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I’ve been given opioids after surgery to take at home. What do I need to know?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/katelyn-jauregui-1527878">Katelyn Jauregui</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/asad-patanwala-1529611">Asad Patanwala</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jonathan-penm-404921">Jonathan Penm</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/shania-liu-1433659">Shania Liu</a>, <a href="https://theconversation.com/institutions/university-of-alberta-1232">University of Alberta</a> Opioids are commonly prescribed when you’re discharged from hospital after surgery to help manage pain at home. These strong painkillers may have unwanted side effects or harms, such as constipation, drowsiness or the risk of dependence. However, there are steps you can take to minimise those harms and use opioids more safely as you recover from surgery. <h2>Which types of opioids are most common?</h2> The <a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">most commonly prescribed</a> opioids after surgery in Australia are oxycodone (brand names include Endone, OxyNorm) and tapentadol (Palexia). In fact, <a href="https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/bcp.16063">about half</a> of new oxycodone prescriptions in Australia occur after a recent hospital visit. <a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">Most commonly</a>, people will be given immediate-release opioids for their pain. These are quick-acting and are used to manage short-term pain. Because they work quickly, their dose can be easily adjusted to manage current pain levels. Your doctor will provide instructions on how to adjust the dosage based on your pain levels. Then there are slow-release opioids, which are specially formulated to slowly release the dose over about half to a full day. These may have “sustained-release”, “controlled-release” or “extended-release” on the box. Slow-release formulations are primarily used for chronic or long-term pain. The slow-release form means the medicine does not have to be taken as often. However, it takes longer to have an effect compared with immediate-release, so it is not commonly used after surgery. Controlling your pain after surgery is <a href="https://www.nps.org.au/assets/4811a27845042173-00a4ff09097b-postoperative-pain-management_36-202.pdf">important</a>. This allows you get up and start moving sooner, and recover faster. Moving around sooner after surgery prevents muscle wasting and harms associated with immobility, such as bed sores and blood clots. Everyone’s pain levels and needs for pain medicines are different. Pain levels also decrease as your surgical wound heals, so you may need to take less of your medicine as you recover. <h2>But there are also risks</h2> As mentioned above, side effects of opioids include constipation and feeling drowsy or nauseous. The drowsiness can also make you more likely to fall over. Opioids prescribed to manage pain at home after surgery are usually prescribed for short-term use. But up to <a href="https://pubmed.ncbi.nlm.nih.gov/35545810/">one in ten</a> Australians still take them up to four months after surgery. <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/msc.1837">One study</a> found people didn’t know how to safely stop taking opioids. Such long-term opioid use may lead to dependence and overdose. It can also reduce the medicine’s effectiveness. That’s because your body becomes used to the opioid and needs more of it to have the same effect. Dependency and side effects are also more common with <a href="https://www.anzca.edu.au/getattachment/535097e6-9f50-4d09-bd7f-ffa8faf02cdd/Prescribing-slow-release-opioids-4-april-2018#:%7E:text=%E2%80%9CSlow%2Drelease%20opioids%20are%20not,its%20Faculty%20of%20Pain%20Medicine.">slow-release opioids</a> than immediate-release opioids. This is because people are usually on slow-release opioids for longer. Then there are concerns about “leftover” opioids. One study found 40% of participants were prescribed <a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">more than twice</a> the amount they needed. This results in unused opioids at home, which <a href="https://www.anzca.edu.au/getattachment/558316c5-ea93-457c-b51f-d57556b0ffa7/PS41-Guideline-on-acute-pain-management">can be dangerous</a> to the person and their family. Storing leftover opioids at home increases the risk of taking too much, sharing with others inappropriately, and using without doctor supervision. <h2>How to mimimise the risks</h2> Before using opioids, speak to your doctor or pharmacist about using over-the-counter pain medicines such as paracetamol or anti-inflammatories such as ibuprofen (for example, Nurofen, Brufen) or diclofenac (for example, Voltaren, Fenac). These can be quite effective at controlling pain and will lessen your need for opioids. They can often be used instead of opioids, but in some cases a combination of both is needed. Other techniques to manage pain include physiotherapy, exercise, <a href="https://theconversation.com/hot-pack-or-cold-pack-which-one-to-reach-for-when-youre-injured-or-in-pain-161086">heat packs or ice packs</a>. Speak to your doctor or pharmacist to discuss which techniques would benefit you the most. However, if you do need opioids, there are some ways to make sure you use them <a href="https://www.safetyandquality.gov.au/sites/default/files/2022-04/opioid-analgesic-stewardship-in-acute-pain-clinical-care-standard.pdf">safely and effectively</a>: <ul> <li> ask for <a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.16085">immediate-release</a> rather than slow-release opioids to lower your risk of side effects </li> <li> do not drink alcohol or take sleeping tablets while on opioids. This can increase any drowsiness, and lead to reduced alertness and slower breathing </li> <li> as you may be at higher risk of falls, remove trip hazards from your home and make sure you can safely get up off the sofa or bed and to the bathroom or kitchen </li> <li> before starting opioids, have a plan in place with your doctor or pharmacist about how and when to stop taking them. Opioids after surgery are ideally taken at the lowest possible dose for the shortest length of time. </li> </ul> <h2>If you’re concerned about side effects</h2> If you are concerned about side effects while taking opioids, speak to your pharmacist or doctor. Side effects include: <ul> <li> <a href="https://theconversation.com/health-check-what-causes-constipation-114290">constipation</a> – your pharmacist will be able to give you lifestyle advice and recommend laxatives </li> <li> drowsiness – do not drive or operate heavy machinery. If you’re trying to stay awake during the day, but keep falling asleep, your dose may be too high and you should contact your doctor </li> <li> weakness and slowed breathing – this may be a sign of a more serious side effect such as respiratory depression which requires medical attention. Contact your doctor immediately. </li> </ul> <h2>If you’re having trouble stopping opioids</h2> Talk to your doctor or pharmacist if you’re having trouble stopping opioids. They can give you alternatives to manage the pain and provide advice on gradually lowering your dose. You may experience withdrawal effects, such as agitation, anxiety and insomnia, but your doctor and pharmacist can help you manage these. <h2>How about leftover opioids?</h2> After you have finished using opioids, take any leftovers to your local pharmacy to <a href="https://theconversation.com/health-check-what-should-you-do-with-your-unused-medicine-81406">dispose of them safely</a>, free of charge. Do not share opioids with others and keep them away from others in the house who do not need them, as opioids can cause unintended harms if not used under the supervision of a medical professional. This could include accidental ingestion by children. <hr /> For more information, speak to your pharmacist or doctor. Choosing Wisely Australia also has <a href="https://www.choosingwisely.org.au/resources/consumers-and-carers/patient-guide-to-managing-pain-and-opioid-medicines">free online information</a> about managing pain and opioid medicines.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/228615/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/katelyn-jauregui-1527878">Katelyn Jauregui</a>, PhD Candidate and Clinical Pharmacist, School of Pharmacy, Faculty of Medicine and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/asad-patanwala-1529611">Asad Patanwala</a>, Professor, Sydney School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jonathan-penm-404921">Jonathan Penm</a>, Senior lecturer, School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/shania-liu-1433659">Shania Liu</a>, Postdoctoral Research Fellow, Faculty of Medicine and Dentistry, <a href="https://theconversation.com/institutions/university-of-alberta-1232">University of Alberta</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ive-been-given-opioids-after-surgery-to-take-at-home-what-do-i-need-to-know-228615">original article</a>. </div>

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Walking can prevent low back pain, a new study shows

