Living with osteoarthritis

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ContentsWhy we’ve created this guide 3

What is osteoarthritis? 4

How it develops 4

Am I likely to get osteoarthritis? 6

How is osteoarthritis diagnosed? 6

How can I manage my osteoarthritis? 7

How does osteoarthritis affect you? 8

Self-help strategies 9

What types of exercise can I do? 9

Overcoming common roadblocks to exercise 10

Healthy eating tips for osteoarthritis 11

Should I avoid certain foods? 12

Will losing weight help improve my symptoms? 12

Managing your pain 13

The biopsychosocial approach 14

Medications for osteoarthritis 14

Over-the-counter pain relievers 15

Prescribed medications 16

Can I use opioids for pain relief? 16

What about alternative medicines? 16

Keeping a record of your medication 18

What is physical therapy and can it help? 18

Types of physical therapies 18

Should I consider surgery? 19

Questions you might want to ask about surgery 20

Preparing for surgery 20

Why is rehab after surgery important? 21

We’re here to help 22

Living with osteoarthritis 23

Having an osteoarthritis action plan 24

Who can I ask for support? 25

Find support near you 26

Why we’ve created this guide

If you’re living with osteoarthritis, know you’re not alone. It’s a common

condition and getting the right support can help you lead an active,

fulfilling life. Here at Bupa we’ve put together this guide to give you

access to practical tips and information about osteoarthritis. It may also

be a useful resource for your family and friends who want to know more

about osteoarthritis and how they can help.

We’re more than just a health insurer. We’re a health and care company

committed to helping people live longer, healthier, happier lives.

Everything from insurance to dental, optical and aged care homes,

to supporting health research and sharing health information. We’re

here to make your life that little bit easier.

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What is osteoarthritis?

Osteoarthritis is a type of arthritis that results from tissue damage in your joints. Your joints become inflamed (swell up) causing you pain and stiffness. This may eventually affect your ability to do your usual activities.

Osteoarthritis is the most common form of arthritis in Australia. It can affect any joint but occurs most frequently in the joints of your hands, feet and spine as well as large weight-bearing joints such as hips and knees.

Osteoarthritis used to be put down to ‘wear and tear’ of your joints. Nowadays, evidence suggests it’s not that simple. While your joints will experience some wear and tear as you age, this is generally not enough to cause osteoarthritis.

Even though there is no ‘cure’ for osteoarthritis, there’s a lot you can do to help relieve any pain or stiffness and reduce the chances of it getting worse.

It’s not just older people

Osteoarthritis affects people of all ages, including children and people of prime working age (25–64 years). But did you know it’s particularly common in people over the age of 45, affecting 1 in 5 Australians? And you’re more likely to develop osteoarthritis if you’re a woman.

How it develops

Osteoarthritis is thought to be caused by your body trying too hard to repair tissue damage in your joints. This triggers a domino effect that can eventually compromise all the structures of the joint.

Osteoarthritis often starts with damage to cartilage, the protective cushion around your joints that helps your joints move smoothly. Worn cartilage is less effective at protecting your joints and contributes to a weakening of the joint bone underneath it.

Sometimes bone damage can trigger new bone development. This can grow too far over the bone’s natural edge, forming bony growths called spurs or osteophytes that may interfere with smooth joint movement and cause pain. Bone and cartilage damage can also cause other parts of your joint to weaken or fail, such as your tendons and ligaments.

Healthy knee

Knee with arthritis

How the knee is affected by osteoarthritis

Femur (thigh bone)

Synovial membrane Cartilage

Thickened and stretched capsule

Osteophyte

Ligament

Capsule

Fibula

Tibia (shin bone)

Thickened and inflamed synovial membrane

Narrowed joint space

Thinner bone

Worn down cartilage

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How can I manage my osteoarthritis?

How you manage your osteoarthritis depends on which joints are affected, how severely it’s affecting you, and on your individual needs.

For most people, a mix of non-drug therapies and medication usually gives the best result. Your doctor and other healthcare professionals will help work out the best combination for you. These therapies will be discussed in detail in the next sections, but may include a combination of:

• Exercise, including general physical activity and specific exercises tailored to you.

• Devices such as walking sticks, elastic bandages, heat packs and home transcutaneous electrical nerve stimulation (TENS) to helpwith either pain, mobility or balance.

• Managing your weight, if needed.

