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12/Feb/2020

The jury is no longer out – the evidence is in

For many years, glucosamine has been one of the most commonly used supplements for osteoarthritis (OA). And even though the jury has been out on how well it works, it has been considered safe to use.

When it comes to glucosamine, there’s been a lot of conflicting research with some studies showing positive results and some showing no effect. To add to the confusion, studies have used different preparations of glucosamine – for example glucosamine sulfate, glucosamine hydrochloride, glucosamine sulfate with chondroitin etcetera – and different dosages. Which makes it difficult to determine how effective glucosamine really is for treating the symptoms of OA.

Until recently, despite the evidence indicating that glucosamine has little, if any benefit for people with OA, it’s been seen to be relatively safe for most people.

Now, a recent study has raised some serious concerns about the side effects of glucosamine for people with shellfish allergy.

What is glucosamine?

At the ends of most of our bones we have a slippery cushion called cartilage. It absorbs shocks and helps our joints move smoothly. Glucosamine is a naturally occurring substance found in our cartilage.

For people who have osteoarthritis, this cushiony cartilage becomes brittle and breaks down. Some pieces of cartilage may even break away and float around inside the joint causing inflammation and pain. The cartilage no longer has a smooth, even surface, so the joint becomes stiff and painful to move.

Treating osteoarthritis

Until recently, treatments for OA have focused on managing the symptoms – controlling pain and reducing inflammation. Medications included analgesics – e.g. paracetamol – and anti-inflammatories – e.g. ibuprofen (*see note). Along with exercise and weight management, these were the mainstays of osteoarthritis treatment. There has been no silver bullet or treatment that worked quickly and effectively.

So when glucosamine first came on the market, with positive reviews, many people were excited at the prospect of this new, ‘natural’ treatment and began taking glucosamine regularly. Glucosamine seemed to provide pain relief for many people with osteoarthritis and improve their joint function.

However over the years as more research has taken place, the evidence for the use of glucosamine has come under more and more scrutiny. Earlier, positive research was mostly funded by pharmaceutical industry, and later research, that showed glucosamine provided limited improvements, was publicly funded. This called into question the potential for bias in the earlier reporting of the benefits of glucosamine.

The peak bodies respond

Based on recent independent evidence, the American College of Rheumatology (ACR) and the Australian Rheumatology Association (ARA) have both responded publicly.

In their latest guidelines for treating OA, the ACR “strongly recommend against” using glucosamine for osteoarthritis. And the ARA has stated that this new information highlights growing evidence that glucosamine doesn’t help people with OA and it‘s a reminder that people with a shellfish allergy shouldn’t take glucosamine.

Safety concerns

It’s been known for some time that glucosamine can interact with blood thinners such as warfarin, and that it may raise blood sugar levels in people with diabetes. Glucosamine may also have a negative effect on cholesterol and chemotherapy drugs and has been linked to worsening asthma

However it’s not been widely known to the general public that many glucosamine supplements are made from shellfish and can cause serious allergic reactions.

Recent research from the University of Adelaide investigated “spontaneous adverse drug reactions [or side effects]…to glucosamine and chondroitin in the Australian population between 2000 and 2011, with a primary focus on hypersensitivity reactions.”

They found that during that period, the Therapeutic Goods Administration (TGA) was notified of 366 recorded adverse reactions. This is more than the combined adverse reactions of other supplements such as echinacea, valerian, black cohosh, ginkgo and St John’s wort. However, hundreds of thousands of people also took glucosamine during that time with no ill effects, highlighting that the risk of a severe reaction was still very low.

A major issue raised is the labelling of glucosamine. Labelling must report that it contains seafood, but not specifically shellfish. And this information is often in small writing. So people who are aware that they have a shellfish allergy may not realise that they’re taking something that’s harmful to them.

In 2016, the TGA changed the rules for this, and required manufacturers to be clear if products contain shellfish. And this information must be easy for consumers to find. However they also gave manufactures until August 2020 to do this. So many products publicly available may still not may it clear to consumers if the product contains shellfish.

So what should you do if you currently take glucosamine?

