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    Lisa Bywaters
    24/Oct/2023
    Health InformationMSK articles

    A weed by any other name

    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.

    More to explore

    CONTINUE READING
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    Lisa Bywaters
    04/Oct/2023
    Health InformationMSK articles

    What is inflammation?

    We talk about inflammation a lot. But what is it? What’s happening in your body when you have inflammation?

    Acute and chronic inflammation

    There are two types of inflammation – acute and chronic.

    Acute inflammation

    Acute inflammation is your body’s reaction to things such as an infection (e.g. a cold or infected wound) or an injury (e.g. a sprained ankle or bee sting).

    Symptoms associated with acute inflammation are:

    • pain
    • redness
    • swelling
    • heat
    • loss of function (e.g. difficulty moving a swollen ankle after spraining it or difficulty breathing through your nose when you have a cold).

    What’s happening in your body with acute inflammation?

    When you sprain your ankle, or get an infection, your immune system automatically springs into action.

    Cells close to the source of the injury or infection release chemicals known as inflammatory mediators (e.g. histamine). They increase blood flow to the area, widening blood vessels and allowing more blood to reach the injured tissue. As a result, the area becomes red and feels hot.

    The extra blood to the area enables more immune cells to reach the injured tissue. This includes white blood cells, or leukocytes, whose role it is to defend your body against infections and disease and start the healing process.

    Depending on the cause, acute inflammation can occur quickly and generally goes away quickly.

    Chronic inflammation

    Chronic inflammation is persistent, low-level inflammation that lasts for months or years. With chronic inflammation, the inflammatory process often begins when there’s no injury or illness present; and it doesn’t end when it should. When this happens, white blood cells may target and damage nearby healthy tissues and organs.

    We don’t really know why chronic inflammation occurs. It doesn’t seem to serve a protective purpose as acute inflammation does.

    However researchers have identified factors that increase your risk of developing chronic inflammation, including:

    • chronic infections
    • physical inactivity
    • poor diet
    • obesity
    • imbalance of gut bacteria
    • disturbed sleep
    • smoking
    • stress
    • ageing.

    Many people don’t know they have chronic inflammation, but they may feel symptoms such as:

    • body and joint pain
    • fatigue and insomnia
    • weight gain or loss
    • frequent infections
    • depression, anxiety and mood disorders
    • digestive problems (e.g. constipation, diarrhoea, acid reflux)
    • skin rashes.

    Chronic inflammation is associated with many diseases, such as rheumatoid arthritis, lupus, heart disease, diabetes, cancer, and bowel diseases like Crohn’s disease and ulcerative colitis.

    If you’re concerned about chronic inflammation and have symptoms like those above that have been troubling you for some time, see your doctor . They’ll talk with you about your symptoms, do a physical exam, and may decide that blood tests are necessary to look for signs of inflammation.

    The blood test will look for elevated C-reactive protein (CRP), which rises in response to inflammation.

    Inflammation is helpful until it’s not

    It’s important to remember that inflammation isn’t inherently bad. Acute inflammation serves a vital role in our health and survival. It helps us recover from injury and infection. However, when it’s chronic, it can negatively affect our health.

    Always talk with your doctor if you have symptoms that are distressing you or making you feel unwell.

    Contact our free national Help Line

    Call our nurses if you have questions about managing your pain, musculoskeletal 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

    This article was first written and published by Lisa Bywaters in April, 2022.

    CONTINUE READING
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    Karla Wignall
    19/Sep/2023

    Rattle Ya Bones Day

    Rattle Ya Bones Day – A National Day of Awareness for all muscle, bone and joint conditions, held every year on Halloween. 🎃 🦇👻

    This year’s theme is: Get informed. Get supported. Check out the Rattle Ya Bones Day web page on how you can get involved!

    CONTINUE READING
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    Karla Wignall
    06/Sep/2023
    Health InformationMSK articles

    Spring cleaning – body, mind and spirit

    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!