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/tash-pocovi-1293184">Tash Pocovi</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/petra-graham-892602">Petra Graham</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/simon-french-713564">Simon French</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> Do you suffer from low back pain that recurs regularly? If you do, you’re not alone. Roughly <a href="https://pubmed.ncbi.nlm.nih.gov/31208917/">70% of people</a> who recover from an episode of low back pain will experience a new episode in the following year. The recurrent nature of low back pain is a major contributor to the <a href="https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(23)00098-X/fulltext">enormous burden</a> low back pain places on individuals and the health-care system. In our new study, published today in <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00755-4/fulltext">The Lancet</a>, we found that a program combining walking and education can effectively reduce the recurrence of low back pain. <h2>The WalkBack trial</h2> We randomly assigned 701 adults who had recently recovered from an episode of low back pain to receive an individualised walking program and education (intervention), or to a no treatment group (control). Participants in the intervention group were guided by physiotherapists across six sessions, over a six-month period. In the first, third and fifth sessions, the physiotherapist helped each participant to develop a personalised and progressive walking program that was realistic and tailored to their specific needs and preferences. The remaining sessions were short check-ins (typically less than 15 minutes) to monitor progress and troubleshoot any potential barriers to engagement with the walking program. Due to the COVID pandemic, most participants received the entire intervention via telehealth, using video consultations and phone calls. The program was designed to be manageable, with a target of five walks per week of roughly 30 minutes daily by the end of the six-month program. Participants were also encouraged to continue walking independently after the program. Importantly, the walking program was combined with education provided by the physiotherapists during the six sessions. This education aimed to give people a better understanding of pain, reduce fear associated with exercise and movement, and give people the confidence to self-manage any minor recurrences if they occurred. People in the control group received no preventative treatment or education. This reflects what <a href="https://www.sciencedirect.com/science/article/abs/pii/S2468781222001308?via%3Dihub">typically occurs</a> after people recover from an episode of low back pain and are discharged from care. <h2>What the results showed</h2> We monitored the participants monthly from the time they were enrolled in the study, for up to three years, to collect information about any new recurrences of low back pain they may have experienced. We also asked participants to report on any costs related to their back pain, including time off work and the use of health-care services. The intervention reduced the risk of a recurrence of low back pain that limited daily activity by 28%, while the recurrence of low back pain leading participants to seek care from a health professional decreased by 43%. Participants who received the intervention had a longer average period before they had a recurrence, with a median of 208 days pain-free, compared to 112 days in the control group. Overall, we also found this intervention to be cost-effective. The biggest savings came from less work absenteeism and less health service use (such as physiotherapy and massage) among the intervention group. This trial, like all studies, had some limitations to consider. Although we tried to recruit a wide sample, we found that most participants were female, aged between 43 and 66, and were generally well educated. This may limit the extent to which we can generalise our findings. Also, in this trial, we used physiotherapists who were up-skilled in health coaching. So we don’t know whether the intervention would achieve the same impact if it were to be delivered by other clinicians. <h2>Walking has multiple benefits</h2> We’ve all heard the saying that “prevention is better than a cure” – and it’s true. But this approach has been largely neglected when it comes to low back pain. Almost all <a href="https://www.sciencedirect.com/science/article/pii/S0140673618304896?via%3Dihub">previous studies</a> have focused on treating episodes of pain, not preventing future back pain. A limited number of <a href="https://pubmed.ncbi.nlm.nih.gov/26752509/">small studies</a> have shown that exercise and education can help prevent low back pain. However, most of these studies focused on exercises that are not accessible to everyone due to factors such as high cost, complexity, and the need for supervision from health-care or fitness professionals. On the other hand, walking is a free, accessible way to exercise, including for people in rural and remote areas with limited access to health care. Walking also delivers many other <a href="https://www.vichealth.vic.gov.au/sites/default/files/VH_Benefits-of-Walking-Summary2020.pdf">health benefits</a>, including better heart health, improved mood and sleep quality, and reduced risk of several chronic diseases. While walking is not everyone’s favourite form of exercise, the intervention was well-received by most people in our study. Participants <a href="https://pubmed.ncbi.nlm.nih.gov/37271689/">reported</a> that the additional general health benefits contributed to their ongoing motivation to continue the walking program independently. <h2>Why is walking helpful for low back pain?</h2> We don’t know exactly why walking is effective for preventing back pain, but <a href="https://www.e-jer.org/journal/view.php?number=2013600295">possible reasons</a> could include the combination of gentle movements, loading and strengthening of the spinal structures and muscles. It also could be related to relaxation and stress relief, and the release of “feel-good” endorphins, which <a href="https://my.clevelandclinic.org/health/body/23040-endorphins">block pain signals</a> between your body and brain – essentially turning down the dial on pain. It’s possible that other accessible and low-cost forms of exercise, such as swimming, may also be effective in preventing back pain, but surprisingly, <a href="https://pubmed.ncbi.nlm.nih.gov/34783263/">no studies</a> have investigated this. Preventing low back pain is not easy. But these findings give us hope that we are getting closer to a solution, one step at a time.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231682/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/tash-pocovi-1293184">Tash Pocovi</a>, Postdoctoral research fellow, Department of Health Sciences, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, Professor, Institute for Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, Professor of Physiotherapy, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/petra-graham-892602">Petra Graham</a>, Associate Professor, School of Mathematical and Physical Sciences, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/simon-french-713564">Simon French</a>, Professor of Musculoskeletal Disorders, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/walking-can-prevent-low-back-pain-a-new-study-shows-231682">original article</a>. </div>

Body

Alleged killer cop files lawsuit against NSW Police

The former police officer accused of murder has now filed a lawsuit against the NSW Police for bullying and harassment. Former NSW Police senior constable Beau Lamarre-Condon is accused of shooting Jesse Baird, 26, and his partner Luke Davies, 29, at Baird’s Paddington house in February and disposing of the bodies on a rural property near Goulburn. While still awaiting trial over the alleged murders, the suit against the police force has been filed, with Sunrise newsreader Edwina Bartholomew sharing the updates. “The defence lawyer for accused killer cop Beau Lamarre-Condon says his client is continuing with a lawsuit against the NSW Police Force for bullying and harassment while he was a constable,” Bartholomew said. Lamarre-Condon's lawyer John Walford confirmed the move to <a href="https://www.dailytelegraph.com.au/subscribe/news/1/?sourceCode=DTWEB_WRE170_a_TCA&dest=https%3A%2F%2Fwww.dailytelegraph.com.au%2Ftruecrimeaustralia%2Fpolice-courts-nsw%2Fchilling-unseen-photos-of-beau-lamarrecondon-cosying-up-with-exlover-he-allegedly-killed%2Fnews-story%2F4fdbac4f0dac6d7ea38b3094e808e3ab&memtype=anonymous&mode=premium&v21=LOW-Segment-1-SCORE" target="_blank" rel="noopener">The Daily Telegraph</a>, saying, “Yes, action against police is continuing … it’s huge.” The former officer has been in protective custody at the Metropolitan Remand and Reception Centre at Silverwater in Sydney's west for the past four months and sources close to the 28-year-old say his mental state is deteriorating. "He's not doing real well at the moment," a source told <a href="https://www.dailymail.co.uk/news/article-13471215/Beau-Lamarre-Condon-Chilling-pictures-accused-killer-Jesse-Baird-Luke-Davies.html" target="_blank" rel="noopener">Daily Mail Australia</a> in April. "Obviously it's set in now - what's happened and the allegations and where he is. I think the rot's set in mentally-wise. He's at a low point at the moment. He's very down. He's hit the lows." Lamarre-Condon is expected to front court again on June 18th. Image credits: 7News / Shutterstock

Legal

"Repeatedly ignored": Daughter of Perth gunman breaks her silence

The daughter of the Perth man who has been accused of murdering a 59-year-old woman and her 18-year-old daughter has broken her silence. Mark Bombara <a href="https://oversixty.com.au/health/caring/the-most-gorgeous-family-tributes-flow-for-slain-mother-and-daughter" target="_blank" rel="noopener">shot and killed</a> Jennifer Petelczyc and her youngest daughter Gretl at their home in Floreat, Western Australia, on Friday afternoon while searching for his ex-wife before taking his own life. Now, his daughter Ariel has released a powerful statement sharing how she repeatedly warned police of the danger he posed as a licensed firearms holder, admitting that her and her mother had feared for their lives. "We were ignored by five different male officers across three occasions of reporting," Ms Bombara said. "By that point we felt completely helpless and I had to focus on getting mum to safety." "I did everything I could to protect my mother, and when my father couldn't find us he murdered her best friend and her best friend's daughter." Ms Bombara explained that her and her mother fled their family home on March 28th, "in fear of our lives and to remove ourselves from an abusive situation", and over the span of four days, contacted police three times to notify them about her father's gun collection. "I felt there was a real and imminent threat to our lives," she said. "I specifically mentioned that there was a Glock handgun which was unaccounted for," Ms Bombara said. "My understanding is this ultimately would be one of the weapons my father used take the lives of two innocent women." She was adamant that the deaths of Jennifer and Gretl Petelczyc were "an act of domestic violence". "My mother and I made clear that lives were at risk, and we were repeatedly ignored. Repeatedly failed. Those failures have cost the lives of two incredible women." "My father should always be considered accountable for his actions. They were his and his alone, however, there are authorities who should have helped us stop him, and they failed." "I want answers." Following the deaths of Ms Petelczyc and her daughter, WA Police did not classify them as domestic violence-related. A police spokesperson said in a statement, "Police have always accepted that the motivation for these crimes were family and domestic violence (FDV) related, however the crimes committed were murder, and ultimately the contributing factors will be a matter for the coroner to consider." Image credits: ABC News / 9News