  • If you have a shellfish allergy stop taking glucosamine immediately and discuss with your doctor.
  • If you have taken glucosamine for some time and haven’t had any negative side effects, and want to continue taking it, then you can do so under the advice of your doctor.
  • Talk to your pharmacist about any potential interactions with other medicines you may be taking.
  • Talk with your doctor about other treatment options – including exercise, weight management, pain management techniques.
  • Call our MSK Help Line weekdays on 1800 263 265 or email helpline@msk.org.au and talk with our nurses about OA and ways you can manage it without glucosamine.
  • Stay up-to-date. As well as being painful, living with a chronic musculoskeletal condition can be confusing and frustrating, especially with so much conflicting information circulating through the news, social media, and our network of family, friends and acquaintances. Follow us on Facebook and sign up for our eNewsletter to stay informed about the latest information, research, events and much more.

* Note

We now know that these medications provide very little benefit for managing the ongoing symptoms of OA. Currently the best evidence is for weight management (maintaining a healthy weight or losing weight if you’re overweight) and exercise. Treatments such as massage, heat and the short term use of anti-inflammatories may provide temporary relief, but the evidence is not as strong.

References


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31/Jan/2020

With our crazy, busy lives it can sometimes feel next to impossible to squeeze in time for exercise. Add to that the unpredictability of living with a chronic condition, and our planned activities can often go flying out the door.

But there are things you can do to be more active. Incidental exercise – or the little bits and pieces you do over the course of your day – can really add up. It’s important to note that incidental exercise should not replace your regular, structured exercise program, but they’re a great way to boost your activity levels.

Here are some things you can do to increase your incidental exercise.

  • Watching TV? Whether you’re watching the latest episode of your favourite show or binge watching an entire series, get up and move around during the ads. No ads? No problems. At the end of each episode, do something active. Go outside and check the letterbox. Take the dog for a walk around the block. If you have an exercise bike or treadmill, use it while watching your show.
  • Love reading? Download an audio book and listen to it as you go for a walk. Just be mindful about how far you walk. It’s easy to get caught up in a book and walk further than you planned! Which has the potential to aggravate your condition and pain levels if you do too much.
  • Going for a long drive? Make your journey more interesting, and more active by scheduling stops for you to stretch, walk around and discover new areas. It’s amazing what you can find when you take the time to explore.
  • Shopping? Park your car a little further away from the shops than you normally would. Walk up or down the travellator or escalator – even if it’s just for part of the ride – rather than just standing in place.
  • Work meeting? Take it outside. Suggest that you have walking meeting. You get to be active and less sedentary, with the added benefit of fresh air.
  • Catching public transport? Get off a stop before your usual one. Explore your neighbourhood while getting some exercise and breathing deeply.
  • On the phone? Walk around while chatting, rather than sitting down. But avoid moving about if you’re texting or looking at your screen. Our aim is to increase activity levels safely, not get injured in the process!
  • Gaming? Fun! But it’s so easy to get caught up in the heat of the battle/chase/adventure, so set your phone alarm to go off every 30 minutes so you can get up and move.
  • Cleaning? Go hard. Give the tiles an extra vigorous scrub. Flatten your recyclables rather than just tossing them straight into your recycling bin. Clean your windows (groan – but how good do they look when you’re done?). Vacuum the house and use all of the little attachments (who knew they made such a difference?).

Obviously there’ll be times when these activities are not possible or practical – especially if you’re having a flare. However some of them may actually help with your pain – things like standing and moving when your back is really sore, breaking up long trips with stops and stretches – they’ll provide exercise and pain relief.

Give incidental exercise a try. Before you know it, you’ll be feeling more energised and noticing a difference with your pain levels, sleep quality and mood.

Plus your house will be sparkling! Win-win!

More to explore


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31/Jan/2020

If you live with persistent pain, then you’ve probably had many nights when sleep has eluded you. You’ve tossed and turned, gotten up, watched TV, checked your phone, gone back to bed, and then tossed some more.

Pain, muscle tension, anxiety and other factors can interfere with your ability to get to sleep, stay asleep and the quality of your sleep. And sadly, not getting enough good quality sleep can affect your pain levels, your muscle tension and your anxiety levels.

It’s like a colossal feedback loop that’s spiraling out of control and you can’t break free. OK, that was a little dramatic, but I’m also a little tired and cranky 🙁

The good news is there are many things you can do to break this cycle and get back to having a good night’s sleep.

