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

### input:
I ve had patella femoral syndrome for 20 years now and have tried everything the doctors have given me. Physical therapy, knee braces, knee taping, prescription medicine both for pain and swelling. My question is what can be done that goes above and beyond this form of treatment? The last few years it has gotten really bad to the point I no longer do anything that requires long periods of standing, walking, and even sitting. I no longer play any type of sports because my knees either give out or lock up on me with no given warning. This has become a daily norm for me lately. I m 45 now and find myself falling on occassion because of this. I m also having trouble sleeping at night because of the intense pain which now has become a 24/7 burden in my life. Please help! I m a veteran that goes through the VA for medical and am afraid that they either minimize the severity of my issue and or they don t really know what to do about it?

### output:

Here I suggest doing more of strengthening exercise with mobility exercise based on your knee problem and knee biomechanics. You have mention here there is a knee pain. And you are not comfortable using knee braces. But I need to know what kind of knee issue you have?does it early stage or chronic stage of knee Oslo arthritis?, or is it pain related to knee cap movement disorder?. Based on this only I can suggest specific things. But still I must suggest you to visit a good physio and take proper treatment which can reduce inflammation and relax your soft tissue. As well also take a good exercise program to strengthen the knee joint. In very sever knee pain I also suggest taking MRI and check what is going wrong inside. And based on the report do visit orthopedic for having opinion on surgery or for minor issues on medication. Also use hot and cold pack regularly and frequently to have more of anti-inflammatory, relaxing and soothing effect on joint. Take care.