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Aches and pains – your questions answered

For this topic, lead physiotherapist Jan Vickery, and her experienced team of musculoskeletal physiotherapists here at AXA PPP, answer your questions about coping with aches and pains.

Aches and pains can have a negative affect on your mobility, mood and even your ability to work productively on a day-to-day (and sometimes long-term) basis. The most common cause of joint pain in people under 50 is injury or overuse. Most cases occur from overdoing normal, everyday activities, such as lifting heavy bags or digging in the garden, rather than doing sport.

Here we’ve rounded up the best of the team’s support and insights around the most commonly asked questions:

I have been getting achy knees and ankles after sitting at my desk all day in work. What could this be?

When you have desk-based job, it's really important to move around a lot during the day. Knees and ankles don't like being kept still for long periods; they stiffen up easily, especially as we get older. Aim to move at least every 20 minutes when you are desk based. If you are someone who tends to get drawn into intensive work and forget about taking a break then try to build indirect triggers to break, like drinking lots of water that will require comfort breaks or printing to a printer that is a short walk away. Instead of emailing colleagues, walk over and talk to them. Also, try to fidget when you are at your desk - some people have stress balls on the floor to keep their feet moving. If you are worried about your stiffness and you feel it is not linked to sitting still for long periods or if it is noticeably worse in the morning then it may be worth seeing your GP.

I have middle back pain, at either side of my spine. I have a feeling it may be posture related but what is the best thing to do to ease this?

We can often account for many of our aches and pains in our spine being due to posture or lack of the right type of movement. It’s important to try to maintain good posture throughout the day to prevent fatigue and slouching. Your chair should do the work for you by supporting your spine in a S shape. Ensure you have good lumbar support (that's in the lower back of the spine), and take regular comfort breaks by moving away from your desk. You should aim to take a five minute break every hour. You can also do simple exercises at your desk to encourage flexibility and increase your circulation, as simple as standing up and stretching backwards or take a brief walk round your desk area. This will help alleviate any pain and discomfort. We always advise if any pain is not settling with these simple strategies to get in touch with your GP or get checked over by a Physiotherapist for more structured advice.

What are the best exercises to do throughout the day at work?

The best thing you can do during your work day is to keep moving regularly. We advise to try and move once every hour, even if that just means getting up and stretching at your desk or walking to get a glass of water or coffee. Simple exercises, like standing and stretching backwards with your hands in the small of your back are helpful or bending from side to side. Think about your upper back, neck and shoulder area which can get stiff or hold tension. Rolling your shoulders, turning your neck side to side and lifting both arms fully up into the air to stretch your upper back are simple exercises. Doing tummy tuck exercises where you tighten your lower abdominal muscles for a few seconds can be very helpful (just remember not to hold your breath!) If necessary, your employers should be able to provide a workstation assessment for you to check your desk set up.

I have been diagnosed with polymyalgia and have been prescribed steroids. What is it and is it possible to improve the condition naturally, without resorting to strong drugs?

Polymyalgia rheumatic is a condition that causes pain, stiffness and inflammation in the muscles around the shoulders, neck and hips. The main symptom is muscle stiffness in the morning that lasts longer than 45 minutes. The cause is unknown, but a combination of genetic and environmental factors is thought to be responsible, and it’s fairly common.

While gentle exercise can be beneficial, because this is an inflammatory condition, it is often necessary to use medication to control it. If you’re concerned about the long term side effects of your medication we’d recommend you discuss this with your GP. Sometimes, a short course of steroids can be helpful to get things under control, then a reduced dose to maintain, but again this need to be discussed with your GP. In terms of exercise, gentle swimming or tai chi can be very helpful to maintain your flexibility, posture and strength.

I've had a stiff neck and shoulders from hours at a laptop and driving. Can you recommend any exercises to stretch them out and solve the stiffness?

Fixed postures or positions, particularly if we are slouched, can cause stiffness, pain and circulatory changes. The best thing you can do to prevent stiffness is to use a monitor which is at eye level, which will prevent you bending your head. If you have to use your lap top, try a lap top raise and don’t balance it on your knees! Take regular breaks away from your desk and do frequent gentle head and neck stretches - turn you head from side to side slowly, look up then down, shrug your shoulders or roll them and stretch your arms above your head from time to time. With driving long distances, stop every hour or so and get out the car and walk around for a few minutes (in a safe environment). I often suggest adjusting your rear view mirror when you first get into the car and if you notice your rear view deteriorates as you’re driving it’s not the mirror moving it’s you slouching, so reposition when you remember!

