Dear doctor;

My mother has both her knees swollen real big and they give her difficulty in walking. She used to walk a lot to work. She has been taking medication, mainly painkillers, but it is the swelling and inconvenience that disturbs. Could this be arthritis yet she used to walk a lot to work until recently? Do arthritis affect people who walk a lot too? She is 57 now.

Muhumuza, 23.

Dear Muhumuza,

Your mother is most likely suffering from osteoarthritis of the knees. As knees bear the weight of the entire body, degenerative changes occur earlier in the knees as compared to rest of the joints. Initially, pain occurs while climbing up, something which imposes more strain. This is associated with stiffness, particularly after inactivity for long time. Swelling can occur at back of knees, which is known as popliteal cyst. This makes the knees look bigger. Walking long distances for long time, wearing high-heels or poorly fitting shoes, trauma, all these factors precipitate and aggravate this problem.  

Varicose veins (dilatation of veins due to weakening of its walls), around knees can also cause pain and swelling of knees. This condition can be associated with osteoarthritis. Infection of the knee or its supporting structures can also cause pain and swelling. But this would occur in one knee and would be associated with fever, pain on touching the knees, loss of appetite and other symptoms of infection. 

Painkillers only suppress pain but do not cure the condition. Physiotherapy, using supportive crepe bandage or elastic stockings while walking, among others, are other measures that help in reducing pain.