Legal

Longer appointments are just the start of tackling the gender pain gap. Here are 4 more things we can do

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/michelle-oshea-457947">Michelle O'Shea</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>; <a href="https://theconversation.com/profiles/hannah-adler-1533549">Hannah Adler</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/marilla-l-druitt-1533572">Marilla L. Druitt</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>, and <a href="https://theconversation.com/profiles/mike-armour-391382">Mike Armour</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> Ahead of the federal budget, health minister Mark Butler <a href="https://www.abc.net.au/news/2024-05-10/endometriosis-australia-welcomes-govt-funding-for-endometriosis/103830392">last week announced</a> an investment of A$49.1 million to help women with endometriosis and complex gynaecological conditions such as chronic pelvic pain and polycystic ovary syndrome (PCOS). From July 1 2025 <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/historic-medicare-changes-for-women-battling-endometriosis">two new items</a> will be added to the Medicare Benefits Schedule providing extended consultation times and higher rebates for specialist gynaecological care. The Medicare changes <a href="https://www1.racgp.org.au/newsgp/clinical/longer-consults-for-endometriosis-sufferers-on-the">will subsidise</a> $168.60 for a minimum of 45 minutes during a longer initial gynaecologist consultation, compared to the standard rate of $95.60. For follow-up consultations, Medicare will cover $84.35 for a minimum of 45 minutes, compared to the standard rate of $48.05. Currently, there’s <a href="https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=104&qt=item&criteria=104">no specified time</a> for these initial or subsequent consultations. But while reductions to out-of-pocket medical expenses and extended specialist consultation times are welcome news, they’re only a first step in closing the gender pain gap. <h2>Chronic pain affects more women</h2> Globally, research has shown chronic pain (generally defined as pain that persists for <a href="https://www.healthdirect.gov.au/chronic-pain">more than three months</a>) disproportionately affects <a href="https://academic.oup.com/bja/article/111/1/52/331232?login=false">women</a>. Multiple biological and psychosocial processes likely contribute to this disparity, often called the gender pain gap. For example, chronic pain is frequently associated with conditions influenced by <a href="https://www.sciencedirect.com/science/article/abs/pii/S0304395914003868">hormones</a>, among other factors, such as endometriosis and <a href="https://theconversation.com/adenomyosis-causes-pain-heavy-periods-and-infertility-but-youve-probably-never-heard-of-it-104412">adenomyosis</a>. Chronic pelvic pain in women, regardless of the cause, can be debilitating and <a href="https://www.nature.com/articles/s41598-020-73389-2">negatively affect</a> every facet of life from social activities, to work and finances, to mental health and relationships. The gender pain gap is both rooted in and compounded by gender bias in medical research, treatment and social norms. The science that informs medicine – including the prevention, diagnosis, and treatment of disease – has traditionally focused on men, thereby <a href="https://www.theguardian.com/lifeandstyle/2015/apr/30/fda-clinical-trials-gender-gap-epa-nih-institute-of-medicine-cardiovascular-disease">failing to consider</a> the crucial impact of sex (biological) and gender (social) factors. When medical research adopts a “male as default” approach, this limits our understanding of pain conditions that predominantly affect women or how certain conditions affect men and women <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10921746/">differently</a>. It also means intersex, trans and gender-diverse people are <a href="https://www.deakin.edu.au/about-deakin/news-and-media-releases/articles/world-class-centre-tackles-sex-and-gender-inequities-in-health-and-medicine">commonly excluded</a> from medical research and health care. Minimisation or dismissal of pain along with the <a href="https://www.hindawi.com/journals/ecam/2016/3467067/">normalisation of menstrual pain</a> as just “part of being a woman” contribute to significant delays and misdiagnosis of women’s gynaecological and other health issues. Feeling dismissed, along with perceptions of stigma, can make women less likely <a href="https://link.springer.com/article/10.1186/s12905-024-03063-6">to seek help</a> in the future. <h2>Inadequate medical care</h2> Unfortunately, even when women with endometriosis do seek care, many <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.15494?saml_referrer">aren’t satisfied</a>. This is understandable when medical advice includes being told to become pregnant to treat their <a href="https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02794-2">endometriosis</a>, despite <a href="https://academic.oup.com/humupd/article/24/3/290/4859612?login=false">no evidence</a> pregnancy reduces symptoms. Pregnancy should be an autonomous choice, not a treatment option. It’s unsurprising people look for information from other, often <a href="https://www.mdpi.com/2227-9032/12/1/121">uncredentialed</a>, sources. While online platforms including patient-led groups have provided women with new avenues of support, these forums should complement, rather than replace, <a href="https://journals.sagepub.com/doi/full/10.1177/1460458215602939">information from a doctor</a>. Longer Medicare-subsidised appointments are an important acknowledgement of women and their individual health needs. At present, many women feel their consultations with a gynaecologist are <a href="https://www1.racgp.org.au/newsgp/clinical/longer-consults-for-endometriosis-sufferers-on-the">rushed</a>. These conversations, which often include coming to terms with a diagnosis and management plan, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1496869/">take time</a>. <h2>A path toward less pain</h2> While extended consultation time and reduced out-of-pocket costs are a step in the right direction, they are only one part of a complex pain puzzle. If women are not listened to, their symptoms not recognised, and effective treatment options not adequately discussed and provided, longer gynaecological consultations may not help patients. So what else do we need to do? 1. Physician knowledge Doctors’ knowledge of women’s pain requires development through both practitioner <a href="https://health-policy-systems.biomedcentral.com/articles/10.1186/s12961-022-00815-4/tables/2">education and guidelines</a>. This knowledge should also include dedicated efforts toward understanding the <a href="https://www.newyorker.com/magazine/2018/07/02/the-neuroscience-of-pain">neuroscience of pain</a>. Diagnostic processes should be tailored to consider gender-specific symptoms and responses to <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00137-8/fulltext">pain</a>. 2. Research and collaboration Medical decisions should be based on the best and most inclusive evidence. Understanding the complexities of pain in women is essential for managing their pain. Collaboration between health-care experts from different disciplines can facilitate comprehensive and holistic pain research and management strategies. 3. Further care and service improvements Women’s health requires multidisciplinary treatment and care which extends beyond their GP or specialist. For example, conditions like endometriosis often see people presenting to emergency departments in <a href="https://www.aihw.gov.au/reports/chronic-disease/endometriosis-in-australia/contents/treatment-management/ed-presentations">acute pain</a>, so practitioners in these settings need to have the right knowledge and be able to provide support. Meanwhile, pelvic ultrasounds, especially the kind that have the potential to visualise endometriosis, take longer to perform and require a <a href="https://www.sciencedirect.com/science/article/abs/pii/S0015028223020757/">specialist sonographer</a>. Current rebates do not reflect the time and expertise needed for these imaging procedures. 4. Adjusting the parameters of ‘women’s pain’ Conditions like PCOS and endometriosis don’t just affect women – they also impact people who are gender-diverse. Improving how people in this group are treated is just as salient as addressing how we treat women. Similarly, the gynaecological health-care needs of culturally and linguistically diverse and Aboriginal and Torres Strait islander women may be even <a href="https://www.mdpi.com/1660-4601/20/13/6321">less likely to be met</a> than those of women in the general population. <h2>Challenging gender norms</h2> Research suggests one of the keys to reducing the gender pain gap is challenging deeply embedded <a href="https://pubmed.ncbi.nlm.nih.gov/29682130/">gendered norms</a> in clinical practice and research. We are hearing women’s suffering. Let’s make sure we are also listening and responding in ways that close the gender pain gap.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/229802/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michelle-oshea-457947">Michelle O'Shea</a>, Senior Lecturer, School of Business, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>; <a href="https://theconversation.com/profiles/hannah-adler-1533549">Hannah Adler</a>, PhD candidate, health communication and health sociology, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/marilla-l-druitt-1533572">Marilla L. Druitt</a>, Affiliate Senior Lecturer, Faculty of Health, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>, and <a href="https://theconversation.com/profiles/mike-armour-391382">Mike Armour</a>, Associate Professor at NICM Health Research Institute, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/longer-appointments-are-just-the-start-of-tackling-the-gender-pain-gap-here-are-4-more-things-we-can-do-229802">original article</a>. </div>