    • Unplug. We’re always connected these days, immersed in the news, social media, video chats, work/school, and phone calls. We’re never far away from a phone, tablet or computer – and we need to step away. Schedule time to put it all aside: perhaps after dinner, or for an hour during your day, or for your entire Sunday. Whatever works for you and your commitments. Just make sure you take some time away from the digital world, step outside and breathe in the fresh, sweet-smelling spring air.
    • Say no. We’re wired to want to please others, so we often find it difficult to say no. But that can make us become overwhelmed and stressed with the number of commitments we have. That’s why we need to look after ourselves and start saying no. The next time someone asks you to do something, give yourself a moment. Don’t answer immediately with an automatic ‘yes’. Ask yourself if this is something you want to do. Are you able to do it – physically and mentally? Do you have the time to do it? Will it bring you happiness? If you answered no to these questions, then you should say no to the request. You may disappoint some people, and they may be a little unhappy with you. But you need to be true to who you are and stand firm. And don’t feel the need to give detailed reasons for saying no. Saying no is really hard, but it will become easier.
    • Change your routine. Do you feel like you’re stuck in a rut? I know it feels like Groundhog Day at times! So look at your routine. What can you change? Take your work/school commitments out of the equation for now. Do you spend your evenings on the couch? Or weekends doing the same old things? Stop and really think about what you would actually ‘like’ to do with your free time. Go for a bike ride? Take up painting? Visit a new place each week? Find things that you enjoy, and fill you with anticipation and happiness, and do them. Now think about your work routine. There may not be things you can change about work – but why not put on your favourite outfit/earrings/shoes/lipstick – even if you’re working from home. Or use some new stationary or bit of tech. It’s amazing how these small changes give us a mental boost.
    • Focus on the basics – eat well, move, sleep – repeat. This time of the year we have access to amazing fresh produce that’s just crying out to be made into delicious salads and stir fries. The days are getting longer and warmer so we can get outside more for our exercise. We can shed the heavy blankets and adjust our sleep habits. There’s never been a better time than now to focus on these basics and make improvements if needed. And finally, make sure you’re staying hydrated by drinking enough water each day.
    • Surround yourself with positive, upbeat people. Positivity and happiness is contagious. These people will inspire you, make you feel good about yourself and the world in general. Too much contact with negative people (in person and via social media) does the opposite and makes the world a gloomy place. So seek out the happy, positive people and enjoy their company. And if you can, ditch the negative people.
    • Take some time out to relax. Try strategies like mindfulness, visualisation and guided imagery. Or read a book, listen to music, walk the dog, create something, play a computer game, have a bubble bath or massage. Whatever relaxes you. And make sure you do these things on a regular basis. They’re not an indulgence – they’re a necessity and vital to our overall happiness and wellbeing.
    • Let’s get serious – sugar, fats, alcohol and drugs. Many of us seek comfort in sugary and/or fatty foods more than we’d like. Or we’ve been using alcohol and/or drugs to make us feel better. Over time this becomes an unhealthy habit. So it’s time to get serious. Ask yourself if your intake of these things has changed or increased? If it has – what do you need to do to fix this? Can you decrease their use by yourself? Or do you need help from your family, doctor or other health professional? The sooner you acknowledge there’s a problem, the sooner you can deal with it.
    • Nurture your relationships. It’s easy to take the people around us for granted, but these people support and care for us day in and day out. They deserve focused time and attention from us. So sit down and talk with your kids about their day. Make time for a date night with your partner and cook a special meal to share together. Call or visit your parents and see how they’re really doing. Reminisce with your siblings about childhood antics and holidays. Our relationships are the glue that holds everything together for us – so put in the effort. You’ll all feel so much better for it.
    • Quit being so mean to yourself. You’re valued and loved. But sometimes we forget that. And the negative thoughts take over. “I’m fat”, “I’m hopeless”, “I’m lazy”, “I’m a burden”. If you wouldn’t say these things to another person, then why are you saying them to yourself? Ask yourself why you even think these things? And how can you reframe these thoughts? If, for example, you tell yourself you’re fat – are you actually overweight or are you comparing yourself to the unrealistic media image of how a person should look? And if you do know you need to lose weight, and want to make that happen, put those steps in motion. Talk with your doctor for some guidance and help. And congratulate yourself for taking action. And as you make these changes be kind to yourself along the journey. There will be stumbles, but that’s expected. You can pick yourself up and move on. Kindly.
    • Throw away the ‘should’s. This is similar to the negative self-talk…we need to stop should-ing ourselves to death. This often happens after we’ve been on social media and seen someone’s ‘amazing’ life. You start thinking “I should be better at X”, “I should be doing X”, “I should be earning X”, “I should look like X”. Remember that most people only put their best images on social media, so everyone’s life looks wonderful. But you’re just seeing the superficial, filtered person, not the whole, and they probably have just as many insecurities as the rest of us. Instead of thinking “I should…”, be grateful for who you are and what you have.
    • Be thankful and grateful. You exist! And yes, the world is a strange and sometimes frightening place at the moment, but you’re here to see it. People love and care for you. Focus on the people in your life and the things you’re grateful to have in your life. Celebrating these things – both big and small – reminds us why we’re here. To bring joy and happiness to those around us, and to make the world a better place.