• Massage or other manual therapies to help in the short-term.

• Pain management using medications and psychological therapies.

• Joint replacement surgery, if other therapies aren’t doing enough to manage your osteoarthritis.

How does osteoarthritis affect you?

Osteoarthritis doesn’t affect everyone in the same way. For some people, taking the occasional pain reliever and keeping fit may be all that’s required. Others find that osteoarthritis has a major impact on their lives.

The Australian Bureau of Statistics 2017-2018 health survey found nearly half those with osteoarthritis had recently experienced joint pain that was interfering with their lives.

Many people in the survey also said they felt depressed and negative, which is understandable when you can’t do what you used to because of osteoarthritis. If you’re feeling this way, it can make it harder to get motivated. Finding strategies that work for you is key to managing your osteoarthritis and leading a fulfilling life.

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How is osteoarthritis diagnosed?

When you first see your doctor about experiencing pain and stiffness, they may examine your joints and ask you some questions. This helps your doctor understand your symptoms and how much pain you’re in.

Usually a diagnosis of osteoarthritis can be made based on your symptoms and medical history. Sometimes your doctor will send you for an X-ray to see what’s happening in your joint, or for blood tests to rule out other types of arthritis. If your doctor thinks you may have a different condition, like gout or a joint infection, a sample of your joint fluid (called synovial fluid) may be taken for testing.

Am I likely to get osteoarthritis?

While your chances of developing osteoarthritis do increase with age, it is not an inevitable part of ageing as ‘wear and tear’ on its own doesn’t trigger osteoarthritis.

You’re more likely to develop osteoarthritis if you:

Have experienced an injury or fracture in the past

Are overweight

Have a family history of osteoarthritis

Were born with a joint abnormality, such as scoliosis (curvature of the spine)

Do repetitive tasks that load the joints (e.g. lots of kneeling, climbing, squatting, or lifting heavy loads)

Have certain illnesses that affect your joint in some way, such as haemochromatosis (excess iron in your body) or gout (excess uric acid in your body)

Have weak thigh muscles (quadriceps) (for knee osteoarthritis)

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Self-help strategies

We hear a lot about the benefits of exercise and a healthy diet. Your lifestyle choices are key to managing and preventing many diseases and conditions, and osteoarthritis is no exception. Regular exercise, a healthy diet, maintaining a healthy weight and not smoking can all help support you in staying physically and mentally well.

What types of exercise can I do?

When you’re in pain the last thing you probably feel like doing is exercise. You might think you’re better off putting your feet up and resting your painful joints. But physical exercise is one of the best things you can do to manage osteoarthritis.

There isn’t one exercise that’s recommended for everyone with arthritis, but low-impact exercises – those with less weight or force going through your joints – are likely to be the most comfortable. You’ll get the best results by working with your doctor and healthcare team, and choosing activities that you are able to do, that you enjoy, can do regularly, and that suit your condition, budget, health and lifestyle.

Ideally, aim do a mix of mobility, strengthening and fitness activities.

• Mobility exercises help your joints move as far as they comfortablycan. Examples include muscle stretching, aquatic exercises, tai chiand yoga.

• Resistance exercises work to strengthen your muscles and bones. By building bone and muscle strength, resistance exercises helpreduce the pressure on your joints, and improves your balance andposture, reducing your risk of falls and injuries. Examples includeexercises that use weights (including aquatic exercises), resistancebands or gym machines.

• Fitness exercises are also called cardiovascular exercises and arethe activities that make you ‘huff and puff’. They improve thehealth of your heart and lungs and tend to use your larger muscles,such as your legs. Examples include walking, swimming andcycling.

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Plenty of fruit and vegetables, in a rainbow of different colours.

Opting for mainly wholegrain or high fibre grain foods, such as wholemeal bread, brown rice and pasta and high fibre breakfast cereals

A variety of protein foods, including lean meat and poultry, fish, eggs, tofu and legumes/beans.

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Healthy eating tips for osteoarthritis

Eating nourishing foods can help make a difference to your health in general and maybe even to the way you feel. Evidence points to a healthy, balanced Mediterranean-style diet as helpful for people with osteoarthritis, in line with Australia’s Dietary Guidelines.

Overcoming common roadblocks to exercise• I don’t have the time.

Think activity rather than exercise. While we should all beaiming for 30 minutes of moderate activity on most days,you can break this up into 10-minute chunks if you don’thave a spare 30 minutes.

