia, visit Energy Made Easy.
When the wind’s howling outside, you know it’s trying to find a way indoors 💨. So cover the bottom of your door with a door snake or an old towel, or add some door seals. Pull your curtains and blinds over the windows at night and during miserable days to keep the warmth inside. If you have floorboards, consider putting down rugs (just be careful they don’t become a trip hazard).
If you can safely do so, close or cover air-conditioning vents, exhaust fans, and unused chimneys. However, it’s important to be aware that some gas appliances require a certain amount of ventilation or fresh air, or they can be unsafe. They should also be serviced every two years or sooner if you notice anything unusual. If in doubt, speak with a licenced gas fitter. Energy Safe Victoria has lots of useful info about heating your home with gas and what to look for when searching for a licenced gas fitter.
Sustainability Victoria also has helpful information on draught-proofing your home. You can also watch these handy DIY draught-proofing videos from the City of Port Phillip (Melbourne).
“It was one of those March days when the sun shines hot, and the wind blows cold:
when it is summer in the light and winter in the shade.” – Charles Dickens.
While it’s tempting to crank the heat up, the most efficient temperature to set your heater to (if you can select the temp) is 18-20 degrees. While that may not sound particularly warm, we’re often outside during the warmer months wearing short sleeves when it’s 18-20 degrees. It’s just a matter of perspective.
And only heat the areas you’re using. If you can turn the heating off in unused parts of your home, do it. Shut the doors and use a draught stopper to prevent the warm air from the rest of the house from escaping into these areas. And turn the heating off when you go to bed or leave home.
Thick curtains made from heavyweight, tightly woven fabrics can prevent heat from escaping your home. For the best results, curtains should be fitted as close to the window frame as possible, extend below the sill and well over the sides of the window frame, and a pelmet fitted over the top. This acts to seal the window from the rest of the room and prevent heat loss. Curtains will also keep the hot air outside in summer.
Open your curtains and blinds on sunny days to let the sun shine on your windows. Even with a chilly wind, the sun will bring wonderful warmth into your home.
And remember to close them when the sun starts to go down. As someone who goes for walks when it’s dark in the early morning and evening, I’m always amazed by how many people have their windows uncovered. You can practically see the heat escaping through the glass. So close them to keep the warmth in and the gaze of the sticky-noses (like me) out 😉.
You sleep better when your body can cool down, so turn the heater off at night. It’s also safer to sleep with the heater off. You can remove the chill from your bed using a hot water bottle or an electric blanket. Just remember to turn your electric blanket off before sleeping.
There’s nothing like slipping into a deliciously warm bed on a cold night, especially if there’s soft flannelette involved! So swap out your lighter, everyday bedding for heavier winter ones. And add layers – a top sheet (if you don’t already use one) and extra blankets. Finally, if you have floorboards in your bedroom, adding a rug under your bed can prevent draughts from making their way to your bed.
When the weather allows, go for a brisk walk outdoors, wearing appropriate clothing, and you’ll warm up in no time. Save on pricey petrol and walk to the shop/school/post office instead of driving.
When you’re at home, exercise indoors using an online program, a DVD or an app. Play with the kids. Clean the house. Do anything that gets you moving, and you’ll feel warmer than if you sit in one place for hours.
However, if you’re having a flare or experiencing a lot of pain, be as active as you can within your limits. And use your heat packs to help relieve muscular pain.
Many of us use our shower to warm up sore joints and muscles so we can get moving. However, hot water uses a lot of energy; even a few extra minutes will add to your bill. If you can, shorten the time you spend in the shower. Aim for four minutes or less. You can use a timer or sing your favourite song. Hunter Water has a great playlist of four-minute(ish) songs to get you inspired.
“There’s no half-singing in the shower;
you’re either a rock star or an opera diva.” – Josh Groban.
Anything that blocks a heater will prevent the warm air from flowing around the room uninterrupted. So move clotheshorses and other obstructions away from the heat source.
Hot air rises, so if you have ceiling fans, flick the reverse or winter mode switch and turn the fan on low. This will pull the cooler air towards the ceiling and push the warmer air down to you.