Body

4 ways to avoid foot pain when travelling

Whether it’s caused by a hectic day of sightseeing or a mad rush through the airports, there’s nothing quite as annoying as foot pain when you’re on holidays. And when you consider how easy it is to avoid (so long as you take the correct preventative measures) you’ll feeling like kicking yourself for putting up with it for all these years. Here are four ways to avoid foot pain when travelling. 1. Choosing the right pair of shoes Out of all the fashion statements, shoes are probably responsible for more chronic foot pain than anything else. So make sure you choose the right pair of shoes for your trip. For example, if you’re going to be walking around all day sightseeing it might be an idea to ditch the stiletto heels for a pair of joggers (even if they’re not quite so aesthetically pleasing). Dr Robert Mathews from Cremorne Medical in NSW says, “I recommend wearing supportive shoe such as running shoes. If you want to wear something more stylish then consider buying some gel insoles to slip in your shoes, you can get a wide variety of these from your local chemist.“ 2. Manage your feet on flights Foot swelling can become quite a big problem on long haul flight, so managing your feet becomes crucial. Simple, preventative measures anyone can take, like wearing support stocks, standing up every so often to move around or even just flexing your feet and wriggling your toes, can make a big difference and greatly reduce the chance of swelling. 3. Slip, slop and slap So many island holidays have been soured by the blistering pain of sunburnt feet. If you’re staying at a resort or near a beach and your feet are exposed, don’t forget to apply sunscreen everywhere. Otherwise you’re going to want to have some aloe vera gel handy! 4. Take time to rest While you’re probably in a mad rush to see everything, fear of missing out can put significant strain on your feet. So make sure you set aside plenty of time every day to put your feet up and rest. It also might be worth considering some extra pampering, like a foot bath or even a half hour massage. You are on holidays after all, so why not treat yourself! Dr Matthews adds, “It may also be worth taking with you some thick band aids in case you develop any blisters from long walks.” Image credits: Shutterstock

Travel Tips

"I killed them": Major twist in slain Aussie brothers case

The girlfriend of the man who allegedly killed Perth brothers Callum and Jake Robinson has reportedly "flipped" on her partner, becoming the star witness in the case. Ari Gisel García Cota was arrested earlier this week, along with her partner Jesús Gerardo Garcia Cota and his brother Cristian Alejandro Garcia, after the bodies of the Robinson brothers and their friend were found on Saturday in a desolate section of Santo Tomas in the Baja California region. According to Mexico police, the three men were killed as a result of a failed robbery, after locals attempted to steal the tyres from their pick-up truck. The bodies of the three men were recovered from a 15-metre deep well, with each man having fatal gun shot wounds to the head. In a major twist to the case, prosecutors revealed to court on Wednesday that Ari Gisel García Cota had become a key witness in the case after turning on the "ringleader" of the crime. “She has flipped on the ringleader and the evidence she’s provided to the prosecution will lead this case going forward,” Nine News correspondent Alison Piotrowski, who was in the courtroom, told 2GB’s Ben Fordham on Thursday. “What’s alleged is that Jesús Gerardo was driving her car that night when he went out to that remote campsite. The prosecution is saying what we’ve been talking about for the last couple of days has potentially happened, that the two Aussies and their American friend were ambushed.” Prosecutors allege Jesús Gerardo “killed them, took their tyres, put the tyres on her car and drove back”. When he went back to their house, the court heard he allegedly told Ari Gisel, “I f**ked up three gringos (English-speaking foreigner).” “She said to him, ‘What do you mean by that?’ And he told her, ‘I killed them’, and then showed her the vehicle with Jake, Callum and Jack’s tyres on her car,” Piotrowski said. “Ari was arrested later that day, she had fled to her mother’s house to get away from him. When the officers arrested her they said, ‘You have the right to remain silent’, and she said, ‘I don’t want to be silent, I want to tell you what I know. I’m a victim of domestic violence, I want to protect my four-year-old so let me help you with this case.’ So she has spectacularly turned on him and will now be crucial in this case moving forward.” Piotrowski added that the stunning revelation explained why Mexican officials “have been able to put him behind bars so quickly and also how they found the bodies”. “This conversation that he had with his girlfriend is pretty damning,” she said. So far only Jesús Gerardo Garcia Cota has been charged in connection with the deaths of the three men, and only with forced kidnapping, while Ari Gisel García Cota and Cristian Alejandro Garcia have only been charged with drug possession. Piotrowski said the kidnapping charges may not be upgraded to murder until the next court hearing, although the judge has more questions about how the three men were killed. “The judge did say that he can’t understand how one sole person could have done this, essentially kidnap and kill three men and take their tyres, it seems like too much,” she said. “He suggested that the prosecution needed to look into more suspects, that they needed to broaden their investigation because it couldn’t have been done by one man alone.” Image credits: Instagram / State Commission of the Penitentiary System of Baja California

Legal

Erin Patterson enters plea for murder charges

Erin Patterson will face trial in the Supreme Court after pleading not guilty to eight charges of murder and attempted murder. The 49-year-old is accused of killing her former in-laws, Don and Gail Patterson, both 70, and Gail's sister Heather Wilkinson, 66. All three <a href="https://www.oversixty.com.au/finance/legal/erin-patterson-arrested-over-fatal-mushroom-meal" target="_blank" rel="noopener">died </a>in hospital days after consuming an allegedly poisonous mushroom lunch at Patterson's home in South Gippsland July 29, 2023. She is also accused of the attempted murder of Heather Wilkinson’s husband Ian, and four separate attempts on her ex-husband’s life, with three occasions dating back to 2021. Patterson appeared in the Latrobe Valley Magistrates’ Court on Tuesday, and pleaded not guilty to all eight of her charges, including three counts of murder and five counts of attempted murder. Patterson told Magistrate Tim Walsh, "not guilty, Your Honour", as he read each of the charges. Her barrister, Colin Mandy SC, confirmed that she was going to use the “fast-track” method to have the case sent to the Supreme Court. The fast track method allows homicide cases to skip a committal hearing where a magistrate hears the evidence and decides if it could support a conviction. Walsh told Patterson hat under the fast track method, he did not have to judge the evidence and could commit her “solely on her election”. The decision also means that details of the prosecution case and her defence will not be aired publicly until after the trial. Patterson was arrested last November but has repeatedly denied the allegations. She was remanded in custody and will appear for a directions hearing at the Supreme Court on May 23. Images: Nine News

Legal

Samantha Murphy's alleged killer faces fresh new charges

The man accused of murdering Samantha Murphy has been hit with fresh charges over a drug and alcohol-fuelled bender. Patrick Orren Stephenson, 22, who has been charged with murdering Ms Murphy, has been slapped with several drink and drug driving charges after he allegedly crashed a motorbike into a tree on the night of October 1st. He has also been also charged with careless driving. A former friend of Stephenson told the <a href="https://www.heraldsun.com.au/truecrimeaustralia/police-courts-victoria/accused-samantha-murphy-killer-patrick-stephenson-charged-with-driving-offences/news-story/1ce6e68acdb7575b876f9e7f9100f285" target="_blank" rel="noopener">Herald Sun</a> the crash occurred following an AFL Grand Final gathering that kicked off in the afternoon and ran late into the night. Stephenson was first arrested in connection with the Ballarat mother's disappearance on March 7th, weeks after the 51-year-old was last seen alive. Samantha Murphy was last seen by her loved ones on the morning of February 4th when she went to go on her daily morning run in the Canadian State Forest. Stephenson has been charged with one count of murder, and is said to not be cooperating with police in efforts to find her body. The new charges come after police have continued their gruelling search for Ms Murphy, three months after she went missing. Despite numerous searches, Victoria Police detectives appear no closer to finding her body despite having her alleged killer in custody. A Victoria Police spokesperson told <a href="https://www.dailymail.co.uk/news/melbourne/article-13374863/Alleged-killer-Samantha-Murphy-fresh-charges-Victoria.html" target="_blank" rel="noopener">Daily Mail Australia</a> this week that the investigation remained "very much active and ongoing". "We are continuing to do all we can to locate her," the spokesperson said. Image credits: Nine