  • Try not to put too much pressure on yourself to go to sleep. This leads to anxiety and stress if you don’t fall asleep quickly. Feeling anxious or stressed will affect your ability to sleep. Get out of bed. Don’t lie in bed tossing and turning. Have a warm drink (e.g. milk, no caffeine), do some gentle stretches or breathing exercises and go back to bed when you feel more comfortable.
  • Develop a sleep routine. Try to go to bed and get up at the same time each day.
  • Try some relaxation techniques. Consider mindfulness, visualisation, deep breathing or a warm bath before bed. These techniques will help you become more relaxed and may help you manage your pain better so that you go to sleep, and sleep well.
  • Write it down. Thoughts, worries and anxiety can prevent good sleep. Don’t take them to bed. Write them down and then put them away. You can deal with them tomorrow.
  • Be active during the day. As well as the many other benefits of regular exercise, it will help you fall asleep and stay asleep longer.
  • Keep a sleep journal. This will help you and your doctor work out what may be causing your sleep problems because it tracks the things that may affect your sleep. Make sure to write down things like the time you went to bed, the time you got up the next morning, how easily (or not) you fell asleep, how many times you woke up and for how long, things that woke you up (full bladder, outside noise, anxiety, pain etc).
  • Keep a water bottle by your bedside so that you don’t have to get up if you wake up thirsty in the middle of the night.
  • Avoid caffeine and alcohol for several hours before going to bed.
  • Don’t look at the clock. Constantly checking the time can make you anxious and anxiety makes it hard to sleep. Try removing your clock from the bedside, or cover it up at night.
  • Avoid using technology in bed. The blue light from laptops and tablets suppresses the hormone (melatonin) that makes us sleepy at night, so be sure to stop screen use at least one hour before bed.
  • Light. Is your room dark enough to allow you to sleep well? If not, look at solutions such as window coverings or a dim switch on your alarm clock. You might also try using an eye mask.
  • Noise. If you have no control over the noise in your environment (e.g. a barking dog, loud party, your partner’s snoring), ear plugs may be an option. Or playing soothing, gentle music softly in the background can also be helpful at cancelling out other noises.
  • Clear your bedroom of clutter. Researchers have found a link between being surrounded by lots of “stuff” and your ability to fall asleep quickly and easily.
  • Seek help. If pain is constantly keeping you awake at night, discuss it with your doctor for information and advice.

More to explore

  • Read our more detailed page on sleep.

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24/Jan/2020

Trying to eat well can seem daunting. Every day it seems a new diet hits the media, endorsed by a celebrity or twelve. And eating healthfully sounds expensive and like too much hard work.

So what can you do to make sense of it all, eat well, and stay on budget?

When it comes to working out what’s best for you and your family, it makes sense to go back to basics.