And to stay safe, fire authorities say you should keep clothing and other fabrics at least one metre from your heater. Never place them on heaters.
Get comfy on the couch with your partner, kids, and pets. Grab a warm blanket or doona, share your body heat, and enjoy being together.
“People don’t notice whether it’s winter or summer when they’re happy.” – Anton Chekhov.
If you’re feeling stiff and sore, heat packs or hot water bottles can provide temporary pain relief and help you get moving. But you need to be careful when using them.
If you’re using a heat pack or wheat bag, let it cool completely before you reheat it. Don’t sleep with your wheat bag or smother it behind you in your chair or bed. This can cause it to overheat and catch fire. Always carefully follow the manufacturer’s instructions and never overheat them in the microwave.
If you’re using a hot water bottle, use hot water from the tap, not boiling water. Wrap it in a cloth or use a cover so it doesn’t come into contact with your skin.
Always examine your hot water bottles and heat packs before use, and toss them out if you notice signs of wear or damage. And always check their temperature before use to ensure they’re not too hot.
Many delicious winter recipes bring comfort and warmth on the most miserable days. So crack open the cookbooks and get cooking! Or go online for inspiration for yummy, warming curries, soups and stews. We’ve got some great recipes to get you started! Can’t be bothered cooking? Simple. Grab a cup of hot chocolate, tea or coffee. It’ll warm your insides and your hands. Perfect! ☕🍵
“Winter blues are cured every time with a potato gratin paired with a roast chicken.” – Alexandra Guarnaschelli.
If you’re in the market for a new heater or hot water system, make sure you’re buying one that’s energy-efficient and best suits your needs. Read Canstar’s guide to energy-efficient heaters and Choice’s article on buying the best hot water system for more info.
Insulation keeps your home warm in winter and cool in summer by preventing heat from escaping or entering your home. This keeps your home at a more consistent temperature and reduces the need to crank up your heating or cooling.
If your home isn’t properly insulated, this is something you can do that’ll have long-term benefits. There’s a substantial upfront cost, but it may be an option for some households. Find out more about insulation, including the different types available and how to install it, from the Australian Government’s website, Your home.
If you’re struggling to pay your energy bills, Energy.gov.au also has some information about support for Australian households, including info on potential rebates that may be available.
We’ve also put together lots of info to help you if you’re struggling with financial stress.
Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.
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
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.
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.
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.
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.
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.
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)
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)
Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.
(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
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.
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.
It’s important to talk with your doctor if you feel like you’re not coping, especially if:
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.
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.
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.
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:
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.
Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.
(1) Chronic pain in Australia, Australian Institute of Health and Welfare, 2020.
Dr Joshua Pate is the author of Zoe and Zak’s Pain Hacks, a new series of children’s books to help children learn about the incredible and mysterious science of pain.
Pain is complex and can be difficult to talk about, especially persistent pain – pain that has persisted for longer than expected. Zoe and Zak’s Pain Hacks is a series of five books designed to help children learn and talk about pain with their family, friends, teachers, and health professionals. The first four books each address one key target concept, the fifth book brings these learning outcomes together with an empowering action plan.
Dr Pate will introduce the series of books and explore why the series has been written. Josh will share the latest research in paediatric chronic pain educational research, and there will be time for a Q&A for families to ask questions.
Our presenter: Dr. Joshua Pate is a senior lecturer in physiotherapy at UTS, and he also is the author of Zoe and Zak’s Pain Hacks. Josh is a passionate pain scientist and energetic educator. His goal is to make pain science education accessible to everyone and reduce the overall burden of chronic pain.
Travelling can be an incredible adventure, but it can sometimes cause anxiety and stress if you have a chronic condition. When you’re out of your normal routine, it can be impossible to know how you’ll feel each day and how this may affect your trip.
Here are some tips and tricks to help you get the most out of your trip and have a fantastic time.
Take time to plan your trip carefully. Being proactive before you go away allows you to plan around your condition rather than have your condition disrupt your trip. You know how your condition affects you – using this information when planning will put you in control.
