Q: Since 3 to 4 weeks I am having problem with my knee joints. The pain started in both legs and it reduces once I stop my routine work in the kitchen and take some rest. I am a hypothroid patient taking Eltroxin medication 100 mg once a day since 12 years, which I take in the morning before breakfast as per the advice of my doctor. I do not have any other problem. I have been living with my husband in Kuwait for 2 years and have a 4 yr old daughter. I had shown to the local doctors here but didn't get complete control of my problem. I have got all the relevant blood tests done such as ESR, CBC, Rh factor and urine analysis; all were normal except that docors told me that I have a marginally high triglyceride level for which they have advised me to avoid fatty foods. My thyroid profile is normal. As I have got the x-rays of both the knees and the doctors have seen that and told that everything is normal I am really confused. Please advise me what should I do now as the pain is persisting. I have been using Olfen 100 mg tab once a day and have been advised to use Olfen jel locally.

A:Without any incidence of trauma, and with normal blood reports, and x-rays, the diagnosis of knee pain can be difficult, especially without physical examination. The modalities used to treat knee pain should be analgesics and physical therapy. Conditioning of the knee by quadriceps and hamstrings stretching and strengthening exercises can help relieve pain. You may also try warm running water during the bath. Hot fomentation relaxes the tissues and can make you feel more comfortable. Avoid sitting on the floor or squatting for the time being. If the pain does not resolve within 6 weeks of initiation of proper treatment, then higher level of imaging may be required. The pain may be in the patello-femoral joint, especially if it hurts on stair climbing.