###Human: Injection for knee pain cause relief only for sometime. Kindly suggest treatment for permanent relief. ###Assistant: Hello. Your x-rays show (attachment removed to protect patient identity), grade 2-3 arthritis (4 is worst) in both knees, however, the x-ray picture does not always match with the clinical symptom as is in your case. I will recommend that you take a course of anti-inflammatory tablets like Diclofenac 100 mg SR once a day after meals, Pantoprazole 40 mg before meals, tablet Ultracet (Paracetamol and Tramadol combination) maximum twice daily for pain. Apply Dynapar gel (Linolenic acid and Paracetamol) locally four to five times a day. Ice the knee 10-15 minutes when the spray is not applied that is there had to be a gap of 45 minutes between the ice and spray and vice versa. If you have access to physiotherapy then Tens (transcutaneous electrical nerve stimulation) therapy will help too.