Give yourself plenty of time to pack and complete any tasks or household chores you need to do well before the day you leave.
Rest up. Even though you may be going on a holiday for rest and relaxation, try and get some rest before you leave. That way, you’ll have more energy to do and see what you want when you arrive at your destination.
Make your itinerary realistic. When you’re on holiday, it’s tempting to pack as much as possible into every single day; however, this can often lead to increased pain and fatigue. Plan rest days or less active days and create an itinerary that’s flexible depending on how you feel each day. It’s better to do less and prevent flare-ups than do too much and end up unwell.
Minimise long journeys where possible. Living in Australia, we know long distances are a part of life, whether travelling overseas or within Australia. However, try to avoid packing your itinerary with long plane, train, car, or bus journeys if you can. Make a list of the key sights you want to see, plan your travel around them and be realistic. If you will be travelling for long periods, plan rest stops and consider layovers to make it more achievable.
If you’re travelling by plane or train, ask for an aisle seat and take strolls up and down the aisles. This’ll help reduce stiffness, and muscle and joint pain. You can also do leg and foot stretches and other gentle exercises while seated.
Consider informing the airline of your medical condition. With advance notice, the airline should be able to:
Talk with the transport operators before you leave. Contact the companies before your journey to see what assistance and services they can provide. This goes for all planes, trains, coaches, ships, boats – basically any form of transport operated by someone else. Let them know if you require help and if you have any mobility aids. Have the specifications of your mobility aids handy in case they need this information. Doing this before you go means the operators can be ready for your arrival and save you any potential stress or inconvenience.
Booking accommodation. When choosing your accommodation, always consider walking distance to other services, the number of stairs and the availability and location of lifts. Make sure you can drop your luggage off at your hotel if you arrive early – you don’t want to carry heavy bags any longer than necessary! Consider booking accommodation with a heated pool or spa, so you can exercise or relax in warm water to loosen sore muscles and ease painful joints.
Pack light. Packing can be one of the hardest parts of travelling – what to take, what to leave at home – so if in doubt, leave it out. Lifting heavy bags on and off trains, buses and through airports increases your risk of injury and fatigue. When you travel, you also end up carting your luggage around more than you may realise. So packing light is essential. Check out some of the travel websites, articles, and blogs if you need tips and advice on packing.
Use lightweight luggage if you have it. If you’re buying new luggage, think lightweight and durable. Look for luggage with good wheels and handles that allow for easy manoeuvrability. A suitcase you can push rather than pull places the load squarely in front of you and means you don’t have to twist your wrists. If you don’t own lightweight luggage, see if you can borrow some from your family or friends.
Don’t forget to pack any special equipment or aids that help make life more comfortable, such as:
Consider wearing a mask and using hand sanitiser when you’re on planes, trains and other public transport. Although many of us have gotten out of this habit, COVID is still around. And nothing spoils a holiday faster than getting sick 🤒. Masking and sanitising are the best strategies to reduce your risk of this occurring.
Separate your medicine. Keep your medicine in separate pieces of luggage to ensure you don’t lose it all should a piece of luggage become lost or stolen. Only carry enough medicine that you need for your own personal use. Pack in your hand luggage any medicine you may need access to quickly so you can get to it when needed.
Organise your medicines. Being away from your usual routine can make it easy to forget to take your medicine/s at the appropriate time. If you take medicines every day, consider using a pillbox with separate compartments for each day (but keep the original packaging with you). More information on travelling overseas with medicine and medical devices can be found on the Therapeutic Goods Administration website.
Check size restrictions on luggage and mobility aids with your travel agent, airline or other transport operators.
Get advice well in advance. Ensure regular blood tests and doctor visits are done before you leave. Discuss any concerns you have about travelling with your doctor (e.g. whether you need to adjust your medicine schedule if travelling to a different time zone).
