Below you will find some general advice about keeping active, the use of heat and cold treatments, safety information when using resistance exercise bands and information on pain medication and steroid injections. Please read the information below and talk to your health care professional if you have any questions or concerns.
If you suffer from the following conditions please discuss the use of heat treatment with a health care professional before using:
The use of heat is normally used to increase blood flow / circulation, reduce pain, ease stiffness, warm up muscles before exercise, relax muscles when tense and decrease muscle spasm.
Methods for applying heat:
If you suffer from the following conditions please discuss the use of cold treatment with a Health Care Professional before using:
Cold therapy is used to reduce swelling and reduce pain.
Methods for applying cold treatment
Ice massage is used to decrease pain over a small area. It can be used for up to a maximum of 10 minutes or less if pain relief occurs sooner.
A Resistive Exercise Band (REB) has been recommended by your Physiotherapist to provide graded resistance to exercises.
The bands vary in strength, indicated by different colours and are latex free.
The REB should only be used by a patient as part of a therapy programme which has been designed by the Physiotherapist in a manner prescribed and demonstrated for the patient.
REBs if not used correctly can cause injury. The following are recommended:
Contact
If further advice is required, please contact your MSK physiotherapy department. You can find the details in our Clinic Location section.
MPFT makes no warranty or representation, express or implied, regarding Resistive Exercise Bands (REB) and cannot accept liability for any damage (howsoever arising and whether or not caused by the Trust’s negligence) resulting from the use or misuse of the REB, including without limitation any use contrary to the instructions given by your physiotherapist, the Trust and/or the manufacturer of REB. Nothing shall exclude the Trust’s liability for any personal injury or death arising as a result of its negligence.
Some medications can be helpful to manage our pain and keep you active. The information below is for adults over the age of 18 only.
Before starting new medications, it is a good idea to look at the information leaflet that comes with your medication and please do not take more than the recommended dose on your packaging or the dose prescribed by a doctor.
If you do experience any significant side effects from taking pain relief, please stop taking immediately and speak to a doctor or pharmacist before continuing to use it.
There are two ways to get medication Over the Counter (OTC) or by prescription.
You do not need a prescription to buy OTC medication. These are available to buy at chemists and supermarkets. They are most effective for mild to moderate pain, before the pain becomes too bad. They are for short term use.
Prescription medication is issued by your doctor and is obtained from a Pharmacy.
Pain relief
Paracetamol is the most common medication used for pain relief. It is often seen as one of the safer pain relief tablets to try first. It comes as a tablet, a liquid or a tablet that dissolves in water. If paracetamol is not helping within a few days, it may be worth speaking to your GP to see whether you would benefit from taking something different. More information can be found on the NHS website.
Non steroidal anti inflammatory drugs (NSAID)
Ibuprofen is the most common NSAID used to treat pain and reduce inflammation. It comes as a tablet, a cream, a gel and patches. The gels and creams may be better for joints such as hands, feet, knees. NSAID tablets are usually stronger than the gels and creams. Certain NSAID are only available on prescription. These are only recommended in short courses and if you have had no benefit within 5-10 days of taking them, they’re unlikely to be helpful so it would be best to stop taking them. More information can be found on the NHS website.
Prescription pain medication
Prescription medication is only available from your doctor, such as: Co-codamol, Tramadol, Naproxen etc.
Please speak to a pharmacist or GP for advice before taking pain medication if you:
Steroid injections may be used within musculoskeletal practice to try to help with pain management and potentially give a window of opportunity for more effective involvement in physiotherapy rehabilitation treatment.
Steroid injections are not guaranteed to help. We would usually expect to see a response within 6 weeks of your injection. If it has not helped at this stage, it is unlikely it will help after this. If it does work, the effects are known to be temporary with the majority of evidence suggesting those that do experience relief usually feel improvement for around 3 months.
As part of your treatment, if a steroid injection may be of benefit then you will be seen by a specially trained clinician. Various factors can then be discussed to see if an injection is the right thing for you.
Most problems can be managed through physiotherapy treatment, modifying activities and use of simple pain relief.
Steroid injections are generally safe but, like all medications, there are some risks and side effects, and certain circumstances mean you may not be able to receive an injection. The person involved in your care will discuss this with you to help you to make a decision about your treatment.
If a steroid injection is agreed between you and your Health Care Professional, you will need to complete a consent form and medical screening questionnaire. Your treatment can be planned around your individual needs. Aftercare advice will also be discussed with you at your appointment.
There is more information about steroid injections on the Versus Arthritis Website.
When living with a musculoskeletal condition it is important to consider lifestyle factors. As people are different, and there are many different types of conditions, what works for one person may not work for another, so it is important to continue trying to make changes to your lifestyle.
