I have knee osteoarthritis. Are there exercises that could relieve my pain?

DEAR DOCTOR K: I have knee osteoarthritis. Are there exercises that could relieve my pain?

DEAR READER: As a fellow sufferer, I know that joint pain from osteoarthritis can really interfere with life. Since putting pressure on the joint can make it hurt more, you might think that exercises would only make the pain worse, and so you might be tempted to avoid exercising altogether.

Does glucosamine and chondroitin help relieve osteoarthritis pain?

DEAR DOCTOR K: What's the verdict on glucosamine and chondroitin? Do they help relieve osteoarthritis pain?

DEAR READER: Whether glucosamine and chondroitin pills help osteoarthritis pain has been controversial. As with most medical controversies, there rarely is a verdict that everyone accepts. So I'm not sure there is a verdict yet in this controversy. In fact, I'm going to argue that the controversy may be misguided: It may not be a question of whether these pills help everyone with osteoarthritis or not.

If my joints hurt does that mean I have osteoarthritis?

DEAR DOCTOR K: My joints hurt. Does that mean I have osteoarthritis?

DEAR READER: Your knee aches from time to time, or maybe your fingers don't seem as nimble as they used to be. That doesn't mean you have osteoarthritis -- but you might.

There are many different kinds of arthritis. They all damage the cartilage, the flexible tissue lining joints. Every joint is a spot where two (or more) bones meet. The cartilage in a joint keeps bone from rubbing against bone.

What causes osteoarthritis pain?

DEAR DOCTOR K: I have osteoarthritis. Can you tell me what is happening in my joints that causes my painful symptoms?

DEAR READER: The short answer is that osteoarthritis causes deterioration of cartilage in the joints. But I suspect you'd like a more detailed response.

Can I relieve my knee pain without drugs or surgery?

DEAR DOCTOR K: I have osteoarthritis of the knee. Are there ways to relieve my knee pain without drugs or surgery?

DEAR READER: Osteoarthritis is a degenerative disease of the joints. If you were to take an X-ray of every bone in the bodies of people over 50, probably most of us would have some degree of osteoarthritis in some joints. If you're still in the early stages of osteoarthritis, a variety of remedies may offer some pain relief without drugs or surgery:

What is infectious arthritis?

DEAR DOCTOR K: I saw my doctor for pain and inflammation in my knee. He said I have arthritis caused by a bacterial infection. Could this be true?

DEAR READER: I'll bet that, like many of my patients, you think of arthritis as something caused by wear and tear on a joint. That is the main cause of the most common type of arthritis, osteoarthritis. However, there are other kinds of arthritis, too.

What are the side effects of medications for juvenile rheumatoid arthritis?

DEAR DOCTOR K: My young granddaughter has juvenile rheumatoid arthritis. I worry about the effects of the powerful medications she has to take.

DEAR READER: Modern medicine has created real miracles. We have been smart enough to create treatments that relieve suffering and prevent premature death beyond what was previously possible. But we are not yet smart enough to create tests and treatments that are free of side effects.

How do anti-TNF drugs work against rheumatoid arthritis?

DEAR DOCTOR K: I have rheumatoid arthritis and take anti-TNF drugs. I'd like to understand how they work.

DEAR READER: Rheumatoid arthritis (RA) is a chronic autoimmune disease in which the body's immune system mistakenly attacks healthy tissue in the joints. Our immune systems are not supposed to attack our own tissues; they're supposed to attack foreign things that enter our body, particularly germs. In autoimmune diseases, however, something goes haywire.

How can I manage osteoarthritis pain?

DEAR DOCTOR K: I was just diagnosed with osteoarthritis. What can I do at home to manage my discomfort?

DEAR READER: Osteoarthritis is the most common kind of arthritis. Tens of millions of us in the United States have it, and it becomes more common as we get older. For some people it causes just occasional aches and pains. But for others, pain and stiffness can make it difficult to perform the daily tasks they've always taken for granted. Simple activities such as getting dressed or cooking dinner can become major efforts.

Should I get a hip replacement?

DEAR DOCTOR K: I'm 58 and have a bad hip. Should I get a hip replacement now or wait until it's absolutely necessary?

DEAR READER: Many patients have asked me the same question over the years. I answer it somewhat differently today than I did 20 years ago, for two reasons. First, the technology of hip replacement has improved considerably. Second, 10 years ago I faced the same question myself.