Legal

How niggling hip pain led a squash coach to life-saving cancer diagnosis

Melbourne squash coach and player Malcolm McClarty had been experiencing frequent pain in his right hip area for about 12 months before he mentioned it to one of his clients, a top medical oncologist, in October last year. The 63-year-old father-of-three coaches Professor Niall Tebbutt at the Kooyong Lawn and Tennis Club in Melbourne. Despite having lost his younger sister to pancreatic cancer just months earlier, Malcolm had been brushing off the pain, thinking it was a niggling sporting injury. Now Malcolm credits Niall, who ordered a prostate-specific antigen test (PSA), with saving his life. Malcolm also coaches Weranja Ranasinghe, a urologist with the Urological Society of Australia and New Zealand (USANZ), who has been his ‘unofficial second opinion’ throughout the journey. Associate Professor Ranasinghe says Malcolm’s diagnosis comes as the newly-released Lancet Commission on Prostate Cancer predicts cases worldwide will double from 1.4 million to 2.9 million by 2040. The USANZ says although the findings are alarming, Australia is well-placed to manage the spike thanks to availability of advanced diagnostic tools, improvements in treatments and quality control registries, but it needs to be coupled with more awareness. “Australia is better placed than many other nations to deal with a sharp spike in prostate cancer cases, but the urgent review of guidelines can’t come soon enough,” says Associate Professor Ranasinghe. “Prostate cancer is not commonly understood or spoken about, particularly amongst high-risk younger men, leaving too many in the dark about their cancer risk and that can be deadly,” he added. “Prostate cancer is already a major cause of death and disability, and the most common form of male cancer in more than 100 countries,” says Associate Professor Ranasinghe. “It’s the most commonly diagnosed cancer in Australia with over 25,000 new cases every year, and more than 11 deaths a day.” Malcolm was devastated to learn his cancer was aggressive Stage Four and had spread to three spots in the pelvic bone. He also experienced other symptoms including frequent and weak-flow urinating at night. He will begin radiotherapy, with chemotherapy on the cards as well. But his attitude is positive; he’s hoping to live for another six to 10 years. Malcolm’s message for other men is simple: if you’re 50 or older, get tested for prostate cancer now. He warns waiting can lead to complex and limited treatment options. Five Risk Factors For Prostate Cancer 1. Age - the chance of developing prostate cancer increases with age. 2. Family history - if you have a first-degree male relative who developed prostate cancer, like a brother or father, your risk is higher than someone without such family history. 3. Genetics - while prostate cancer can’t be inherited, a man can inherit certain genes that increase the risk. 4. Diet - some evidence suggests that a diet high in processed meat, or foods high in fat can increase the risk of developing prostate cancer. 5. Lifestyle - environment and lifestyle can also impact your risk, e.g. a sedentary lifestyle or being exposed to chemicals. For more information, visit <a href="https://www.usanz.org.au/" target="_blank" rel="noopener">https://www.usanz.org.au/</a>

Caring

Student wrongly named as Bondi killer sues Seven Network

A 20-year-old university student who was wrongly named as the Bondi Junction killer has made moves to sue the Seven Network for defamation. As the terrifying rampage at the eastern suburbs Westfield unfolded on Saturday which resulted in the deaths of six people, Ben Cohen was named by the Seven Network as the knife-wielding man. Mr Cohen’s name was wrongly linked to the attack by Sunrise co-host Matt Shirvington shortly after 6am on Sunday and again by journalist Lucy McLeod just 10 minutes later. It wasn't until hours later that Seven identified the right man, Joel Cauchi, as the killer as journalist Sarah Jane Bell issued an on-air apology to Mr Cohen during the evening news bulletin. “Earlier this morning, reports of the incident incorrectly named the perpetrator as 40-year-old Benjamin Cohen,” she said on air. “It was later confirmed that the name of the 40-year-old is Joel Cauchi from Queensland. Seven apologises for any distress caused by our earlier reports.” Mr Cohen is still reeling from the incident, saying he has been targeted by online trolls on social media ever since he was wrongly named by the network. His name was one of the most trending topics on X in Australia the day of the mass stabbing, with many people quick to point out Mr Cohen's Jewish identity, claiming the stabbings were an act of violence in support of the war in Israel against Palestine. The university student has taken the first steps in launching legal action against the network, engaging with two of Australia’s foremost defamation lawyers in Patrick George of Giles George as his solicitor, and Sue Chrysanthou SC as barrister. Mr George confirmed he had sent a concerns notice to Seven, the first step in defamation proceedings. “We await a response from Seven,” Mr George told NCA NewsWire. Mr Cohen told <a href="https://www.news.com.au/national/nsw-act/courts-law/student-wrongly-named-as-westfield-bondi-junction-killer-moves-to-sue-seven/news-story/f4c67b123e19cbf3d5a6a6bf39708ea8" target="_blank" rel="noopener">news.com.au</a> earlier this week that he had been inundated with friend requests and messages on social media after being named by Seven, with the unwanted attention taking a toll on his mental health. “It’s just gone crazy, it’s like ‘look, you’ve got the wrong guy’,” Mr Cohen, a first year computer science student, told news.com.au. “People don’t really think too hard about what they’re posting and how it might affect someone. It’s very dangerous how people could just make stuff up and destroy people’s lives.” Image credits: news.com.au

Legal

Family of Bondi killer break silence

The devastating events that unfolded at Westfield Bondi Junction have left a community in shock and mourning, grappling with the aftermath of a senseless act of violence. Joel Cauchi's frenzied stabbing attack claimed the lives of six innocent people, leaving many others injured and traumatised. Now, amidst the grief and confusion, Cauchi's family has stepped forward to offer their perspective on the tragic incident. In a statement conveyed through Queensland police, Andrew and Michele Cauchi, parents of the assailant, expressed profound sorrow and disbelief at their son's actions, describing the events as "truly horrific". “We are absolutely devastated by the traumatic events that occurred in Sydney yesterday,” they said. “Our thoughts and prayers are with the families and friends of the victims and those still undergoing treatment at this time. “Joel’s actions were truly horrific and we are still trying to comprehend what has happened. He has battled with mental health issues since he was a teenager. “We are in contact with both the NSW Police Force and Queensland Police Service and have no issues with the police officer who shot our son as she was only doing her job to protect others and we hope she is coping alright.” Assistant Commissioner Roger Lowe of the Queensland Police provided additional insights into Joel's circumstances leading up to the attack. He disclosed that Joel had been diagnosed with schizophrenia at the age of 17 and had received treatment for mental health issues in the past. However, in recent years, his condition had worsened, casting a shadow over his family's attempts to understand and support him. The revelation that Joel had been sleeping in a vehicle or at a backpacker hostel prior to the attack underscores the challenges faced by individuals grappling with mental illness and homelessness. Despite sporadic communication with his family, Joel's isolation and distress seemed to have deepened in the days preceding the tragic incident. In the wake of the attack, the Cauchi family exhibited a remarkable level of cooperation with law enforcement agencies, expressing concern for the welfare of Inspector Amy Scott, who was compelled to use lethal force against Joel Cauchi. Their willingness to engage with authorities and convey their condolences to the victims' families highlights their recognition of the gravity of the situation and their desire for understanding and healing amidst the tragedy as the community mourns this unbearable loss. Cauchi' victims included Pikria Darchia, a 55-year-old artist and designer; osteopath Ashlee Good, 38; security guard Faraz Tahir, 30; Dawn Singleton, 25 – the daughter of Australian multi-millionaire advertising guru John Singleton; architect Jade Young, 47; and student Yixuan Cheng, 25. A dozen others – mostly women – were also injured, including Good’s infant child. Images: Nine News

Caring

Australian Idol host opens up on painful health battle

Australian Idol host and singer Ricki-Lee Coulter has revealed that she has been battling endometriosis for over a decade. The 38-year-old took to Instagram to share the process that led her diagnosis, straight from the hospital bed, following her laparoscopy and excision surgery. "For over a decade I’ve been dealing with chronic pain that has progressively gotten worse,” she began the post. “Anyone with endometriosis knows it takes a long time to get to the point where you have surgery and can get any kind of diagnosis — and that you have to advocate for yourself and keep pushing for answers. “Over the years I have seen so many doctors and specialists, and have been down so many different paths to try to figure out what was going on — and for so long I thought the pain was just something I had to deal with. “But the past couple of years, it has become almost unbearable and is something I’ve been dealing with every single day. “I met with a new GP at the start of the year, who referred me to a new specialist, and we went through all the measures that have been taken to try to get to the bottom of this pain — and the only option left was surgery. “So this week I had a laparoscopy and excision surgery — and they removed all the endometriosis they found, and I can only hope that is the end of the pain. “I’m now at home recovering and feeling good. Rich is taking very good care of me xxx," she ended the post. She also shared a few photos after her surgery, and of her recovering at home. One in nine women suffer from endometriosis, a condition where the tissue similar to the lining of the uterus grows outside the womb, which sometimes moves to other areas of the body. Friends and followers shared their support in the comments, with reality TV star and fellow endo-warrior Angie Kent saying: “Sending you lots of love! You’re not alone in this — it’s a marathon not a sprint, unfortunately. “But there’s an amazing chronic invisible illness sista-hood out here! I hope you have a good support system with the recovery including an amazing women’s health practitioner.” “Sending lots of love,” Sunrise host Natalie Barr added. “Sending you so much love. Been where you are now and it gets so much better honey,” wrote Jackie O. Images: Instagram

Caring

Surgery won’t fix my chronic back pain, so what will?