  • Plan your meals/snacks and write a list of the ingredients you need before you hit the shops. This is a must, because it’s easy to forget things, buy the wrong quantities or buy items you don’t need in the heat of the moment (hello Tim Tams 🙂 ).
  • Go generic. Check out the generic, home brand and no-name versions of your staples, such as flour, tinned tomatoes, legumes, oats. They’re generally cheaper and are often the exact same product as the name brand, just with less fancy packaging.
  • Read the nutrition panel on your foods. It’s a good habit to get into so that you can track the amount of energy (kilojoules), fat, salt, sugar etc in your foods. It’s also useful when you’re comparing different brands of the same product.
  • Swap a meat dish or two for a vegetarian meal. Research has found that a vegetarian diet costs less than a diet that includes meat. You don’t have to go all out vego, but simply swap a few of your meat dishes for plant-based meals. They’re tasty, healthy and cheap. Just make sure you do your research and use healthy recipes. You can find a lot of yummy recipes online.
  • Reduce your kitchen waste. Shopping with a list will help here, and also only buying what you need. Take note of the foods that you often throw out because you didn’t use them before they became an unidentifiable furry blob in your fridge. Avoid buying that item, or buy less of it when you shop. Or look for ways to use food that’s becoming slightly less than fresh, but is still good. Soups are a great way to use the last of the vegies in your fridge crisper. Also check out the Foodwise website. It has lots of tips to help you reduce waste, as well as recipes, meal plans, info on what’s in season and loads more.
  • Buy fresh fruit and vegetables that are local and in season. It’s cheaper, fresher, yummier and supports our local farmers. The Foodwise website can help you find what’s in season. They even have a seasonal meal planner. Very handy!
  • Grow your own. If you enjoy gardening, why not try growing some of your own produce? Whether it’s small scale with a few pots of herbs on your balcony or larger scale vegie patch and fruit trees in your backyard, you can experience the pleasure, and reap the rewards of growing some of your own foods.
  • Frozen and canned vegetables can often be used in place of fresh vegies. They’re still healthy and they’re often cheaper. They’ll also keep longer.
  • Read the unit price when comparing products. This will enable you to see the difference in price regardless of brand or quantity, and you can work out which provides the best value for money. Unit pricing works by using a standard measurement across all products of the same type. So for example, if you compared orange juice X with orange juice Y, orange juice X costs $5.25 for a 2 litre bottle, so its unit price is $2.63 per litre; orange juice Y costs $5.74 for a 1.5 litre bottle, so its unit price is $3.83 per litre. So orange juice X is cheaper per litre. Luckily, you don’t have to tie yourself up in knots doing this math when you’re shopping – the unit price is provided on the shelf label and online. Thank goodness! Shopping is hard enough!
  • Shop around. Just because you’ve always shopped at [insert shop of choice here] doesn’t mean you always have to shop there. Keep an eye on catalogues, visit the local farmers markets, join online groups with other savvy shoppers so you’re always in the know about who’s providing the best value for money for your groceries.
  • For items that last, and that you use regularly, buy in bulk. This includes things like rice, dried/canned legumes and pasta.
  • Finally, don’t shop when you’re hungry. It’s a really easy way to suddenly find lots of yummy, and unhealthy things in your basket, that weren’t on your shopping list. It’ll blow your budget and your plans for healthy eating right out of the water. So shop after you’ve eaten, or munch on an apple or banana or handful of nuts before you even consider walking into the bright lights and air-conditioned aisles of your local shopping centre. Your budget will thank you for it.

More to explore


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23/Jan/2020

Using humour and laughter to help manage your pain

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 do tend to laugh at, and share with others, the well-crafted meme or social media post that ridicules and scoffs at these things because we identify with the truth behind them. And with the best ones, you can tell that someone who knows what it’s like to live with pain and illness has created them. You’re recognising 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 your friends or family. Something was said, a joke was told or you all saw something ridiculous. There’s nothing like it. You snort, you chortle, your eyes water, you gasp for breath, your belly starts to hurt and, when you look at each other, you laugh some more. When you finally do stop, you feel euphoric. Everything seems better, you feel happier and you can’t wait to do it again.

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

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. 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.

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

Laughter causes a variety of chemical responses in your body. The ‘feel good’ hormones – endorphins, serotonin and dopamine – are released into your bloodstream. They boost your mood and make you feel more positive. Endorphins are your body’s natural pain reliever. Releasing them into the body reduces your feelings of pain. Laughter can also help boost your immune system. And, let’s face it, it’s just a lot of fun!

So next time your pain is getting you down, why not give laughter a go?

Finally, 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 just for the sheer joy of it. But when you have a chronic illness and persistent pain, a balanced treatment approach that involves appropriate medications and medical care, healthy lifestyle, exercise, mindfulness and yes – laughter – is the best way to live with a chronic condition.

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

Things to try:

  • watch/stream a funny movie, TV show
  • listen to a funny podcast
  • talk with a friend and reminisce about a funny experience you had together
  • watch cat/dog/panda videos on YouTube (you know the ones you see pop up on social media regularly!)
  • think about the funniest joke you ever heard.

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22/Jan/2020

Written by Steve Edwards

“A cortisone injection? You want to stick a needle in my sore foot?”

Your health care clinician has suggested you have a cortisone injection into your foot. As with any medical procedure, both of you are best advised to discuss the benefits and risks before proceeding. It helps to know what cortisone is, what it does, and why it’s been offered to you.

Cortisone is an anti-inflammatory medication that’s often used to treat musculoskeletal conditions. It’s a synthetic version of cortisol, a hormone that naturally occurs in your body. Injected into the affected area, cortisone can lower inflammation and pain, remove fluid, and thin scar tissue or adhesions. So if your clinician diagnoses a musculoskeletal condition affecting your foot or ankle – such as arthritis, bursitis, neuroma, or tendinitis – a cortisone injection is commonly raised as an effective treatment option.

