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She has moderate Osteoarthritis where there is wear and tear of supporting tissue called cartilage. This is a progressive disease and causes pain on walking, climbing stairs. It would be better for her to consult pain management doctor who can asess her. These days there are lot of good treatment options like platelet rich plasma therapy. Even I would advise against giving pain killers.

Walking too much and cycling can produce pain. Basically Im osteoarthritis the cartilage is worn out. Any heavy strenuous physical activity is to be avoided. Get a orthopaedician opinion and get intraarticular hyaluronic acid injection if possible. That will help

Non weight bearing exercise like those taught by physios or pool aerobics help a lot in initial stages till muscle tone improves then cycling in appropriate posture and walking with good shoes and on softer surfaces would be helpful.

Osteoarthritis is painful On reviewing the X-ray, she seems to be in the moderate stage She need to continue walking ( least impact on knees) to keep - her joints active and mobile -her other system healthy She could reduce the impact on the knee by - physiotherapist- strengthening her knee - losing weight - avoid lifting and stairs