<a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/christopher-maher-826241">Christopher Maher</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/fiona-blyth-448021">Fiona Blyth</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/james-mcauley-1526139">James Mcauley</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> This week’s ABC Four Corners episode <a href="https://www.abc.net.au/news/2024-04-08/pain-factory/103683180">Pain Factory</a> highlighted that our health system is failing Australians with chronic pain. Patients are receiving costly, ineffective and risky care instead of effective, low-risk treatments for chronic pain. The challenge is considering how we might reimagine health-care delivery so the effective and safe treatments for chronic pain are available to millions of Australians who suffer from chronic pain. <a href="https://www.aihw.gov.au/getmedia/10434b6f-2147-46ab-b654-a90f05592d35/aihw-phe-267.pdf.aspx">One in five</a> Australians aged 45 and over have chronic pain (pain lasting three or more months). This costs an estimated <a href="https://www.aihw.gov.au/getmedia/10434b6f-2147-46ab-b654-a90f05592d35/aihw-phe-267.pdf.aspx">A$139 billion a year</a>, including $12 billion in direct health-care costs. The most common complaint among people with chronic pain is low back pain. So what treatments do – and don’t – work? <h2>Opioids and invasive procedures</h2> Treatments offered to people with chronic pain include strong pain medicines such as <a href="https://pubmed.ncbi.nlm.nih.gov/30561481/">opioids</a> and invasive procedures such as <a href="https://pubmed.ncbi.nlm.nih.gov/36878313/">spinal cord stimulators</a> or <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/imj.14120">spinal fusion surgery</a>. Unfortunately, these treatments have little if any benefit and are associated with a risk of significant harm. <a href="https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-06900-8">Spinal fusion surgery</a> and <a href="https://privatehealthcareaustralia.org.au/consumers-urged-to-be-cautious-about-spinal-cord-stimulators-for-pain/#:%7E:text=Australian%20health%20insurance%20data%20shows,of%20the%20procedure%20is%20%2458%2C377.">spinal cord stimulators</a> are also extremely costly procedures, costing tens of thousands of dollars each to the health system as well as incurring costs to the individual. <h2>Addressing the contributors to pain</h2> Recommendations from the latest <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/low-back-pain-clinical-care-standard">Australian</a> and <a href="https://www.who.int/publications/i/item/9789240081789">World Health Organization</a> clinical guidelines for low back pain focus on alternatives to drug and surgical treatments such as: <ul> <li>education</li> <li>advice</li> <li>structured exercise programs</li> <li>physical, psychological or multidisciplinary interventions that address the physical or psychological contributors to ongoing pain.</li> </ul> Two recent Australian trials support these recommendations and have found that interventions that address each person’s physical and psychological contributors to pain produce large and sustained improvements in pain and function in people with chronic low back pain. The interventions have minimal side effects and are cost-effective. In the <a href="https://jamanetwork.com/journals/jama/fullarticle/2794765">RESOLVE</a> trial, the intervention consists of pain education and graded sensory and movement “retraining” aimed to help people understand that it’s safe to move. In the <a href="https://pubmed.ncbi.nlm.nih.gov/37146623/">RESTORE</a> trial, the intervention (cognitive functional therapy) involves assisting the person to understand the range of physical and psychological contributing factors related to their condition. It guides patients to relearn how to move and to build confidence in their back, without over-protecting it. <h2>Why isn’t everyone with chronic pain getting this care?</h2> While these trials provide new hope for people with chronic low back pain, and effective alternatives to spinal surgery and opioids, a barrier for implementation is the out-of-pocket costs. The interventions take up to 12 sessions, lasting up to 26 weeks. One physiotherapy session <a href="https://www.sira.nsw.gov.au/__data/assets/pdf_file/0005/1122674/Physiotherapy-chiropractic-and-osteopathy-fees-practice-requirements-effective-1-February-2023.pdf">can cost</a> $90–$150. In contrast, <a href="https://www.servicesaustralia.gov.au/chronic-disease-individual-allied-health-services-medicare-items">Medicare</a> provides rebates for just five allied health visits (such as physiotherapists or exercise physiologists) for eligible patients per year, to be used for all chronic conditions. Private health insurers also limit access to reimbursement for these services by typically only covering a proportion of the cost and providing a cap on annual benefits. So even those with private health insurance would usually have substantial out-of-pocket costs. Access to trained clinicians is another barrier. This problem is particularly evident in <a href="https://www.ruralhealth.org.au/15nrhc/sites/default/files/B2-1_Bennett.pdf">regional and rural Australia</a>, where access to allied health services, pain specialists and multidisciplinary pain clinics is limited. Higher costs and lack of access are associated with the increased use of available and subsidised treatments, such as pain medicines, even if they are ineffective and harmful. The <a href="https://www.safetyandquality.gov.au/publications-and-resources/resource-library/data-file-57-opioid-medicines-dispensing-2016-17-third-atlas-healthcare-variation-2018">rate of opioid use</a>, for example, is higher in regional Australia and in areas of socioeconomic disadvantage than metropolitan centres and affluent areas. <h2>So what can we do about it?</h2> We need to reform Australia’s health system, private and <a href="https://www.health.gov.au/sites/default/files/documents/2020/12/taskforce-final-report-pain-management-mbs-items-final-report-on-the-review-of-pain-management-mbs-items.docx">public</a>, to improve access to effective treatments for chronic pain, while removing access to ineffective, costly and high-risk treatments. Better training of the clinical workforce, and using technology such as telehealth and artificial intelligence to train clinicians or deliver treatment may also improve access to effective treatments. A recent Australian <a href="https://pubmed.ncbi.nlm.nih.gov/38461844/">trial</a>, for example, found telehealth delivered via video conferencing was as effective as in-person physiotherapy consultations for improving pain and function in people with chronic knee pain. Advocacy and <a href="https://pubmed.ncbi.nlm.nih.gov/37918470/">improving the public’s understanding</a> of effective treatments for chronic pain may also be helpful. Our hope is that coordinated efforts will promote the uptake of effective treatments and improve the care of patients with chronic pain.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/227450/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, Professor, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/christopher-maher-826241">Christopher Maher</a>, Professor, Sydney School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/fiona-blyth-448021">Fiona Blyth</a>, Professor, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/james-mcauley-1526139">James Mcauley</a>, Professor of Psychology, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, Professor of Physiotherapy, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/surgery-wont-fix-my-chronic-back-pain-so-what-will-227450">original article</a>.

Body

Inside the alleged hide out of Samantha Murphy's accused killer

The Scotsburn property where Samantha Murphy's <a href="https://www.oversixty.com.au/finance/legal/everything-we-know-about-samantha-murphy-s-accused-killer" target="_blank" rel="noopener">accused killer</a> allegedly hid in is up for sale with a $1million-plus price tag. Patrick Orren Stephenson was staying at the property when he arrested on March 6, after police stormed in with a search warrant. The 5.46 hectare property is located about 18km away from central Ballarat, where Stephenson was believed to have been partying the night before he was accused of murdering Murphy. Stephenson is believed to have been living between this property and another one located less than 100m away on Yendon No 2 Road with his girlfriend prior to his arrest. The Daily Mail reported that a for sale sign was recently spotted at the property, which has four bedrooms and is advertised as featuring "a renovated galley-style kitchen, a generous lounge room with plenty of natural light, two living areas including a family/rumpus room for shared moments." "A school bus passing the front door adds to the convenience for families," the ad read. The property is also described as practically off-grid, with solar power and an underground bore water supply. It remains unknown how long Stephenson had lived at the home. Images: McGrath Ballarat/ InsideLook- Real Estate Media