There are no diets or dietary supplements that will cure your condition, but some people do find improvements to their symptoms on changing what they eat.
On balance, altering your diet probably won’t have as great an impact on your condition as your medical treatments, and we wouldn’t recommend stopping any of your medications without discussing it first with your GP. However, it’s still worth considering your diet for the following reasons:
The two most important things to think about are:
Any of the following measures taken together are likely to be beneficial:
The most important link between you and your diet is certainly your weight; we know that being overweight puts an extra burden on the joints of the back, knees, hips, feet and ankles. Because of the way joints work, the pressure on your knee joints is 5-6 times your body weight when you walk so even a small weight loss can be a big difference.
One way to find out whether you are a healthy weight is to calculate your body mass index (BMI). You can use the BMI calculator on the NHS website, or use the calculation below;
Multiply your height in meters by itself e.g. 1.7(m) x 1.7=2.89
Divide your weight in Kilograms (KG) by the number you got in stage 1. e.g. 90(kg) divided by 2.89 = 31.14
The result is your BMI = 31
For most people a healthy BMI is in the range of 20-25
The only way to lose weight, and keep it off, is to make permanent changes to the way you eat and/or the amount of exercise you do. You need to balance your food intake against the energy you burn.
Your body needs food;
Some people however may need help and support to achieve their weight loss.
Research has shown that both muscle strengthening and aerobic exercise (physical activity that makes the heart beat faster) can reduce pain and improve the ability to do everyday tasks. This doesn’t seem to matter whether this takes place as home-based exercises or in an organisation (NHS, Gyms, and Hydrotherapy). They are all as effective as one other.
Therefore, things that help people to keep physically active are;
Experts emphasise that it is important to keep up exercise routines in order to continue to benefit. Research has shown that group and home based exercise are equally effective. It is therefore important to make a positive change to your lifestyle in order to be more active (The MOVE consensus (2005)).
Many community centres now offer group activities such as keep fit or Tai Chi or chair-based exercise groups. The people who organise and run these activities know that some people worry about going along to these sessions for the first time practically if you are on your own but they are aware of this but there is usually a few regulars around to help look after you.
There are also exercises on this website that can help you get started at home.
There are lots of benefits to stopping smoking and these really do start straight away. You will save money and you will also:
Please speak to your GP or pharmacist about help stopping smoking.
Vitamin D helps control a lot of processes in the body and is very important for musculoskeletal health as these nutrients are needed to keep bones, teeth and muscles healthy and strong.
A severe lack of vitamin D can lead to bone problems such as rickets in children, and osteomalacia in adults. Osteomalacia occurs when bone quality deteriorates. The symptoms can come on slowly and give you pain without an injury. This can lead to broken bones, muscle pain and weakness, resulting in difficulty with stairs, getting up off the floor or standing after sitting in a low chair or a different walking pattern.
Vitamin D deficiency can also cause secondary problems with your thyroid gland, loss of bone thickness, muscle weakness and can increase your risk of falling as you age.
Good Vitamin D levels may also help in:
Everyone in the UK is at risk but some are at higher risk than others, these include people:
Sunlight: During the spring/summer months, most people can get enough vitamin D through sunlight. If you have fair skin, around 20-30 minutes of sunlight on the face and forearms around the middle of the day (from 11am-3pm) 2-3 times a week is enough to make enough vitamin D in the summer months in the UK. The sunlight has to fall directly on to bare skin. If you have darker skin, you can still make some vitamin D through exposure to sunshine. However, you may not be able to make enough from sunshine and diet alone, so you should consider taking a vitamin D supplement all year round.
Too much exposure to the sun's rays can be damaging. Avoid burning as this can lead to an increased risk of skin cancer.
Supplements: There are a range of products available at supermarkets, pharmacies and other retailers; the recommended dose of vitamin D is 10 micrograms (or 400 International Units (IU)) per day. Taking more than this dose is not necessary, but if you are unable to find a vitamin D supplement providing 10 micrograms (400 IU), products providing up to 25 micrograms (1000 IU) are suitable for everyone.
Diet: Only 10% of Vitamin D is found in our diet, in either foods containing it naturally or that have been fortified.
Food sources include:
Cows' milk is generally not a good source of vitamin D because it is not fortified in the UK, as it is in some other countries.
NICE recommends that health professionals should NOT routinely test people’s vitamin D status unless they are classed as being particularly high risk or show clinical signs of deficiency.
In summary: Public Health England and NICE advise that everyone should consider taking a daily vitamin D supplement during the autumn and winter. Those at higher risk should take daily supplements, all year round.
The recommended dose of vitamin D is 10 micrograms (or 400 International Units (IU)) per day.
On the Bee Free website you will find lots of resources which have been put together by patients like you, working with experts at Keele University, Mind and the NHS.