• I’m not really motivated.Enlist an exercise buddy. When you’ve arranged tomeet a friend for a walk it’s much harder to back out ofthe commitment.

• I’m in too much pain.Many people with arthritis have some amount of pain allthe time and exercise may actually help combat this. Ifyou notice that exercise causes unusual pain or increasesyour pain, you should stop exercising and speak with yourGP or physiotherapist.

• I feel too tired.If you feel tired, aim to exercise for a minimum of 10minutes and see how you go. Choose to exercise at atime in the day when you feel the least tired, such asin the morning.

• A gym membership is too expensive.You don’t need a gym to get a good workout. Walking isfree, and you can do strength training by using your ownbodyweight and/or weights and exercise bands at home. Milk, yoghurt,

cheese, and/or dairy alternatives (such as soy milk) fortified with calcium, mainly reduced fat.

Avoiding foods high in added sugar, salt and saturated fat, such as biscuits, cakes, soft drinks, sports drinks, pastries, processed meats, pizza, and savoury snacks.

Limiting your intake of alcohol. Australia’s alcohol guidelines recommend no more than 10 standard drinks a week, and no more than 4 drinks in any one day.

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Will losing weight improve my symptoms?

That depends on whether you’re carrying excess weight. Before beginning any sort of diet, it’s best to first get advice from your GP or dietitian, as depending on your age your body mass index (BMI) may not be the best indicator of whether you’re considered overweight.

Being overweight can put pressure on your joints, particularly of the knee and hip, as well as increase inflammation, both of which can make the pain worse. Losing weight will help make moving around easier, decrease stress on your joints and reduce your pain.

The best approach to weight loss is combining a healthy diet – low in added sugar and saturated fat and high in plant foods such as fruit, vegetables and wholegrains – with regular physical activity. A reasonable goal is to aim for weight loss of between 5% and 7.5% from your current weight, over a 12 to 18-month period.

Did you know Bupa offers a program that could help you manage your osteoarthritis?

Have you heard of the Osteoarthritis Healthy Weight for Life program*? The 18-week program has been specially developed by leading Australian and international medical and physiotherapy experts to help with weight loss, muscle strengthening and pain management.

The program is available to eligible customers* who have diagnosed osteoarthritis of the hip or knee, and is designed to improve your symptoms, reduce pressure on your joints, and help you delay or potentially avoid knee or hip replacement surgery altogether. The program delivers online education modules, phone and web-based support, personalised coaching and goal setting, GP communication, and post-program follow up.

Find out more and whether you’re eligible at bupa.com.au/OAHWFL

*Must hold a domestic Bupa Hospital policy which includes joint replacement cover. Program and clinical eligibility criteria, waitingperiods, fund and policy rules apply.

Should I avoid certain foods?

There are many diets that promise to ‘cure’ your osteoarthritis or ease the pain, but most of these are not supported by credible evidence and are often quite restrictive.

There is no need to avoid or limit:

• Nightshade foods.

These include tomatoes, potatoes, eggplant and capsicum. Thereis little evidence these foods worsen arthritis symptoms and the nightshade vegetables add variety and fibre to your diet.

• Acid-producing foods.

According to supporters of the alkaline diet, acid producing foodsinclude meat, eggs, grains, refined sugar and processed foods.Rest assured that your arthritis will not get worse if you eatthese so called ‘acidic’ foods, as your body does an excellentjob of maintaining a strict acid/alkaline balance. There are plentyof reasons to limit refined sugar and processed foods, but acid production isn’t one of them.

• Dairy foods.

Dairy foods get plenty of bad press, much of it claiming thatthey trigger inflammation in the body. But rather than promoteinflammation, studies have shown that dairy foods have theopposite effect – they are anti-inflammatory. Dairy foods arealso rich in calcium, an important mineral for strong bones, so if you do restrict dairy make sure you eat enough calcium-rich foods.

Managing your pain

Pain is the main reason people with osteoarthritis seek help. Changes to the nerves in your joint can mean that you become more sensitive to pain, but this is only part of the explanation. It’s now thought that how you react to pain plays a part as well. This is influenced by many things, including your mood, previous experiences and how much attention you give the pain experience.

