She has severe arthritis — bone rubbing on bone in her hip because the cartilage is gone, and her sciatic nerve is being pinched. She has spinal stenosis and fibromyalgia as well, as far as we can tell.

She’s tried things from your column from time to time. She’s been to pain doctors, had five shots, acupuncture, seen a chiropractor and has had physical therapy. We rub her down with different things. She sparingly takes pain medication, which doesn’t always work, applies ice for 20 minutes once or twice a day and still is in severe pain most of the time. She cannot walk due to it.

I keep thinking surely there is something that can help other than surgery. She’s not interested in that option because of her age and her negative reactions to anesthesia and many drugs. Is there a noninvasive procedure that can help, a cream she can use, a specialist she can see or a pill she can take? I find it so hard to believe that in this day and age someone has to be in such severe pain. A once very active woman has been all but stopped.

DEAR READER: As with any medical condition and possible options, a physician must look at the whole picture. The thing that stands out is her age. Most people don’t respond as well to surgery at 92 as they would when younger, recuperation is longer than in a younger person and, as you pointed out, she has had negative reactions to anesthesia.

I cannot comment on her macular degeneration other than to recommend she see a top-notch ophthalmologist if she hasn’t already done so.

Osteoarthritis, sciatica, spinal stenosis and fibromyalgia have one symptom in common — pain. There are options for relief.

Initially, I might suggest massage by a therapist. You might check with her physician or your local hospital for recommendations. If you are fortunate enough to have a visiting nurse’s facility in your community, they will likely make house calls.

Purchase a whirlpool insert for her bath tub or obtain a chair for the shower that will allow soothing water to help ease her pain.

Instead of ice, consider a warming topical ointment such as Castiva or another over-the-counter product that has a castor oil base plus capsaicin to provide relief from the pain. If you can’t find any product at your local independent store, ask them to order it for you.

Make an aromatherapy “hot-pack” of sorts from an old pillowcase cut down to about 8 inches in height. Fill it with dry white rice and lavender or chamomile. Stitch up the fourth side to prevent the contents from spilling out. At appropriate times, pop it into your microwave for about 30 seconds to warm. Wrap it around her neck. The scent may lessen her pain by providing soothing relief as she inhales.

Speak with her physician about modifying her medication. Sometimes when one drug in a specific class isn’t adequate, another is. Also, be sure you run my rather benign suggestions past him or her before initiating them.

To give you related information, I am sending you copies of my Health Reports “Understanding Osteoarthritis” and “Fibromyalgia.” Other readers who would like a copy should send a self-addressed, stamped No. 10 envelope and a $2 check or money order for each report payable to Newsletter and forwarded to PO Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title(s) or print out an order form from my website www.AskDrGottMD.com.

DEAR READER: In answer to your question, I am unaware of any scientific studies to support its use; however, I’d defy anyone to go up against what the Roman Empire began using almost 2,000 years ago as a healing herb for countless maladies. Scientific studies aside, what is valid is what works. Ginger has been used with success to treat nausea during pregnancy, to prevent car or motion sickness, as an anti-inflammatory for arthritis and joint pain and post imbibing too much alcohol. Even as a tea, its soothing qualities are well known. Give it a try. It won’t do you any harm, and, if you fail to improve, you can speak with your physician regarding what he or she might recommend instead.

DEAR READER: Osteoarthritis is a chronic condition that results from a breakdown of joint cartilage. Healthy cartilage allows our joints to move easily and without pain. When osteoarthritis is present, a degeneration of the cartilage that cushions bone ends occurs. Over time, some areas of cartilage may wear away completely, resulting in damage to the bone and extreme pain on movement. The ends of the bone may form spurs, and the ligaments may thicken. This common disorder affects about one in three people and, while most common in older adults, it can affect people of any age.