    (Originally written and published by Lisa Bywaters 2020).

    Call our Help Line

    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.

    More to explore

    CONTINUE READING
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    Karla Wignall
    06/Sep/2023
    Health InformationMSK articles

    What a pain in the neck!

    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 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.

    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.

    More to explore

    CONTINUE READING
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    Kay Mwaba
    14/Aug/2023

    Caring for yourself, the carer

    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:

    • Why caring for ourselves is so important
    • What stops us caring for ourselves?
    • Making a self-care commitment

     

    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.

    CONTINUE READING
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    Lisa Bywaters
    09/Aug/2023
    Health InformationMSK articles

    Your guide to shoulder pain and how to treat it

    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.

    Let’s start with the basics – how your shoulders work.

    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:

    • the acromioclavicular joint – where the top of your shoulder blade (acromion) meets your collarbone
    • the sternoclavicular joint – where your collarbone meets your breastbone (sternum) near the base of your neck
    • and the scapulothoracic joint – where your shoulder blade meets the chest wall (thorax). It allows your shoulder blade to move smoothly over your ribs.

    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.

    When things go wrong – shoulder pain.

    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:

    • Other musculoskeletal conditions, such as rheumatoid arthritis, osteoarthritis, and polymyalgia rheumatica can affect the shoulder, causing pain.
    • Inflammation or injury to the soft tissues (e.g. muscles, bursae, tendons, ligaments) in and around the shoulder, for example, bursitis and frozen shoulder.
    • Ongoing stress or anxiety that causes your muscles to remain tense.
    • Neck and upper back joint and nerve problems can cause pain to be felt in and around the shoulder.
    • Referred pain. Shoulder pain may also be caused by problems affecting your abdomen (e.g. gallstones), heart (e.g. heart attack) and lungs (e.g. pneumonia).

    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.

    Symptoms of shoulder pain.

    Unsurprisingly, the main symptom of shoulder pain is pain! Other symptoms include:

    • Reduced movement, stiffness and pain when moving your shoulder.
    • Weakness of the shoulder/upper arm.
    • Pain when lying or putting pressure on the affected shoulder.
    • Pins and needles (tingling). This is more likely to be associated with neck problems than the shoulder itself.

    Diagnosing shoulder pain.

    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:

    • ask you questions about your shoulder pain, including potential causes (e.g. recent injuries, other health conditions), if you’ve had shoulder pain before, and how it affects you
    • ask about any other symptoms or health issues you have
    • do a thorough physical examination.

    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.

    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.