Cortisone injections also contain a local anaesthetic. For certain conditions an injection can be painful, so the anaesthetic may be injected separately before the cortisone to block this pain.

The clinician may or may not use ultrasound technology to guide the injection. For pain relief in the foot or ankle, research finds no statistically-significant difference between procedures conducted with or without ultrasound. Interestingly, trials on cadavers injected with dyed cortisone show how it rapidly spreads from the injection-point to adjacent tissue, indicating that pinpoint accuracy is not key to effectiveness.

There are several types of cortisone. In most cases the clinician will administer a long-duration cortisone, taking effect within 1-3 weeks, with benefits lasting between 1-9 months, depending on the condition and its severity. There’s a clinical consensus that no more than 3 injections should be administered to the same body-part within a 12-month period, though there’s no research literature to clearly support this belief.

After the injection, you can quickly return to most activities. The clinician may recommend you avoid strenuous physical exertion such as gym workouts or running for a few days, so the cortisone isn’t displaced from the target tissue.

As for risk-factors, there’s been research into whether the injection may risk tearing tendons in the target area. There’s no recorded case of this in human trials, though it has occurred in trials on dogs and horses. There were cases of more general tissue damage recorded in early trials on American gridiron players, but various factors could have produced this result – the needle used, the amount of fluid injected, and the subjects receiving multiple injections within a short period.

No medical procedure has a 100-percent success rate, but a single cortisone injection administered by a trained clinician is both safe and effective in providing medium-term pain relief. Side effects are minimal, and the benefit to your musculoskeletal condition is potentially vast. And for some foot-specific conditions – such as a neuroma (pinched nerve), or plantar fasciitis (heel pain due to scar tissue) – a cortisone injection can often be a cure.

Our guest blogger

Steven Edwards is a trainee foot and ankle surgeon with the Australasian College of Podiatric Surgeons. He also teaches pharmacology and foot surgery to undergraduate podiatry students at La Trobe University.


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20/Jan/2020

How we discovered Sam had arthritis

My son Sam is now 18 years old. He was diagnosed with juvenile idiopathic arthritis (JIA) just after his 13th birthday.

Seeing your previously healthy and sport-loving son crawling down the hall just to get to the bathroom is heartbreaking. The impact on our whole family was enormous. You just can’t imagine the changes you suddenly have to make. One minute we were dealing with all the normal teenage activities and the next we had an occupational therapist talking to us about putting grab rails and mobility aids through our house. The whole future you envisage for your child changes in a split second.

Sam complained for a few weeks of sore knees but like most mum’s vying for that “Mum of the Year trophy” I pretty much ignored him, figuring it was too much sport or growing pains or something along those lines.

It was the Queen’s Birthday long weekend and he had a weekend off sport so I thought ok, this will give his knees a rest and a chance to settle down and everything will be fine. We went for a short walk as a family on the Sunday and after about ten minutes he said to me “Mum, I can’t walk anymore, my knees are killing me”. We headed home where he lay down on the couch and after an hour or so he got up and discovered that it wasn’t just his knees anymore, the pain had now spread to his ankles and hips.

The next morning I took him up to our GP who ran a range of blood tests and told me she wanted to see him again on the Friday but if it got worse before then, to take him to the ER. On Wednesday morning he woke up and the pain had also moved to his wrists, shoulders and elbows. We headed out to the Monash Hospital where we began what would be a long relationship with the wonderful paediatric rheumatology team there.

Sam was officially diagnosed with JIA two weeks later and started on methotrexate that day. His pain got worse and worse and he was admitted to the hospital for a week for further testing. After ruling out a lot of other nasties, he was eventually diagnosed as having pain amplification syndrome (PAS) also known as amplified musculoskeletal pain syndrome (AMPS).

To be honest, this floored me more than the diagnosis of JIA. I really felt that they didn’t know what he had, so they were just pulling something out of thin air! The PAS was harder to deal with in many ways than the JIA. With JIA I felt we had a well-trodden path to follow whilst with the PAS it felt very hit and miss.

We saw a pain specialist through Monash and Sam was put on a lot of different drugs with various success. Eventually we found some websites and read a lot of information on pain and educated ourselves about what pain is and the importance of movement. Sam did a lot of hydrotherapy and got moving and strengthening his body once again and slowly we began to see improvement.

