Thank you Bryan for your response. I can tell you I have tried prescription medication remedies (no effect);Votaren (limited effect), physio, acupuncture, Traditional Chinese Medicine that included acupuncture and cupping. The TCM & cupping gave me some relief but it is the Pain Relief Now on a daily basis that gets me through. I did share this with my orthopedic surgeon and he said "they should be contacting me" Thank you for developing this product. Truly a God send to me."is item. Give people the info they need to go ahead and take the action you want. .