My friend Mary, 92 years old, in assisted living, has had a flare up arthritis in her left knee three times now in 2 weeks. Terribly painful for, but we question why its always in the same place and why so often? She uses a walker, takes care of herself, hasn t abused it to our knowledge or hers either, they give her Tramadol once every 8 hrs. Also about the tramadol, can she have it more often when the pain is so severe. The severe pain will last 24 hrs at least then the dull pain the next 3 days and then it comes again. Thank you very much