I have a hot patch in the front of my leg just above my knee. It is about 3 inches square and gets very hot especially if I stand around. Is this connected with my back problem, and what can be done about it?

A hot patch at your knee could be related to a number of things. As long as there is no swelling, redness or heat associated with the hot patch, which would need checked over by a health professional, then it might be nerve related. Make sure you are not leaning anything on your leg for a prolonged period or crossing your legs constantly. If it’s there when you’re standing then change position regularly or walk around. If these things don’t help then see your GP to get it check over.

I have a trapped nerve my left little finger. Is there any way to un-trap it myself?

Try to avoid putting any pressure along the outside border of your hand (i.e. don't lean on it). You should also try to massage the finger regularly to stimulate the nerve and circulation. Avoid leaning on your elbow also, as it may actually be contributing to the numbness. Occasionally these symptoms can stem from your neck so check you are optimising your posture and try a few gentle neck stretches (turning your head right and left a few times an hour). Discuss with your GP if it doesn't improve within a month.

I am 65 and find that a different bit of me aches each day; yesterday it was left knee, the previous day right thumb, the day before left wrist, some days it’s stiff back. Is this just part of getting old?

As we get older we do get lots of aches and pains; however that doesn't mean that we just sit back and accept the inevitable. We do need to decide if some of the aches and pains are due to natural age-related changes (unfortunately as we get a bit wrinkly on the outside this happens on the inside as well!), in which case keeping moving and gentle exercise is the best management plan. Much of your pain may actually be referred pain coming from the nerves in your spine, or may be related to an activity you’ve been doing. Try keeping an activity log and monitor if certain things make your symptoms worse, then try modifying your activities to take the strain off your joints. If things are not settling within a few weeks then see your GP for further advice.

How can I deal with arthritic knees during exercise?

Our knees are major load-bearing joints in our body and can react to excessive loading. If you’re running, you need to make sure you have good supportive footwear that will absorb some of the impact or adding a cushioned insole on a temporary basis. If you’re cycling, then ensure your seat height is properly adjusted. If you’re weight training, don't use weights that are so heavy that you end up putting too much pressure on your joints. Particularly if you’re doing squats or lunges - check your technique and make sure your knees doesn’t go over your toes!

After years of playing the guitar, I now have pains in my fingers and it is so bad that I can hardly play anymore. I’ve been diagnosed with osteoarthritis been prescribed diclofenac, but after 6 months of taking it, I am no better off. Any suggestions please?

If there has not been a noticeable improvement on the medicines, we would suggest going back to your GP. Depending on what they find when they assess you, they may recommend a different type of medication or refer you for physio. There are a number of methods to relieve pain and stiffness in the fingers, like specific exercises, heat, cold, or therapeutic wax. It is likely that you will need to find the best methods of helping you to manage your difficulties and you are likely to go through periods of good and bad with them. The main thing is to get specific help and advice to help you to manage better - there may not be a magic wand.

I am experiencing pain in both feet, which my GP says is tendonitis. Which exercises would help to stretch out the tendons and get rid of the problem?

It might not be a case of needing to stretch the tendons. Insoles can have a massive impact on the type of problem that you describe. A podiatrist or physio would do a full assessment to see exactly which tendon is being affected and why. It may be due to you’re the way you stand, your shoes, muscle weakness or other reasons. If indicated, they can have a bespoke insole made for you and then advise how to tackle any of the specific problems they identify. It’s also probably best to avoid high heels if you wear them - it's amazing how many people continue to wear heels with this sort of problem.

I have had muscle pain in my arms for a few months now – could it be tennis elbow?

Tennis elbow is very specific and is generally easy to diagnose. It affects the muscles on the outside of your elbow. The movement that is typically most affected is bending your wrist upwards. Holding a tea cup is something that people with tennis elbow often find difficult. Luckily it usually gets better on its own but make sure you rest the arm or, specifically if you recognise the movement that provokes your symptoms, then try to moderate if possible. If you’re worried, it’s best to visit your GP, who may refer you to a Physio who is often best placed to advise on treatment and recovery.

Want to find out more about your muscles, bones and joints? Visit our Musculoskeletal Centre, which provides information and advice on back and joint pain. If you’d like to ask a question not covered here, visit our Ask the expert page.

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