Q: I have been suffering from knee joint pains since the last two years. I consulted an orthopaedic specialist who diagnosed it as Osteoarthritis. He gave me tab. Etoxib 120 mg for 15 days and cartisafe for 3 months. He also told me to take precautions like for sitting etc. I took the same for 15 days (Etoxib) and Cartisafe for 3 more months. It was under control during the same period but again started when I left the medicines. I want to know if that is there any permanent cure for the same or I have to these medicines for life long? I have been taking other medicines for my heart problem which I have mentioned. I have undergone bypass surgery six years back.

A:The life-style in India and most of the Southeast Asian countries is such that the knees are under great stress (e.g. sitting cross-legged, squatting, sitting on the floor and other lower levels then getting up, going up-and-down the stairs, doing push-ups). This leads to cracks in the soft bone (cartilage) that covers the bony ends that go to make a joint. The cracks in the cartilage then progress slowly. The steady deterioration in the cartilage structure that finally leads to complete cartilage damage that leaves bare bones to rub on each other and cause pain. This condition is called osteoarthritis - the commonest (90%) cause of knee pain above the age of 50 years among Indians. Unfortunately, once the cartilage is damaged it cannot be re-grown (somewhat like if somebody loses an arm, there is no way to grow a new arm!). One has to somehow manage. There are 2 things for this 1. Change in life-style so that further cartilage damage is slowed down or retarded (avoids the things mentioned above) 2. Appropriate muscle strengthening exercises to give support to the joint to somehow manage despite the abnormal structure of the knee. I strongly advise to refrain from taking painkillers as most of them are toxic to liver, kidneys and tend to raise blood pressure. Paracetamol is possibly the safest simple pain-reliever that you may take. When every thing fails, there is a very encouraging way to treat this condition namely by knee arthroplasty operation. I strongly recommend that you meet a specialist in this disease.