Brief Answer: Conservative management is the first option. Detailed Answer: Hi, thanks for writing to XXXXXXX Conservative management (non surgical management) is the first choice for the treatment of arthritic knees. Definitely, long term usage of RETOZ (ETORICOXIB) is not advisable as it is likely to produce systemic complications. Relatively safe analgesics with regard to renal function are Paracetamol & Tramadol. So, you can take these medications under the supervision of a doctor. I have gone through all of your hematological investigation reports that you have attached. The conservative management of arthritic knee is as follows - * PHYSICAL THERAPY : The mainstay of treatment in the early case is physical therapy, which should be directed at maintaining joint mobility and improving muscle strength. Exercise can strengthen your muscles, which can help keep your joints more stable, and the stronger muscles help to absorb energy and protect the joint surface. Stick to gentle exercises, such as walking, biking or swimming. Other measures, such as massage and the application of warmth, may reduce pain. * LOAD REDUCTION : Protecting the joint from excessive load may slow down the rate of cartilage loss. It is also effective in relieving pain. The heavier you are, the more stress you put on your joints. Weight reduction for obese patients, wearing shock-absorbing shoes, avoiding activities like climbing stairs and using a walking stick are worthwhile. * ANALGESIC MEDICATION : Simple over the counter medications like acetaminophen is sufficient in most cases. If this fails to control pain, a non-steroidal anti-inflammatory drug (Naproxen, Aceclofenac) may be better. It is not advisable to take any analgesic medication for a prolonged period of time as they may cause serious damage to the kidneys. * USE OF HEAT & COLD : Both heat and cold can relieve pain in your joint. Heat also relieves stiffness, and cold can relieve muscle spasms and pain. * OVER THE COUNTER PAIN CREAMS : Local massaging with creams and gels may provide temporary relief from osteoarthritis pain. Some creams numb the pain by creating a hot or cool sensation. Other creams contain medications, such as aspirin-like compounds, that are absorbed into your skin. Pain creams work best on joints that are close to the surface of your skin, such as your knees and fingers. * USING ASSISTING DEVICES : Assistive devices can make it easier to go about your day without stressing your painful joint. A cane may take weight off your knee as you walk. Carry the cane in the hand opposite the leg that hurts. * GLUCOSAMINE & CHONDROITIN SULFATE : Daily intake of Glucosamine & chondroitin supplements over a period of 3-4 months will help in reducing the arthritic pains and thereby decreases the necessity to take daily analgesic medications. Research suggests that vitamins C and D may help protect you against the progression of osteoarthritis. * VISCOSUPPLEMENTATION: Hyaluronic acid injections given into the joint (especially large joints like knee joint) in prescribed dosages will give good short term pain relief in arthritic joints ranging from 1-2 years. Hope I have addressed your query. Happy to help further Regards

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Brief Answer: Please find the answers below. Detailed Answer: Hi, Nice to hear from you. 1. I am not the right person (being an orthopedic surgeon) to give you right advise on varicose veins, which are usually dealt by either General surgeons or Vascular surgeons. As far as my knowledge goes, SYMPTOMATIC varicose veins needs to be treated by surgical measures. Please discuss the issues related to the complications of the procedure with your treating doctor. 2. There is no harm in using Etoricoxib once in a while for pain relief, as it is a potent analgesic than paracetamol. For SOS pain treatment, if your pain is of severe intensity- go for Etoricoxib. If the pain is of moderate intensity, you can use paracetamol. But in terms of safety, paracetamol is preferred to etoricoxib. Hope I have justified your query. Good day

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