Sam missed the majority of the second half of year 8 and a similar amount of year 9 before finally finding the right combination of medications that worked for him. The burden of the pain was enormous but missing out on school, playing sport and contact with his friends was even harder. The medication he was on also made him put on a lot of weight and some of the kids at school could be cruel.

I was no longer able to work as Sam needed my support at home for both his day to day care as well as his multiple appointments so I approached Musculoskeletal Australia about volunteering half a day per week. To be honest it also gave me a much needed break from the stresses of suddenly becoming a full time carer! I started working on the Help Line which not only gave me vital information about JIA but gave me access to a knowledgeable nurse as well as a number of other volunteers who could share their own stories with me.

Along with a great rheumatology team and the correct medications, Sam works hard on his fitness to ensure he remains well enough to do the things he wants to do. He also needs to pace himself which, like many teenagers, he does with varying degrees of success! Although he still has challenges that other teenagers just can’t imagine, he’s now studying full time at Uni, has a part time job and is able to participate fully in life – just as any 18 year old should be doing.

On a side note – I’m now working at MSK Australia 3 days a week running the MSK Kids program. It’s a program I love and am very passionate about. You can contact me about MSK Kids Tuesdays-Thursdays on 8531 8039 (1800 263 265) or buffy@msk.org.au


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12/Sep/2019

The weather’s changing. You can smell the blossoms, the freesias and other spring flowers bursting into life. The days are getting longer. The sun’s shining and the temperature’s rising.

Hooray! I’m over winter. The time for hibernating is over. I just want to lose the winter woollies, say goodbye to soup and get out and about.

So I’ve made a list of all the things I want to do now that the weather is getting better. I’m going spring into spring! Here’s a few that may get you inspired:

  1. Get outdoors. We’re so lucky in Australia to have beautiful and accessible parks and gardens. Whether you’re into a gentle stroll, a brisk hike, a walk through history, or all of the above, there’s something there for you. A good place to start is the parks service website in your state or territory, your local council website, and the National Trust website.
  2. Try a new sport/exercise. If your exercise program has become boring, or you’re in a bit of an exercise rut, spring is the perfect time to blow off the cobwebs and try something new. Try trampolining, have a Frisbee tournament, learn to dance the samba/tango/tap/swing, borrow a bike and go for a ride, join a sporting team, go bird watching. The sky’s the limit. Just think about the types of things you enjoy doing, or sound fun to you, and incorporate them into your exercise program.
  3. Take part in a fun run/walk. This is the time of the year when fun runs and walks seem to happen every weekend. Find one that appeals to you – the location, the distance, the charity it supports – and sign yourself up. Even better sign up the family and friends as well!
  4. Volunteer your time and skills. Whether it’s something you do regularly or as a once off, volunteer work can be extremely rewarding for yourself and your community. Think about the types of things you’re passionate about, your skills, the amount of time you can give, and look around your local community to find the best match. Or visit the GoVolunteer website to search the database for volunteering opportunities.
  5. Grab your camera or phone and start snapping. It’s amazing the quality photos we can take on our phones. Post your pics on social media, and be inspired by others. Spring is the perfect time to get some gorgeous photos. And it’s amazing how differently you start seeing everyday things when you start imagining them through a camera lens. Things that once faded into the background become stunning architectural shapes, or vibrant vistas. Before you know it you’ll be experimenting with angles, perspective and light. If you need help, there’s plenty of tips and tricks online about taking photos with your phone. Or investigate photography courses in your local area. You’ll learn new skills and meet new people.
  6. Dig in the dirt. Many people find gardening a relaxing past-time, and it can distract us from our pain and our problems. So with our gardens coming alive, why not get out and get your hands dirty. Plant some bright flowers in pots or garden beds around the entrance to your house. Prune trees and shrubs and remove any dead winter growth. Add some mulch to the gardens beds. Then grab a cold drink, sit back and enjoy the fruits of your labours. Oh – and if you sometimes find your condition affects your ability to garden, check out this blog post.

More to explore

Photo by Maria Shanina on Unsplash.


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09/Feb/2019

And stay focused and motivated

It’s important to have goals in life. Whether it’s a goal involving travel, a new career, financial security or a goal relating to your health and fitness, having a clear goal – or an endpoint – gives you something to aim for.

