Q: I am 31 years old and have the following problems: lower back pain for more than 10 years and now this has been diagnosed to be Spondylolisthesis of L5 over S1, Grade-1; knee joints pain for last 3 years. My uric acid level is 6.5 for which I took Zyloric for one month and it has reduced my knee pain to a certain extent. I also have cervical spondylitis in my neck – an early de-generative syndrome. Along with this there is shoulder muscle pain in both my shoulders. I have consulted a couple of doctors but could not get proper advice apart from being prescribed Zyloric. Some even say that cervical spondylitis is just like a grey hair and hence no treatment is really required. Now I have acute pain in my neck, upper and middle back once I get up from bed. In office, I get lower back pain too. My knee pain has reduced but not vanished. What do I do now? Are there any lifestyle changes for me? I travel to office on my bike for 16 kms daily (to and fro). Please help.

A:I think you need to be clear on certain issues. 1. Spondylosis as you mentioned is indeed like greying of hair. Some have it early and some have it late. There is no specific treatment for it other than symptomatic treatment for pain and exercise combined with a health lifestyle, which would mean avoiding obesity and smoking. Your neck pain could be because of cervical spondylosis and all that you need to do for that is do isometric neck exercises. To explain this simplest way is to imagine sitting upright against a wall and trying to push the wall back with your head while you are sitting straight. Make a count of 10, which means you hold pressure for 10 seconds then relax. Repeat this for 3 four minutes every hour especially while are sitting at the computer or writing. 2. Shoulder pain may be as a result of spondylosis or occupation because of your work on the computer. 3. The spondylolisthesis is unrelated to any one of these and needs to be watched closely as it can deteriorate and you might need surgical intervention. But don't be alarmed the decision for surgery is based on very clinical findings: a. Persistent pain and difficulty in standing or walking. b. Increasing neurological paralysis. c. Difficulty in passing urine with neurological deficit. The conservative treatment for Spondylolisthesis is to be on exercises for bending the spine and wait reduction. You will have to learn the exercises from a therapist. 4. Zyloric is a medicine for gout, when the Uric Acid levels are above 7 mg/dl. You could avoid all red meat, large beans (E.g. Soya Beans, Rajma, all Cocoa products) to reduce the uric acid levels, though they are normal in your case.