Talk with your doctor about vaccinations, especially if you’re going overseas. This protects your own health, but also some countries, airlines and cruise lines require proof of certain vaccinations before entering or boarding. The Smart Traveller website has more information about vaccinations and overseas travel. Note: Some vaccines should be avoided if you have an autoimmune condition or take medicines that suppress your immune system. Your doctor or rheumatologist can advise you on this.
Check that your medicines are legal and not restricted or banned where you’re going. You can do this by contacting the relevant consulate or embassy; a list is available on the Smart Traveller website. Carry a letter from your doctor listing your medicines, the dosage and what they’re for, as well as your doctor’s contact details. Keep medicines in their original packaging, or if you’re using a pillbox, keep the packaging with the pillbox.
For more information about medicines and travelling, read Travelling with medications: A guide by the International Association for Medical Assistance to Travellers.
Stock up. Make sure you have enough medicines (for your personal use) to last until you return home. You may not be able to get the same medicines elsewhere – especially if you’re overseas.
Store your biological medicines properly. If you’re taking biological medicines (biologics or biosimilars), they may need to be stored at a specific temperature in a special travel wallet. Seek advice from your rheumatologist and the pharmaceutical company about this. Check with your airline/s to see if they can assist you, for example, with ice for the travel wallet or placing your medicine in the aeroplane’s fridge.
Make sure your container is clearly labelled with your name and contact information, or attach your boarding pass. And make sure you don’t leave your medicine on the plane!
Don’t place your medicines in with your checked luggage. The baggage compartment gets extremely cold while the plane is in flight, and your medicine may freeze and be ruined.
Fridges away from home. Once you’re at your destination, you should be able to use the mini-fridge in your hotel room to store your biologics. You should check that the fridge is adjusted properly to a suitable temperature. Also, in some countries, the power in a hotel room turns off when you leave the room. Ask the hotel staff about this upon arrival.
Contact the pharmaceutical company that makes your biological meds before you travel. Most have a customer support line and are an excellent source of information on the correct storage of medicines.
Know what you’re covered for. You can get travel insurance if you have a pre-existing condition such as arthritis, but it’s vital that you understand precisely what your coverage provides and whether it’s adequate for your needs. Different types of travel insurance will have different limitations on what’s covered, so shop around. A medical declaration form may be required in some instances. To learn more, check out our information on travel insurance for people with a chronic illness.
Rest up. After your trip, take a day or so to unpack and rest before returning to your normal routine. Contact your healthcare team if you have to reschedule any medical appointments or have symptoms that need attention.
Look after yourself. Even though you’re travelling, you should continue to do the things that help you manage your condition and pain at home, such as regular exercise, eating a healthy diet and getting enough quality sleep. They’ll contribute to good physical and mental health and wellbeing and help you keep pain and fatigue in check.
Getting around airports. Websites for all Australian international airports and domestic terminals have accessibility information, as do the individual airlines. Check these out before you go.
Give yourself plenty of time to make flights and connections and deal with your luggage. That way, you’re not rushing, which leads to stress and anxiety. Rushing can also make you push yourself too hard and lead to increased pain and fatigue.
Choose your meals carefully. Most airport and rest stop food choices are high-fat, high-salt, highly processed foods that promote inflammation. Carry healthy snacks, drink plenty of water, and drink alcohol and caffeine in moderation.
Check out the blogs of other travellers with special needs. Stories of other people who’ve visited the places you want to go to and who have accessibility needs are often great resources to help you plan your journey.
Take it easy, and have a great time! Remember, your trip is meant to be fun. Travel can be associated with both physical and mental stress that can be magnified if you have a health condition that causes you pain. So when planning your trip, factor in a plan B – just in case your original plan needs to be altered to allow you time to rest or take it easy. For example, if you’d planned a walking tour of a place you’re visiting, look into alternatives such as hop-on/hop-off bus tours or riding a bike. Build enough flexibility into your holiday to allow for these alterations so that you’re relaxed and not stressed about staying on schedule.
By planning your trip carefully, being flexible with your schedule, and taking your condition into account, you can have a fantastic holiday.
So get out there and enjoy yourself!
Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.
September 6, 2023
September 6, 2023
August 9, 2023
