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25/Jun/2020

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

Healthcare costs

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

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

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

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

Employment

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

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

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

Wow. This became really depressing really quickly 😒.

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

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

Hidden costs

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

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

Pandemic pain

And then came COVID.

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

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

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

Contact our free national Help Line

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

More to explore


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11/Jun/2020

Sore neck? Back? Knees? Feel like you’ve aged 20 years with all the niggles, twinges and outright pain you’re feeling lately? You’re not alone. Many of us, even those who don’t live with a musculoskeletal condition, are feeling the physical effects of months of isolation, changes to our routine and living more sedentary lives than usual.

There are many reasons for this, and the good news is there’s lots you can do to deal with these annoying aches and pains.

Working or studying from home

When many of us first started working from home, it felt strange but also pretty cool. No dreaded peak hour commute. Yay! Instead we moved a bit more leisurely, lingered over coffee and our slippers stayed on all day. But after months of sitting at makeshift desks, or using laptops for hours on end, or struggling with tech issues and video calls, the cool phase is well and truly gone.

You may notice that you’re getting a sore neck more often, or your back aches, or you’re really tight across your shoulder blades. Or when you stand up your knees and/or hips let you know quite emphatically that you’ve been sitting in one place for a loooong time.

The problem is most of us don’t have a dedicated working space that’s set up as well as the one we had in the office. And since we’re likely to be working from home for quite some time, we need to deal with these issues rather than continuing to put up with them and the resulting aches and pains. Some simple things you can do include:

  • Have a routine – and stick to it. Find what works best for you and your specific situation. Whether you’re home schooling your kids, sharing your work space and equipment with your partner, or keeping your pets off your laptop, all of these things will factor into your routine. For me, internet access is really poor during the late afternoon, so starting work earlier and finishing earlier meant I could work more productively and with much less frustration. We’ll all have different solutions to suit our unique situations. So work out what’s best for you and stick with it. And don’t forget to talk with your employer if your new routine affects how/when you work.
  • Check out your work space. Is it helping or hindering you? Are you putting up with an uncomfortable space because you’re not sure what else to do? If so Safe Work Australia has a guide to help you set up your workstation and ABC News also has some practical hacks to take some of the pain out of working from home.
  • Move. When you’re working from home it’s easy for time to get away from you. We don’t have our usual cues to move such as getting up to go to the copier or attending a meeting in another room or just going to chat with a workmate. We’re sitting more and moving less. So you need to schedule time to get up, move around, stretch, go outside. Set up regular alerts on your phone/computer/watch – whatever works for you – and make sure you move. You’ll really notice a big difference at the end of your day.
  • Talk with your employer. If you need to adjust your hours, or you’re having issues with equipment or tech, or you’re having other issues working from home, discuss this with your manager or with HR. Together you should be able to come up with some solutions to ease these issues.

Managing stress

We’re living through a worldwide pandemic. Even after several months it feels surreal to say that. It’s important to acknowledge that it’s a really stressful time. Apart from worrying about getting sick, we’re also stressed about work, making sure the kids don’t fall behind at school, managing our chronic conditions, our finances, our family, and concern about the future. Add in the current unrest across the globe and it’s amazing we’re not all hiding under the bed.

But stress can cause physical aches and pains. It can also affect the quality of our sleep, our pain levels and can trigger a flare. So it’s important we find ways to manage stress effectively.

Many of the practical strategies we use to manage pain can be used to manage stress. These include: deep breathing, exercising, pacing, talking with a friend, mindfulness, guided imagery, progressive muscle relaxation and doing something you enjoy (e.g. reading, gardening, walking your dog, playing music).

But if you’re finding it difficult to manage your stress, talk with a professional such as your doctor or psychologist. There’s help available. And remember you can access them via telehealth if you prefer.

Spending more time at home

Even though isolation is easing we’re still meant to stay at home as much as we can. And with the weather getting really chilly, we’re getting cosy on the couch with the doona and the remote, as we binge lots of TV (or is that just me 😂). There’s just so much to watch!

Hanging out on the couch and binge watching TV is ok occasionally, but we don’t want to get into the habit of doing it too often. Slouching on the couch and not moving for long periods can aggravate our existing musculoskeletal conditions. And if we’re not moving and being active regularly it can also make it difficult to manage our weight.

So make sure you get up and move. Take a break. Go for a walk or do some exercises or stretches.

Break up your day with a mix of activities – both physically active (e.g. walking, gardening, tidying) and more passive (e.g. reading, watching TV, sitting at a computer).

Be aware of your posture

Bad posture can sneak up on us. Working at a computer, sitting on the couch reading a book, standing around watching the kids in the playground, lifting shopping out of the boot of your car – if you’re not paying attention to your posture, it’s easy to slouch, hunch over or strain.

As I’m typing this I’m literally straightening up from the curled position I was in, hunched over my laptop. And wow – it feels amazing when you sit up straight. It’s the same when you’ve been sitting on the couch for a while – when you stand up, stretching feels soooo good.

So be aware of your posture as you’re sitting and standing. For more info read our tips for good posture.

