Q: My mother aged 62 years has severe osteoporosis. Different doctors have given different pain killers. Recently I took her to an Orthopaedic specialist who diagnosed it as a wear and tear of the cartilage between the bones of the knees and because of bone friction, there is swelling and pain. He advised surgery and replacement of cartilage. He prescribed a pain killer, calcium tablets and pain relief gel. My mother is not willing to go for surgery though there is perennial swelling on her knees especially in the mornings and it is difficult for her to walk. Recently, there was news from Australia that instead of different new age pain killers, it is better to give paracetamol as it is more effective and very cheap also. Should we give her paracetamol for pain relief? She also uses hot water bottle for some relief. Can you please advise some home remedy for pain relief in her joints especially in the knees?

A:There are 2 diseases apparently which your mother is suffering from as is understood from the account given by you. These are: 1. Osteoporosis 2. Osteoarthritis For osteoporosis, which implies fragile bones, some very good medications are available to strengthen the bones, besides calcium and vitamin D. However, before these can be started, bone mineral density measurement by DEXA method is necessary for confirmation of diagnosis. You should consult a rheumatologist for this purpose. For osteoarthritis, if the disease is too advanced and joint requires replacement, surgery would be the most effective option. Paracetamol is safe but the dose has to be 3-4 grams per day and it will only relieve pain and not improve the joint structure or function! Application of creams for pain-relief is of doubtful value. Physiotherapy would be better, please consult a physiotherapist for quadriceps exercises.