Pain is more than discomfort. It can limit what you do physically and socially, cause emotional distress and fatigue, make you afraid of exercising or moving too much, and can also cause sleep problems. Pain can fluctuate in intensity, both within and between days. While you may fear your pain will get worse with time the good news is this isn’t inevitable.

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Medications for osteoarthritis

Together with physical activity, non-drug therapies and other self-help strategies, pain relievers may also help you manage your osteoarthritis.

Be patient. Finding the best pain relievers for you might be hit and miss at first – what works for one person might not for you.

Sleep and pain

Pain or joint discomfort may make it harder for you to sleep well, but did you know that it’s a two-way street? Poor sleep may make your joint pain worse. If you’re doing everything you should to get a good night’s slumber and it’s still not happening, talk to your doctor. Other factors in your life can also affect your sleep – stress, anxiety and depression for instance. There’s plenty of support available to help you manage sleep and all the factorsthat can affect it.

For more sleep hygiene tips, visit bupa.com.au/better-sleep

The biopsychosocial approach

There are many factors that can influence how much pain you’re in, and that’s why you may be offered a combination of medical, physical and psychological therapies. This approach is called the biopsychosocial model and is considered the most effective way to improve function, pain and mood.

If you’re offered psychological support, it doesn’t mean the doctor thinks the pain is all in your head. There is evidence that psychological therapies, particularly cognitive behavioural therapy (CBT), can be effective in managing osteoarthritis pain.

It can identify negative thoughts you have around your pain and what it stops you doing. Then by challenging these thoughts, CBT can help you replace them with more positive ones.

A psychologist can also give you guidance on relaxation techniques and pacing your daily activities, keeping socially connected, and help you deal with any anger, frustration or sadness that you might feel when you’re in pain. If you do notice you’re feeling depressed or more sad than usual, it’s important to let your doctor or psychologist know so they can help you.

Medications come with side effects. They can also interact with other medications or supplements you may be taking. Talk to your pharmacist or doctor before you take any over-the-counter medications like pain relievers, just to make sure they’re suitable for you.

Over-the-counter pain relievers

Over-the-counter pain relievers include non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. You can get them as tablets/pills, creams, gels or lotions. NSAIDs can also help reduce any joint inflammation (swelling).

You could also try paracetamol to see if it relieves the pain, although it appears to be less effective than NSAIDs for treating osteoarthritis pain. You can also buy combination formulations of paracetamol and ibuprofen, which are considered a good alternative to pain relievers that are no longer available without a prescription.

If over-the-counter pain relievers don’t work for you, or they do work but you start needing to take them regularly, it’s time to speak to your doctor again. They can explain the best way of taking these medications safely or offer other strategies or medications that might be better for you.

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Can I use opioids for pain relief?

Opiate medications aren’t recommended for treatment of osteoarthritis pain. They can have potentially serious side-effects that usually outweigh any benefits they might have in providing pain relief. Opioids may be considered for you as a short-term remedy if your pain is severe and seriously impacts your daily living.

If you’re interested in trialling these medicines or already taking them, talk to your doctor. There may be alternative treatments that might be better for you.

What about alternative medicines?

There are a number of alternative medicines and supplements around that claim to help osteoarthritis. If you’re considering these, talk to your doctor or pharmacist first. That’s because there’s less information about alternative medicines compared with conventional medicines. As new evidence is emerging all the time, you can stay updated by visiting Arthritis Australia arthritisaustralia.com.au.

Prescribed medications

COX-2 inhibitors Your doctor may prescribe you this type of NSAID if you’re at risk of stomach bleeds. These medications are less likely to cause this side effect than other types of NSAIDs.

Corticosteroid injections

Your doctor may offer you a corticosteroid injection into your joint if your osteoarthritis flares up. These are helpful for short-term pain relief and to reduce inflammation, but you can’t have them too often because of potentially serious side effects.

Other medications People living with pain can also experience depression, anxiety and have difficulty sleeping. You may be prescribed medication to help with these as well as medications to help manage some of the side-effects of pain relievers.

Glucosamine and chondroitin Glucosamine is a sugar that is produced in your body and is one of the building blocks of cartilage. Chondroitin is also found in your body and is thought to draw water and nutrients into cartilage. It’s claimed that both these supplements, taken alone or together, slow down the breakdown of cartilage and reduce pain, but the evidence doesn’t support their long-term effectiveness.