    • Heat and cold packs may provide temporary relief from pain and stiffness. Generally speaking, heat can relieve muscle spasms and tension. Cold can reduce swelling.
    • Physiotherapy will aim to fix problems such as shoulder, neck and upper arm stiffness and weakness. A physiotherapist will provide exercises to help improve mobility and the range of movement for your shoulder. They’ll also help you modify movements and activities that worsen your pain. This often includes learning new ways to do things related to your work, sport, or everyday activities that aggravate your shoulder. They may also tape your shoulder and show you how to use taping to support your shoulder and reduce stress on it.
    • Occupational therapy. If your shoulder pain makes everyday activities difficult, seeing an occupational therapist (OT) may be helpful. They can help you learn better ways to carry out activities such as bathing, dressing, working or driving. They can also provide aids and equipment to make everyday activities easier.
    • Medicines may help reduce the pain you’re experiencing while you work to maintain and restore movement and function. But it’s important to understand they’re not a long-term solution to shoulder pain. Talk with your doctor or pharmacist for advice about pain medicines. There are different types available, both over-the-counter and by prescription. They include:
      • Non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs reduce inflammation and pain but have side effects, so using the lowest dose for the shortest period is best.
      • Topicals. Rubs, gels, ointments, sprays, patches and creams applied to your skin (topically) can provide temporary pain relief.
      • Corticosteroid injection. If you have persistent shoulder pain and haven’t had relief from oral medicines or other treatments, your doctor may suggest a corticosteroid (steroid) injection. Corticosteroid injections into the joint can reduce inflammation and provide short-term pain relief for some people. However, pain relief varies and may last a few days to weeks. The number of injections you can have is limited due to potential harm. Discuss the benefits and risks of steroid injections with your doctor.
    • In cases of a frozen shoulder, hydrodilatation may be recommended. This is an injection of fluid (saline and a steroid) into the joint. There’s some evidence that it may relieve symptoms and improve range of motion. However, it’s unclear if this is due to the hydrodilatation, the steroid in the injection, shoulder exercises, or a combination.

    What about surgery?

    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.

    Managing shoulder pain to prevent future problems.

    Most people with shoulder pain will find it gets better over time. But there are things you can do to proactively prevent future problems.

    • Learn more about your shoulder pain. Are there activities or jobs that trigger your shoulder pain or make it worse? Knowing as much as possible about your shoulder pain means that you can make informed decisions about your healthcare and actively manage it.
    • Follow the advice of your healthcare team. The information, exercises, and modifications provided by your physio or occupational therapist during the worst of your shoulder pain will help prevent you from aggravating your shoulder and causing future issues.
    • Exercise regularly. Although you might think you need to protect your shoulder by not moving or resting it, it’s made for movement. And resting can make things worse. Regular exercise is vital for maintaining flexibility, muscle strength, and bone health. When starting an exercise program, you should incorporate activities that improve flexibility, muscle strength, balance, and overall fitness and endurance. Start exercising slowly and gradually increase the time and intensity of your exercise sessions over weeks and months. A physiotherapist or exercise physiologist can help you work out an exercise program right for you.
    • Manage your stress. Living with stress or anxiety can worsen your pain by causing the muscles throughout your body to tense or spasm. This is often felt in the shoulders and neck. There are many ways to reduce stress or anxiety, including exercise, massage, mindfulness, heat, breathing exercises, and guided imagery.
    • Get back to your normal activities. Try to be as active as possible and get on with your day-to-day life, including work and exercise. Returning to heavy manual jobs may take longer, and you may need support from a physio and/or OT.

    Contact our free national Help Line

    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.

    More to explore

     

    CONTINUE READING
    Feet-in-socks.jpg
    Lisa Bywaters
    13/Jul/2023
    Health InformationMSK articles

    Brrr, it’s cold out there

    Budget-friendly tips for staying warm this winter

    “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.

    Dress for the weather.

    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.

    Shop around.

    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.

    Deal with draughts.

    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.

    Turn down the temperature.

    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.

    Install heavy curtains.

    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.

    Let the sun shine in.

    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 😉.

    Cool down at night.

    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.

    Winter-proof your bed.

    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.

    Get active.

    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.

    Shorten your showers (if you can).

    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.

    Give your heater some space.

    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.

    Snuggle up.

    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.

    Use heat packs and hot water bottles.

    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.

    Warm up from the inside out.

    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.

    Choose energy-efficient heaters and hot water systems.

    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.

    Insulate.

    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.

    Billing and payment help.

    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.

    Contact our free national Help Line

    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.

    More to explore

    CONTINUE READING
    dodgy-knee.jpg
    Lisa Bywaters
    18/May/2023
    Health InformationMSK articles

    Got dodgy knees? Find out what helps.

    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 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.

    More to explore

    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

    CONTINUE READING
    doctor_patient_consult-1200x800.jpg
    Lisa Bywaters
    23/Mar/2023
    Health InformationMSK articles

    5 reasons to see your Dr about pain

    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 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.

    More to explore

    Reference

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

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