### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I started out taking 25mg of trokendi xr for migraines. After a while it was increased to 50 mg. About this same time, I received lab results back that showed a defiency in vitamin D. I began taking 10000 mg of vitamin D3 per day. The migraines stopped...I haven t had another one since then. After that the trokendi was increased to 75 mg. I woke up to bad low back pain that lasted for weeks. I didn t realize that it could be a side effect of the trokendi. About 2 weeks later the doc increased trokendi to 100 mg. I started having tremendously severe knee pain in both knees. It hurts to walk, stand, sit down, or get up. My knees feel swollen. When I realized this was a side effect, I stopped taking the trokendi. It s been almost a week, and the swelling went down and the pain decreased. However it didn t go away. As the week has gone on, the swelling in my knees has come back and the pain is getting really bad again. Could this be permanent damage caused by the trokendi? Not sure what I should do.

### output:

Hello, Thanks for your query on Chat Doctor"As"per your clinical history is concerned please follow like this -1)Do a clinical examination by your Doctor [rheumatologist] and to confirm do X-ray and MRI scan.2)Do take OTC painkiller [naproxen] and do consult with your physiotherapist for specific exercise plan.3)If conservative treatment failed to solve your problem then go for [Cortisone shots and Lubrication injections]Do follow lifestyle modifications like this-1)Do exercise. Exercise can increase your endurance and strengthen the muscles around your joint, making your joint more stable. Try walking, or swimming. 2)Try to lose weight. Being overweight or obese increases the stress on your weight-bearing joints, such as your knees and your hips. 3)Apply over-the-counter pain creams. Creams and gels available at Chat Doctor.  4)Use assistive 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 or hip as you walk. Carry the cane in the hand opposite the leg that hurts. Hope that helps