Q: My mother is 50 years old, weighs 75 Kg, and is suffering from knee pain for the last 4-5 years. Doctors say that the gap between the bones of her knees has reduced. Recently, we consulted a rheumatologist, who advised treatment by injecting fluid in the knees to increase the gap over a period of three weeks. The treatment is going to cost around Rs. 15000. Is such a procedure advisable? What is the success rate?

A:The problem that your mother has is the commonest form of arthritis called osteoarthritis. It is basically a life-style problem (the way we Indians misuse our knee joints since childhood by sitting cross-legged, squatting, sitting on low levels, sitting on floor for performing most of our daily activities, using Indian style toilet seats and going up-and-down the stairs frequently). In addition, with age we keep gaining weight; mostly around our waist (remember for each 1 kg weight gain 4.5 kg extra weight is added on the knee joints - due to fulcrum physical principle). These knee abuse items then lead to cracks in the soft bones at the end of the bones (called cartilage) that goes on increasing with destruction of cartilage (often mistakenly called as gap between the bones has reduced). As there are many small things that can be modified in the life-style in addition to some types of medicines and exercise, you are strongly advised to keep her under the care and advice of the rheumatologist. Intra-articular depot-steroids (like tricort) have been shown to improve the health of the cartilage and can definitely give some relief. But, by far walking, walking and more walking has been proven scientifically to help in improving this condition including some degree of repair of the broken cartilage. Therefore, keep walking and keep reducing weight and avoid all the wrong habits mentioned above.