Glucosamine is usually sourced from shellfish. Unless the glucosamine comes from a plant source avoid it if you have a seafood or shellfish allergy. Both glucosamine and chondroitin interact with the blood-thinning (anticoagulant) medication, warfarin, and may increase your risk of bleeding. It is also unclear whether it is safe to take glucosamine if you have diabetes.

Vitamin D Vitamin D controls calcium levels in the blood. As calcium is essential for bone, cartilage and muscle development, the logic is that vitamin D may help slow down joint degeneration. Studies of people with knee osteoarthritis found no observable benefit from taking vitamin D supplements.

Fish oilsOmega-3 fatty acids found in fish oils may help reduce inflammation in people with rheumatoid arthritis and psoriatic arthritis. Unfortunately, there don’t seem to be any confirmed benefits of taking fish oil if you have osteoarthritis.

TurmericOne of the chemicals found in turmeric spice – curcumin – is thought to help with inflammation. There is little evidence to judge if curcumin works – and is safe to use – for osteoarthritis. Until more evidence is available, it’s best to find tried and tested ways of managing your osteoarthritis.

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Keeping a record of your medication

When you’re taking many different medicines in your week, such as prescription, over-the-counter and herb or vitamin supplements, it can be tricky to remember what, how and when to take them.

Keeping a medicines list is a useful way to ensure you and your health care team knows which medicines you use, to help prevent any avoidable side effects or drug interactions.

NPS MedicineWise has created a free smartphone app you can download to your phone to create your medicines list. You can also download their medicine list template (available in several different languages) to print out, fill in and keep in your wallet or handbag. This way your list is always available to take to your appointments or show your pharmacist.

See the NPS website (www.nps.org.au) for more information on making your medicines list and the MedicineWise app.

As your needs and medications can change, make sure you update the list and discuss any concerns or raise any questions with your pharmacist or health team.

What is physical therapy and can it help?

Physical therapy is the use of specialised techniques designed to strengthen the muscles around your joints, increase your flexibility and reduce pain. It’s important you explain clearly to your physical therapist how your osteoarthritis is affecting your life so you can work together to create the best plan for you. This could include exercises, joint protection and pain management techniques.

When creating your therapy plan, your physical therapist may suggest combining a physical therapy with another type of exercise or weight loss. So it’s important you also work with your GP, dietitian or other allied health professional to make sure your plan works best for you

Types of physical therapies

• Heat therapy such as hot packs or towels (with or without massage) can improve circulation and help relax muscles. Thiscan be done at home or used in your rehab program.

• Hydrotherapy also called pool therapy, uses the buoyancyin water to support your body weight, reducing the naturaldownward pulling weight on your joints. If you are living with knee osteoarthritis, research shows hydrotherapy can reduce pain and improve your ability to perform daily tasks.

• Acupuncture over several weeks can be useful to improve the pain associated with knee osteoarthritis. Make sure you see a qualified acupuncturist for treatment.

• Tai Chi has been shown to relieve pain and improve function in cases of knee osteoarthritis. It can also help your mental health by reducing the anxiety around living with osteoarthritis.

Should I consider surgery? Hip and knee replacements are among the more common types of surgery for people with osteoarthritis and are successful in improving mobility and reducing pain.

Surgery could be an option if your osteoarthritis is so severe that, despite medication and other therapies, it’s causing you significant pain, affecting your sleep and greatly reducing your ability to get around or do everyday tasks.

Other surgical options for osteoarthritis include:

• Hip joint resurfacing – an alternative to total hip replacementwhere only parts of the damaged joint are replaced.

• Replacement of other affected joints including shoulders, elbows,wrists, fingers, ankles, toes and intervertebral discs.

• Surgery to fuse a joint to make it more stable. (most commonlydone in ankles, wrists, fingers and thumbs).

• Osteotomy which is surgery that cuts and repositions bone to betteralign a joint, or to reduce the pressure on it (usually done on knees and occasionally hips).

Every surgical procedure carries risks. Some major surgeries, like hip and knee joint replacement, also involve commitment from you. You’ll need to make sure you’re as fit as possible for the surgery and be willing to commit to physiotherapy and other rehabilitation interventions after surgery. A full recovery could take months.

Surgery may not be suitable for everyone. Talking to your doctor and surgeon will help you make an informed decision based on reliable advice and information. And remember, you can always get a second opinion if you’re unsure.