Increase your incidental exercise

Because we’re more sedentary than usual, and don’t have many of our usual outlets for exercise, we need to find ways to become more active. Increasing our incidental exercise is one way to do this. Incidental exercise is the little bits and pieces you do over the course of your day such as walking to a letterbox to post a letter, playing with the grandkids, cleaning the house. It’s not a part of your structured exercise plan, but it is important. There are many ways you can increase your incidental exercise without too much effort or disruption to your day. Read our blog to find out more. Before you know it you’ll be feeling more energised and noticing a difference with your pain levels, sleep quality and mood.

Dress appropriately

It’s getting really cold and many of us are a little stressed at the thought of high energy bills as we stay home and use the heater more. It’s tempting to keep the heat down, but that can cause your muscles to become tense, aggravating your musculoskeletal condition. So it’s important to keep warm. One of the simplest things you can do to stay warm is to dress for the weather. Let’s face it we’re not going anywhere, so wear the thick socks, the cuddly jumper and the daggiest track pants. Whatever keeps you warm.

We also need to be mindful of our footwear. Although it’s tempting to stay in our slippers all day, our feet and ankles need proper support. Wear the right footwear for whatever you’re doing. Going for a walk? Put on your sneakers. Working at home? Wear your casual shoes/boots that support your feet and keep you warm. And lounging around in the evening? Get those slippers on.

Be careful of trips and falls

Hands up if you’ve tripped over cables, laptop bags, files, excited dogs, folders, exercise equipment, books, and other stuff that’s suddenly cluttering your home? With all of the other things going on at home at the moment, school, work, exercise, entertainment…we’ve had to make space for all sorts of things in order to be get by. Which means our risk of tripping or falling has suddenly increased, especially if you’ve got nowhere to put these things and they’re constantly in the living area. So be careful as you move around your home – don’t rush, put things away if you can and tie or tape down cables. Preventing a fall, especially if you have a musculoskeletal condition, is easier than dealing with the significant injuries a fall can cause. So please be careful.

Treating pain

Even when you’ve done everything you can to prevent joint pain and muscle strain, you may still find you’re a bit sore. Depending on how severe this pain is, you may be able to treat it simply with heat and cold, massage, short term use of medication, distraction and many other strategies. Check out our A-Z guide for managing pain for more hints and tips.
However if the pain is severe, it’s affecting your day to day activities, your ability to sleep, or it’s lasted for some time with no relief, it’s a good idea to talk with your doctor about it. Together you can find out what’s causing the pain, and the most effective ways to treat it. Don’t simply put up with it.

Contact our free national Help Line

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


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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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02/Aug/2018

Gathering your all-star support team

Written by Amanda Sobey

Attempting to take control of your chronic condition can at times be a daunting and uncertain challenge. Ensuring you have a strong team around you to help tackle each milestone, step by step, can make it feel achievable.

So who might be in your personal support team?

Health professionals

Depending on your individual needs, your team may be made up of a variety of health professionals. These could include your GP, rheumatology nurse, specialist, pharmacist, physiotherapist, rehabilitation practitioner, occupational therapist, nutritionist or dietitian, physiotherapist, remedial massage therapist, acupuncturist, health coach, counsellor, podiatrist, or your exercise physiologist. Share your goals with your health practitioner up front to maximise the limited time in your appointments and so they can help you progress.

Your personal cheer squad

Surrounding yourself with people who lift you up and encourage you to take charge of your condition can be empowering.

Family and friends

Let them know how they can help you and keep them in the loop as you go along. Let them celebrate the small wins with you. Examples could be receiving positive results of reduced inflammation from your latest blood test, that you managed to walk around the block comfortably, or that you had a pain-free night’s sleep. They might be able to help you hang out that load of washing or put a home cooked meal in your fridge. They can provide a second pair of ears when you need to off-load, question information you’ve been given or accompany you to your next medical appointment. They can also be great companions for a belly laugh, keeping active and getting out of the house!

Peer support group contacts

Being able to connect with people who are going through the same challenges can mean the world. This might be through online social networks or contacts you’ve made at meetups. Group members will be at various stages of their conditions. Some will be newly diagnosed, others may be long-time chronic illness warriors. They’ll be happy to share their experiences and provide insight based on what has helped them.

Studying?

Consider letting your teacher or course convenor know about your condition, so that they can provide assistance if you need to ask for an extension, or are unable to attend a class. It’s also worth finding out about other support services available at the school or university you are studying with.

In the workplace

If you feel comfortable, let your employer or HR Manager know about your condition so that they can provide flexibility, if and when you need it. They’ll be appreciative of any information you can share with them about your condition, so they know how best to help.

On the road to wellness

With the right support around you, taking control of your chronic condition can feel even more possible. Keep your care team in the loop, share your highs and lows and be sure to celebrate each milestone on your wellness journey.

Our guest blogger

Amanda Sobey is a co-founder of Young Adults with Arthritis+ (YAWA+), an online peer support network for young adults in Australia aged 18-35 with arthritis and related chronic conditions. Amanda was diagnosed with rheumatoid arthritis at age 22 and is passionate about raising awareness and helping others on their wellness journey.

For more information please visit the following links:

Facebook: www.facebook.com/yawaplus
Twitter: www.twitter.com/yawaplus
Instagram: www.instagram.com/youngadultswitharthritisplus




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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