But if you find it hard setting goals, and putting in place the steps you need to achieve them, you’re not alone. Here are a few pointers for setting a goal. I’ve used a weight loss goal as an example:

Be as clear as possible about what it is that you want to achieve, and how you’ll do it.

A common acronym used for goal setting is SMART: Specific, Measurable, Achievable, Realistic and Time frame.

Be specific. What is it you’re aiming for? Ask yourself the 5 W’s – who, what, when, where, why. What do you want to accomplish? Why? Who will be involved to help you? When and where will you do this?

You need to be able to measure your goal so that you know when/if you’ve achieved it. Losing weight is not a measurable goal, but losing 5kgs in 8 weeks is. You’re able to track your weight loss and the time frame.

Your goal needs to be something that’s achievable for you. It should challenge you and stretch you a little, but should be something that’s attainable, e.g. losing 20kgs in 2 weeks isn’t achievable, however, losing 5kgs in 8 weeks is.

You need to be realistic – your goal needs to be doable – for you and for your own circumstances. Losing 5kgs in 8 weeks is realistic for you because you’ve discussed it with your doctor, you’re committed (you know it’ll help ease your pain), you’ve enrolled in a weight loss class for information and support and you’ve joined a water exercise class so that you can exercise without making your knees more painful.

Your goal should have a time frame. Losing weight someday is not a timed goal. Having a time frame, e.g. 8 weeks, gives you motivation and helps keep you on track.

Using the SMART system, write down your goal and the steps you need to get there. Stick it on your fridge, bathroom mirror or someplace you’ll see it often. Refer to it regularly. If you have any hiccups along the way, that’s okay, don’t give up. Just refer back to your goal and move on.

Now that you know how to set a goal, it’s time to think of one of your own. What is it that you want to do or achieve?

Remember to think SMART and you’ll get there in the end! Good luck.


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01/Feb/2019

We all get tired. We overdo things and feel physically exhausted. It happens to us all.

But something that most of us living with a chronic, painful condition experience, and that can be hard for others to really understand, is fatigue.

Fatigue’s that almost overwhelming physical and mental tiredness. It may be caused by lack of sleep, your medications, depression, your actual condition (e.g. rheumatoid arthritis) or just the very fact of living with persistent pain.

Fatigue can make everyday activities seem too hard, and can get in the way of you doing the things you enjoy. The good news is there’re many things you can do to manage fatigue.

They include:

  • Exercise and being active – while this may sound like the last thing you should do when you’re feeling fatigued, exercise can boost your energy levels, help you sleep better, improve your mood, and it can help you manage your pain. If you’re starting an exercise program, start slowly, listen to your body and seek advice from qualified professionals.
  • Frankie says relax – listening to music, reading a book, taking a warm bubble bath, meditating, deep breathing, visualisation, gardening, going for a walk…they’re just some of the ways you can relax. By using relaxation techniques, you can reduce stress and anxiety (which can make you feel fatigued), and feel more energised.
  • Eating a well-balanced diet – this gives your body the energy and nutrients it needs to work properly, helps you maintain a healthy weight, protects you against other health conditions and is vital for a healthy immune system. Make sure you drink enough water, and try and limit the amount of caffeine and alcohol you consume.
  • Pace yourself. It’s an easy trap to fall into. On the days you feel great you do as much as possible – you push on and on and overdo it. Other days you avoid doing things because fatigue has sapped away all of your energy. By pacing yourself you can do the things you want to do by finding the right balance between rest and activity. Some tips for pacing yourself: plan your day, prioritise your activities (not everything is super important or has to be done immediately), break your jobs into smaller tasks, alternate physical jobs with less active ones, and ask for help if you need it.
  • Get a good night’s sleep – it makes such a difference when you live with pain and fatigue. It can sometimes be difficult to achieve, but there are many things you can do to sleep well, that will decrease your fatigue and make you feel human again.
  • Talk with your doctor about your meds – sometimes fatigue can be caused by medications you’re taking to manage another health condition. If you think your medications are causing your fatigue, talk with your doctor about alternatives that may be available.

So that’s fatigue…it can be difficult to live with, but there are ways you can learn to manage it. Tell us how you manage. Share your tips for managing fatigue.




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

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