Preparing for surgery

Decided to go ahead with surgery? Bupa has prepared a helpful Going to Hospital guide (bupa.com.au/preparing-for-hospital) which covers all you need to know about preparing for surgery so you can focus on getting better.

You can also use the medication record app mentioned earlier in this guide to show your surgeon all the medications and supplements you are taking.

Why is rehab after surgery important?

After surgery you’ll want to get back your physical strength and mobility as soon as possible. Rehabilitation (rehab) is often an important step in most people’s recovery.

The rehab you need may involve support from a range of health professionals to help you restore movement and strength to joints and muscles, ease any pain and swelling, and help you return to normal activities such as walking.

It’s important to discuss your rehab options with your treating doctor before your surgery.

Depending on your personal situation and care needs, your rehab options may include:

Rehab in hospitalRehab at homeVisiting

a physiotherapist

If you need rehab, your treatment will usually start in the days immediately following surgery.

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Questions you might want to ask about surgery

Do I really need this procedure?

How long will I need to stay in hospital?

How long will it take to recover?

What will happen if I don’t have it?

How successful is this surgery? Is it likely to improve my quality of life?

What will I need to do to fully recover (e.g. follow a physiotherapy or exercise program; use a crutch for a while)?

Do you have any information about the surgery I can read before making a decision? (Or is there a good website I can go to for information?)

What are the risks with this type of surgery?

We’re here to help

Bupa’s Rehab Choices ProgramEligible customers* can access rehab services at home that are the same as having rehab in hospital, at no extra cost, if this is suitable for them. This can be very helpful if you cannot travel or prefer the convenience of having rehab at home after your surgery. To find out more about the program, and your rehab options, visit bupa.com.au/rehab-choices

*Must hold a Bupa Hospital Policy which includes cover for rehabilitation. Programeligibility criteria, waiting periods, fund and policy rules apply.

Bupa’s Hip and Knee Support Line

If you’d like to know how we support customers who have hip or knee osteoarthritis, or you’re having hip or knee replacement surgery and you’d like to explore your rehab options, you can call our free help line and speak to a Bupa health professional. Call 1800 817 632 Monday to Friday, 9am-5pm AEST/AEDT.

Members First physiotherapy providersContinuing your rehab once you return home plays a crucial role in helping you recover. Depending on your program and rehab goals, you may need to visit a physio. If you have Bupa Extras cover that includes physiotherapy you can visit your local community Members First Provider for physiotherapy services (visit bupa.com.au/find-a-provider) for the best value. Waiting periods and yearly limits apply.

The reality of living with reduced movement in your joints from osteoarthritis is not easy. Joint pain, stiffness and swelling can affect your ability to go to work, do chores around your house or possibly sleep at night. Some examples of how your day-to-day life could be affected include difficulties with:

• Opening boxes of food

• Tucking in bedsheets

• Writing

• Using a computer mouse

• Driving a car

• Walking

• Climbing stairs

How well you can perform these tasks, called activities of daily living, can be assessed by your health care support team. They can make sure you don’t live or work in unsafe conditions.

Your support team can also show you ways to simplify tasks, and depending on how easy or difficult you find them, they can advise on suitable aids and equipment, including:

• Tools such as ergonomic knives and easy grip cooking utensils thathelp you prepare food and open jars and bottles.

• Long-handled sponges for showering and shoe horns for reachingyour feet when putting on your shoes.

• Reachers to grab things from the floor when tidying up so you don’thave to bend over too far.

• Trolleys to carry groceries (instead of shopping bags).

• Mobility aids such as knee braces or walking sticks to helpyou walk easier.

Living with osteoarthritis

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Having an osteoarthritis action plan

Your action plan starts with a set of goals you’d like to achieve for living with osteoarthritis. It’s a plan that makes it clear what resources you’ll need to reach these goals and the steps you need to take to achieve them.

Breaking your goals into several smaller steps is a useful way to see the actions you need to take. These may include:

Who can I ask for support? How well you live with your osteoarthritis depends on how well you are supported. The health professionals involved in your care can help you tailor the exercises, joint protection and pain management techniques that will best help you manage your osteoarthritis.

• Physiotherapists – will assess your balance, flexibility andmovement during daily activities to develop an appropriateexercise program. If you have surgery you might need to seeyour physio during rehabilitation.