Legal

Accused mushroom killer moved to protected unit over safety fears

Erin Patterson, accused of poisoning three elderly individuals and attempting to murder several others, finds herself secluded within the confines of a protected unit in a Victorian prison. The move, reportedly necessitated by safety concerns, places Patterson away from the general prison population, reflecting the gravity of the allegations against her. According to sources cited by <a href="https://www.heraldsun.com.au/truecrimeaustralia/the-mushroom-ccok/accused-mushroom-murderer-in-jail-unit-with-pedophile-rapist/news-story/824c4f35c9d9b8f7553af2704836ea82" target="_blank" rel="noopener">the Herald Sun</a>, Patterson now resides in the protected wing of the Dame Phyllis Frost Centre, a correctional facility in Victoria. The decision to relocate her stems from fears that she may face harm from fellow inmates due to the nature of her alleged crimes. The Herald's insider disclosed, "If Erin got out of protection, the girls would hurt her." Allegations of her involvement in the deaths of three elderly individuals have evidently rendered her a target among fellow inmates, necessitating stringent security measures. “She allegedly killed three elderly people," the source continued. “There’s a rule, you don’t touch the elderly and you don’t touch babies so because of that, you go into protection." Patterson stands accused of several crimes, including the murder of her former in-laws, Don and Gail Patterson, alongside Gail's sister Heather Wilkinson. Their deaths, following the consumption of a meal containing deadly mushrooms at Patterson's residence in Leongatha, shook the community. Furthermore, Patterson faces charges of attempted murder, notably targeting her ex-husband Simon and Heather Wilkinson's husband Ian, with the alleged attempts spanning over various dates. As Patterson awaits her court appearance scheduled for May, the case continues to captivate public attention. In the coming months, the court will delve deeper into the intricacies of the case, striving to uncover the truth behind the allegations. Image: News.com.au

Legal

Everything we know about Samantha Murphy's accused killer

The disappearance of Samantha Murphy, a beloved mother-of-three, sent shockwaves through the quiet community of Ballarat. As details emerged, the focus shifted towards Patrick Orren Stephenson, a young man <a href="https://www.oversixty.com.au/finance/legal/new-details-emerge-in-samantha-murphy-murder-charge" target="_blank" rel="noopener">accused of the crime</a>, whose life story offers a complex juxtaposition of privilege, athletic ambition and now, alleged tragedy. Patrick Stephenson, now 22 years old, grew up in the shadow of his father, <a href="https://www.afl.com.au/news/118551/orrens-family-affair" target="_blank" rel="noopener">Orren Stephenson</a>, a prominent figure in the world of AFL. Orren's late-life draft into the AFL introduced Patrick to the glamorous world of professional sports at a young age. Patrick, often seen tagging along with his father, had a firsthand view of the prestige and camaraderie within the football clubs, an experience many boys would envy. The Stephenson family, well-regarded in the Ballarat community, seemed to exude an aura of positivity. However, perceptions of Patrick were mixed among locals. While a local newspaper once featured him advocating for road safety alongside his football friends, news of his arrest painted a different picture, depicting him as a troubled teenager. On a fateful Thursday, Patrick Stephenson was charged with the murder of Samantha Murphy, <a href="https://www.oversixty.com.au/health/caring/please-come-home-family-s-emotional-plea-to-missing-woman" target="_blank" rel="noopener">whose disappearance</a> had gripped the community since February 4. Despite initial suppression orders, <a href="https://www.oversixty.com.au/finance/legal/new-details-emerge-in-samantha-murphy-murder-charge" target="_blank" rel="noopener">details about the accused</a> began to surface, shedding light on his upbringing and associations. Patrick's childhood was steeped in football culture, mirroring his father's passion for the sport. Orren Stephenson's stint in the AFL provided the family with unique opportunities, including access to elite football circles. Patrick, enamoured with the lifestyle his father's career afforded, embraced the world of football wholeheartedly. Neighbours recall a seemingly happy home life for the Stephensons, with Patrick attending private schools known for their conservative values and strong sporting traditions. However, in recent years, Patrick's involvement with the local football scene had waned, signalling a potential shift in his priorities. <a href="https://www.oversixty.com.au/finance/legal/man-arrested-in-search-for-samantha-murphy" target="_blank" rel="noopener">The arrest of Patrick Stephenson</a> in Scotsburn, a rural hamlet near Ballarat, left the community in disbelief. Residents, unaware of any motive or connection to the accused, expressed shock at the unfolding events. Despite extensive searches and appeals for information from the police, the whereabouts of Samantha Murphy's body remains unknown, adding to the sense of unease gripping the region. As the Ballarat community grapples with the loss of Samantha Murphy, questions linger about the events leading to her tragic demise. Patrick Stephenson's life, once intertwined with the glamour of professional football, now stands at the centre of a harrowing investigation that in many was has only just begun. Images: Redan Football Club / Supplied.

Legal

How long does back pain last? And how can learning about pain increase the chance of recovery?

<a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Back pain is common. One in thirteen people have it right now and worldwide a staggering 619 million people will <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">have it this year</a>. Chronic pain, of which back pain is the most common, is the world’s <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">most disabling</a> health problem. Its economic impact <a href="https://www.ncbi.nlm.nih.gov/books/NBK92510/">dwarfs other health conditions</a>. If you get back pain, how long will it take to go away? We scoured the scientific literature to <a href="https://www.cmaj.ca/content/cmaj/196/2/E29.full.pdf">find out</a>. We found data on almost 20,000 people, from 95 different studies and split them into three groups: <ul> <li>acute – those with back pain that started less than six weeks ago</li> <li>subacute – where it started between six and 12 weeks ago</li> <li>chronic – where it started between three months and one year ago.</li> </ul> We found 70%–95% of people with acute back pain were likely to recover within six months. This dropped to 40%–70% for subacute back pain and to 12%–16% for chronic back pain. Clinical guidelines point to graded return to activity and pain education under the guidance of a health professional as the best ways to promote recovery. Yet these effective interventions are underfunded and hard to access. <h2>More pain doesn’t mean a more serious injury</h2> Most acute back pain episodes are <a href="https://www.racgp.org.au/getattachment/75af0cfd-6182-4328-ad23-04ad8618920f/attachment.aspx">not caused</a> by serious injury or disease. There are rare exceptions, which is why it’s wise to see your doctor or physio, who can check for signs and symptoms that warrant further investigation. But unless you have been in a significant accident or sustained a large blow, you are unlikely to have caused much damage to your spine. Even very minor back injuries can be brutally painful. This is, in part, because of how we are made. If you think of your spinal cord as a very precious asset (which it is), worthy of great protection (which it is), a bit like the crown jewels, then what would be the best way to keep it safe? Lots of protection and a highly sensitive alarm system. The spinal cord is protected by strong bones, thick ligaments, powerful muscles and a highly effective alarm system (your nervous system). This alarm system can trigger pain that is so unpleasant that you cannot possibly think of, let alone do, anything other than seek care or avoid movement. The messy truth is that when pain persists, the pain system becomes more sensitive, so a widening array of things contribute to pain. This pain system hypersensitivity is a result of neuroplasticity – your nervous system is becoming better at making pain. <h2>Reduce your chance of lasting pain</h2> Whether or not your pain resolves is not determined by the extent of injury to your back. We don’t know all the factors involved, but we do know there are things that you can do to reduce chronic back pain: <ul> <li> understand how pain really works. This will involve intentionally learning about modern pain science and care. It will be difficult but rewarding. It will help you work out what you can do to change your pain </li> <li> reduce your pain system sensitivity. With guidance, patience and persistence, you can learn how to gradually retrain your pain system back towards normal. </li> </ul> <h2>How to reduce your pain sensitivity and learn about pain</h2> Learning about “how pain works” provides the most sustainable <a href="https://www.bmj.com/content/376/bmj-2021-067718">improvements in chronic back pain</a>. Programs that combine pain education with graded brain and body exercises (gradual increases in movement) can reduce pain system sensitivity and help you return to the life you want. These programs have been in development for years, but high-quality clinical trials <a href="https://jamanetwork.com/journals/jama/fullarticle/2794765">are now emerging</a> and it’s good news: they show most people with chronic back pain improve and many completely recover. But most clinicians aren’t equipped to deliver these effective programs – <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">good pain education</a> is not taught in most medical and health training degrees. Many patients still receive ineffective and often risky and expensive treatments, or keep seeking temporary pain relief, hoping for a cure. When health professionals don’t have adequate pain education training, they can deliver bad pain education, which leaves patients feeling like they’ve just <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">been told it’s all in their head</a>. Community-driven not-for-profit organisations such as <a href="https://www.painrevolution.org/">Pain Revolution</a> are training health professionals to be good pain educators and raising awareness among the general public about the modern science of pain and the best treatments. Pain Revolution has partnered with dozens of health services and community agencies to train more than <a href="https://www.painrevolution.org/find-a-lpe">80 local pain educators</a> and supported them to bring greater understanding and improved care to their colleagues and community. But a broader system-wide approach, with government, industry and philanthropic support, is needed to expand these programs and fund good pain education. To solve the massive problem of chronic back pain, effective interventions need to be part of standard care, not as a last resort after years of increasing pain, suffering and disability.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222513/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, Post-doctoral Researcher, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-long-does-back-pain-last-and-how-can-learning-about-pain-increase-the-chance-of-recovery-222513">original article</a>.