All of our joints are susceptible to osteoarthritis, but those most commonly affected are ones that bear weight — knees, hips, spine, feet, neck, lower back and hands. When the knees or hips are involved, pain may be experienced with motion but may disappear when at rest. When the spine is involved, stiffness and discomfort can be felt and can generate to the lower back. There may be pain generating to the head or down the arms.

I cannot determine from your brief note why you have the condition. It may be related to a sports injury when you were younger, or you may have a family history of OA. There is also a consideration of a chemical change that has occurred in your cartilage, causing it to break down faster than it can be produced. You also may be carrying more weight than is healthy for your frame, or you may be relatively inactive. As you can see, there are a number of causes for a woman at the early age of 54 to develop this condition.

You might be helped by over-the-counter or prescription NSAIDS (nonsteroidal anti-inflammatory medication). There are also glucosamine/chondroitin combinations available at your local pharmacy that may help to build cartilage and improve your joint mobility. If appropriate, consider weight reduction. Above all, stay as active as possible. Keeping your joints as mobile and flexible as possible can help reduce your pain and stiffness. Consider yoga, tai chi or water aerobics. On the home front, consider rubbing castor oil on your painful joints. Some of my readers have found success by using purple grape juice and liquid pectin commonly used to make jam. Simply mix 1 to 2 tablespoons of pectin in 8 ounces of grape juice, and drink it once a day.

When all else fails and the pain becomes unbearable, speak with your physician regarding heavy-duty pain medication or surgery. Your personal physician knows your complete medical history and can help you make the determination as to whether you are well enough to consider such a step. Many hospitals also have occupational therapists, who can evaluate the situation and offer suggestions.

To provide related information, I am sending you a copy of my Health Report “Understanding Osteoarthritis.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

When I arrived in this country at the age of 28, I started taking cod-liver oil regularly with breakfast every single day. When a nephew of mine from Norway visited some time ago, I asked him what he thought of the value of cod-liver oil. Arthritis was his specialty, and he thought it was useful against rheumatoid problems. He said it works painlessly, almost like oiling a joint.

I have basically no signs of pain anyplace in my body, except I fell off a roof and broke my leg when I was 78. That hurt! I still swim one lap over one-quarter mile once a week and keep telling my relatives in Norway I think I’ll swim a kilometer some day and get my name in the paper. I could do it. I don’t remember the last time I had a cold or was ill for any reason. I never have to get up in the night.

The last time I went to see my physician for a regular checkup, he had another doctor examine me. Afterward when they reviewed my lab results, my doctor said they were incredible and that he thought maybe he should eat the way I do. Part of my health is no doubt due to my genes, but I believe it is also due to the fact that I, especially during the last 20 to 25 years, have begun realizing that our bodies are made up of everything we eat. In order to stay healthy, we ought to consume a great variety of foods and include cod-liver oil.

DEAR READER: What can I say? As I have written in the past, it was common in my generation for parents to force their children to take cod-liver oil, which was thought to be healthful. Today, it is known to be. It is a good source of omega-3, vitamins A and D, and essential fatty acids EPA and DHA. These fatty acids appear to provide resistance to illnesses such as the common cold and influenza. Omega-3 fatty acids are a form of polyunsaturated fats the body derives from food. Because the body cannot produce fatty acids, they must be obtained through the foods we eat or supplements we take. Studies are limited and inconclusive but suggest this addition may be beneficial for cardiac conditions, eczema, behavioral disorders, inflammatory disorders such as arthritis and more. The jury is still out as to whether it can actually lower cholesterol levels. Cod liver acts as a natural anticoagulant, so if readers choose to add the supplement, I suggest they run it past their primary-care physician before doing so. The Food and Drug Administration has not approved it, but there is little harm (and perhaps a great deal of good) in adding cod-liver oil to the diet. Heaven knows you appear to be a walking, talking testimonial to this theory.

To provide related information, I am sending you a copy of my Health Report “Vitamins and Minerals.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

DEAR READER: Arthritis is pain and stiffness of the joints. You don’t specify what type she has, so I will generalize because there are actually more than 100 forms.

