Q: I am a 40-year-old woman, a mother of two children. I weigh 60 kg and walk for an hour to keep myself fit, for the past 3 years, 5 times a week. Of late, I am having a lot of pain in my right knee. I have visited an orthopaedician and also gone through a row of exercises such as yoga, physiotherapy, etc. but of no use. The pain remains and I am unable to walk for more than 15 minutes at a time. I am regular with my physio exercises also. An MRI revealed osteoarthrosis of the right knee joint and chondromalacia patellae and myxoid degeneration of posterior horn of both menisci. My doctor says that there is no major damage but the pain remains. What is myxoid degeneration of menisci? What should I do to continue my fitness routine and get relief from the pain?

A:Assuming the diagnosis given by your doctor and corroborated by your MRI to be correct, osteoarthrosis can have a difficult course at times. The degree of pain may be unrelated to the degree of damage to the joint. Some times the X-rays look terrible but patient may not have too many symptoms. At times the X-rays look good but the patient may have severe symptoms. There is no way of predicting either category. In patients with persistent pain one must always look for possible explanations. These could be: 1. A torn meniscus 2. A significant damage to under surface of patella 3. A loose body getting locked 4. Associated raised levels of Uric Acid and several other conditions. Diagnosis may be possible only through exclusion. You must also exclude diabetes if you have a family history of diabetes. Management may be difficult. In case, it is very painful it is safer to avoid all those activities that cause pain. Pain indicates that the body wants you to take care and take rest. The only exercise that may be good is the isometric exercise for the quadriceps. Learn this from a physiotherapist. Once the pain subsides then you could gradually increase your activity level. You may take a simple pain killer like paracetamol. If despite all this pain is persistent, you will need to see an orthopaedic surgeon once again.