Body

Socceroos great hospitalised following chest pains

Mark Bosnich had a health scare this week that landed him in hospital. The former Socceroos and Manchester United goalkeeper was exercising at work when he began to experience chest pains. Not wanting to risk it, the 52-year-old made the quick decision to get himself checked out at a hospital in Sydney. The Aussie football great took to X, formerly known as Twitter, to update fans on his condition, straight from his hospital bed on Wednesday night. “Will not be able to see you all tomorrow morning,” he wrote, along with the schedule of matches for the Champions League airing on the streaming platform Stan. “But will be fine by Friday … but join us here in Oz from 6.35am (aedt).” <blockquote class="twitter-tweet"> Will not be able to see you all tomorrow morning,but will be fine by Friday…but join us here in Oz from 6.35am(aedt) <a href="https://twitter.com/ChampionsLeague?ref_src=twsrc%5Etfw">@ChampionsLeague</a> Rd 16 <a href="https://twitter.com/PSG_English?ref_src=twsrc%5Etfw">@PSG_English</a> VS <a href="https://twitter.com/RealSociedadEN?ref_src=twsrc%5Etfw">@RealSociedadEN</a> & <a href="https://twitter.com/OfficialSSLazio?ref_src=twsrc%5Etfw">@OfficialSSLazio</a> vs <a href="https://twitter.com/FCBayernEN?ref_src=twsrc%5Etfw">@FCBayernEN</a> <a href="https://twitter.com/StanSportAU?ref_src=twsrc%5Etfw">@StanSportAU</a> <a href="https://twitter.com/UEFA?ref_src=twsrc%5Etfw">@UEFA</a> .xmb <a href="https://t.co/LRL5D9YtOu">pic.twitter.com/LRL5D9YtOu</a> — Mark Bosnich (@TheRealBozza) <a href="https://twitter.com/TheRealBozza/status/1757715714583191600?ref_src=twsrc%5Etfw">February 14, 2024</a></blockquote> Bosnich was missing from Stan Sport’s Champions League coverage on Thursday and his on-air colleagues, Max Rushden and Craig Foster, explained what had happened. “For those of you who don’t know, he (Bosnich) had chest pains, he’s had a stent put in,” Rushden said during coverage of one of the matches. He was making a lot of noise … and he said ‘I’m going to get it checked out’. “He did, he’s OK. He’s back tomorrow but we are sending you our love Boz, it is very quiet without you.” Fellow Socceroo Foster added: “We miss you buddy. I hope you’re well and feeling OK.” Bosnich's hospital admission didn't stop him from keeping up with the matches as he shared a photo of himself tuning in to Champions League on a tablet, and thanked everyone for their well-wishes. <blockquote class="twitter-tweet"> Thank you all for your wonderful messages….will be back 2morrow on <a href="https://twitter.com/StanSportAU?ref_src=twsrc%5Etfw">@StanSportAU</a> for <a href="https://twitter.com/EuropaLeague?ref_src=twsrc%5Etfw">@EuropaLeague</a> Knockout <a href="https://twitter.com/acmilan?ref_src=twsrc%5Etfw">@acmilan</a> vs <a href="https://twitter.com/staderennais_en?ref_src=twsrc%5Etfw">@staderennais_en</a> on air from 6.35am(aedt)…xmb <a href="https://t.co/bVxj93CCWv">pic.twitter.com/bVxj93CCWv</a> — Mark Bosnich (@TheRealBozza) <a href="https://twitter.com/TheRealBozza/status/1757893486920302943?ref_src=twsrc%5Etfw">February 14, 2024</a></blockquote> During Thursday's game, Rushden was keen for anyone watching to heed the warning from Bosnich. “If you’re not sure about anything, health-wise, get checked,” Rushden said. “Men are useless at talking about it and doing anything about it. “The sooner you find anything is wrong, the better it is. That is our message and that is Bozza’s message too.” Images: X

Caring

Mother of Vyleen White's alleged killer speaks out

The mother of the teenager who allegedly stabbed Vyleen White has spoken out, sending her condolences to White's family. The woman's 16-year-old son has been accused of the <a href="https://oversixty.com.au/health/caring/grandmother-fatally-stabbed-in-front-of-granddaughter" target="_blank" rel="noopener">deadly stabbing</a> of the 70-year-old Queensland grandmother, who was fatally injured at a shopping centre while on an outing with her 6-year-old granddaughter. The mother, who cannot be identified, apologised to the victim's family, along with the greater community for what happened. "I'm sorry to the community because I didn't know that the kids do that," the mother said. She said her son told her "I love you mum" as police put him in handcuffs and led him away. The mother also apologised to White's family, saying, "I feel sorry about that, yeah, because it's so bad." It is believed the teenager was out on bail when he allegedly committed the stabbing, after being charged last year with stealing a car and three counts of armed robbery. Four other teenagers have also faced court in relation to the alleged murder of Ms White, all charged with unlawful use of a motor vehicle. The mother's statement comes after Vyleen's <a href="https://oversixty.com.au/health/caring/tragic-new-details-emerge-as-vyleen-white-s-husband-speaks-out" target="_blank" rel="noopener">husband</a> shared that they were preparing celebrations for their 50th wedding anniversary when his wife was brutally murdered. He told 7News, “I’m dealing with it the best way I can at the moment. When they stabbed her, they stabbed me.” Image credits: 9News

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I’ve been given opioids after surgery to take at home. What do I need to know?

Walking can prevent low back pain, a new study shows

Alleged killer cop files lawsuit against NSW Police

"Repeatedly ignored": Daughter of Perth gunman breaks her silence

Longer appointments are just the start of tackling the gender pain gap. Here are 4 more things we can do

4 ways to avoid foot pain when travelling

"I killed them": Major twist in slain Aussie brothers case

Erin Patterson enters plea for murder charges

Samantha Murphy's alleged killer faces fresh new charges

How niggling hip pain led a squash coach to life-saving cancer diagnosis

Student wrongly named as Bondi killer sues Seven Network

Family of Bondi killer break silence

Australian Idol host opens up on painful health battle

Surgery won’t fix my chronic back pain, so what will?

Inside the alleged hide out of Samantha Murphy's accused killer

Accused mushroom killer moved to protected unit over safety fears

Everything we know about Samantha Murphy's accused killer

How long does back pain last? And how can learning about pain increase the chance of recovery?

Socceroos great hospitalised following chest pains

Mother of Vyleen White's alleged killer speaks out

Our Partners

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Shop

Catalogues

Newspaper

Contests

Entertainment

Travel

Health

Lifestyle

Finance

Property

Compare

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Information

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Search

I’ve been given opioids after surgery to take at home. What do I need to know?

Walking can prevent low back pain, a new study shows

Alleged killer cop files lawsuit against NSW Police

"Repeatedly ignored": Daughter of Perth gunman breaks her silence

Longer appointments are just the start of tackling the gender pain gap. Here are 4 more things we can do

4 ways to avoid foot pain when travelling

"I killed them": Major twist in slain Aussie brothers case

Erin Patterson enters plea for murder charges

Samantha Murphy's alleged killer faces fresh new charges

How niggling hip pain led a squash coach to life-saving cancer diagnosis

Student wrongly named as Bondi killer sues Seven Network

Family of Bondi killer break silence

Australian Idol host opens up on painful health battle

Surgery won’t fix my chronic back pain, so what will?

Inside the alleged hide out of Samantha Murphy's accused killer

Accused mushroom killer moved to protected unit over safety fears

Everything we know about Samantha Murphy's accused killer

How long does back pain last? And how can learning about pain increase the chance of recovery?

Socceroos great hospitalised following chest pains

Mother of Vyleen White's alleged killer speaks out

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