Osteoarthritis is pain in the joints accompanied by progressive stiffness without extensive inflammation, chills or fever. It is a chronic disease of the joints resulting from a cartilage breakdown. Rheumatoid arthritis has pain, inflammation, swelling and stiffness that typically occurs symmetrically on both sides of the body. The infectious form includes symptoms of inflammation, chills, fever and pain, and may be linked to another illness. Then there’s gout, Behcet’s Syndrome, CREST syndrome, fibromyalgia and a whole host more.

Some patients respond to topical ointments with capsaicin or castor oil rubbed onto painful joints; purple grape juice and liquid pectin mixtures; or omega-3 fish oils.

Plantar fasciitis is pain and inflammation in a dense band of tissue of the foot that connects the heel bone to the toes. It is common in runners, overweight people, pregnant women and in those who wear shoes without adequate support.

The methylprednisolone your friend has been prescribed is a steroid that prevents the release of substances in the body that cause inflammation. It is also used to treat several allergic disorders, arthritis, psoriasis, ulcerative colitis and a number of other conditions.

Steroids can weaken a person’s immune system, thus making him or her more susceptible to infection. They also have the ability to reactivate recent infection. Steroids should be reduced slowly and not discontinued abruptly because of potential side effects from withdrawal. Your friend should avoid being near people with chickenpox, measles, active infections or who are otherwise sick. She should not receive any “live” vaccines while on the drug. The drug can also alter certain medical testing, so she should be sure to make her usage known to avoid being misdiagnosed.

Side effects of high doses include hypertension, heart arrhythmias, muscle weakness, chest pain, shortness of breath, visual problems, tarry or bloody stools, pancreatitis and more. Long-term use can lead to easy bruising, acne, facial hair, loss of libido, headache, insomnia, nausea, changes of body fat and more.

The bottom line is that she should take the drug precisely as it is prescribed. Modifications (which are obviously acceptable) might be made by her prescribing physician. Should she develop kidney disease, osteoporosis, glaucoma, cataracts, congestive heart failure or a number of other conditions, her doctor will likely make dose adjustments and order special testing while she is on the medication.

To provide related information, I am sending you copies of my Health Reports “Consumer Tips on Medicines” and “Fibromyalgia.” Other readers who would like copies should send a self-addressed stamped No. 10 envelope and a $2 check or money order for each report to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

DEAR READER: Before jumping to the conclusion of bone cancer, you should consider the more common occurrence of arthritis of the hip, a condition that leads to pain in one or both hips as the cartilage begins to wear down.

If you underwent radiation, this could have sped up the deterioration of the connective tissues. The pain could also simply be age related, but because you did not provide any history, such as age, health status, medications, etc., I can’t determine whether this is likely.

I urge you to speak to your physician, who can order an X-ray that will show whether there are any abnormalities within the hip or bone suggesting arthritis, cancer or other causes, such as osteoporosis. If anything is abnormal, further testing will be necessary to determine the cause.

I, too, have had 3 cortisone shots in my hip (no recommendation from my doctor for hip surgery) and so far they only offer temporary relief.

Inasmuch as I did not read your original article about the castor oil rubs and grape juice with pectin, I am very interested in knowing your instructions for such. I realize there is no guarantee that this treatment will help me but I would like to give it a try.

DEAR READER: Castor oil is simply rubbed onto the affected joint or joints twice a day.

To eight ounces of purple grape juice, add 1-2 tablespoons liquid pectin. This mixture can be taken up to 3 times a day until pain is decreased and then reduced to 1 glass per day as a maintenance.

Because of the high reader interest, I have recently written a health report that contains the most popular and effective home remedies.

To give you related information, I am sending you a copy of my Health Report “Dr. Gott’s Compelling Home Remedies”. Other readers who would like a copy should send a self-addressed 4 ¼” X 9 ½” letter-sized stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.