• Occupational therapists (OTs) – may teach you specifictechniques for managing joint pain. You may also see an OTafter surgery to work with you on your rehab goals and developtechniques to get you moving again.

• Exercise physiologists – will use their expertise in exercisetherapy to tailor and supervise a physical activity program foryou. The focus will be on muscle strengthening, stretching andbalance. It may not always involve gym equipment as the aim isto provide a program you can continue long term.

• Podiatrists/orthotists – specialise in conditions affectingthe feet. A podiatrist can create orthoses and braces to wear inyour shoes to manage foot, knee or hip joint pain.

• Osteopaths – work to improve function in the muscles andjoints affected by osteoarthritis. They may also give you specificexercises to do at home to strengthen muscles or manage pain.

• Psychologists – will often see people with osteoarthritis to helpthem better manage their response to pain.

• GP – will regularly see you to help manage your osteoarthritis.It’s important you have a GP you feel comfortable with and whounderstands your concerns. Your GP may also refer you to someof the other health professionals.

• Rheumatologist – a specialist doctor with training in themanagement of osteoarthritis. You may see a rheumatologistif you have severe or worsening osteoarthritis and will need areferral from your GP.

Health professionals aren’t the only people you can call on for help.

• Support people – family members and friends who canaccompany you to appointments, join you in physical activitiesand listen to you when you feel overwhelmed.

• Carer (if needed) – a professional who visits you in your homeor a trusted friend or family member who you can ask for helpwith daily activities.

It should also list who in your healthcare team can help you and a timeline for reaching your goals. Be realistic about what you can and can’t achieve and if you’re unsure speak to your doctor and other members of your health care team.

If you haven’t created an action plan before and don’t know where to start, here are some questions to get you thinking:

physical activity and strengthening exercises

equipment needed to support your daily tasks

healthy eating plan for weight management

coping skills for managing pain such as mindfulness or meditation.

What do you want to be able to do most in six months’ time?

What would be helpful in reaching your goal?

What stands in the way of reaching your goal?

What do you think you can do from today?

Who can support you? e.g. family, friends, allied health practitioners

Do you have any other concerns about your condition?

You can find additional tips from NPS MedicineWise and Arthritis Australia about creating an action plan at arthritisaustralia.com.au/healthcareprofessionals/gps/nps-osteoarthritis-management-a-team-approach-2

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Find support near youLearning about your condition and being part of a support group, where you can talk through your feelings with others who understand, can help you feel more empowered and less isolated.

Arthritis Australia offers a range of information and support services, including self-management courses, community programs, information and education seminars and support groups. To find out more contact Arthritis Australia on 1800 011 041 or visit their website at arthritisaustralia.com.au

Where can I get more information?If you’d like to contact to find out if you are eligible for any of the programs or services to support you managing your health, you can speak with a Bupa Health Professional by calling 1300 030 238 Monday to Friday 9am-5pm AEST/AEDT, or you can complete the Bupa Telehealth Request a Call Form online at bupa.com.au/request-a-call

For more information and support:

• Contact your local doctor

• MyJointPain at myjointpain.org.au

• Pain Management Network at aci.health.nsw.gov.au/chronic-pain

• Pain Australia at painaustralia.org.au

• Independent Living Centres at ilcaustralia.org.auor on 1300 885 886

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MSD Manual. Overview of pain [Online; updated Feb 2020; accessed Jan 2021] Available from: www.msdmanuals.com

Nicholas M Molloy A Tonkin L et al. Manage your pain. Practical and positive ways of adapting to chronic pain. Sydney, NSW: HarperCollins Publishers Australia 2011

National Health and Medical Research Council. Australian Dietary Guidelines [Online] 2013 [Accessed Feb 2021] Available from: www.eatforhealth.gov.au

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Last updated: May 2021

© Bupa HI Pty Ltd (ABN 81 000 057 590) and its related companies (“Bupa”) May 2021. This information has been developed and reviewed for Bupa by health professionals. To the best of their knowledge it is current and based on reputable sources of medical research. It should be used as a guide only and should not be relied upon as a substitute for professional medical or other health professional advice. Bupa makes no warranties or representations regarding the completeness or accuracy of the information. Bupa is not liable for any loss or damage you suffer arising out of the use of or reliance on the information, except that which cannot be excluded by law. We recommend that you consult your doctor or other qualified health professional if you have questions or concerns about your health.

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