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Why does my right knee have excruciating pain whenever I kneel on it?

I am a 50 year old male, average height and a bit overweight. I have never had serious knee problems. I walk much more than the average person, averaging seven miles per day for the past ten years. I have flat feet, but wear orthotics and comfortable (tennis type) shoes everyday. My feet have been flat for as long as I can remember, perhaps since birth. This pain appears to be recently occurring, and I do not remember it happening anytime prior to the past year or two and I have never suffered any serious knee injuries that I am able to recall. I have never taken anything for the pain, but it even hurts to put weight on the knee (in a kneeling position) on my bed mattress.
It is worth having this looked at by your primary care doctor to make sure nothing serious is going on. The most likely possibility is that you have evolving osteoarthritis, which is "wear and tear" or age-related arthritis. This is the type of arthritis that is caused by aging and breakdown of the cartilage in the major joints, and it is initially treated by modifying your type of exercise (avoiding high impact exercise), ice, and anti inflammatory medicines like ibuprofen or naprosyn. Another possibility would be patello femoral pain syndrome, which occurs when the patella does not track well over the femur, leading to some breakdown of the cartilage in the patella. It often is characterized by pain that is worse with bending the knee, and it is more common in people with arch problems. You may need to make sure that the orthotic you are wearing is the appropriate one that prevents over pronation. Also, leg strengthening exercises can be an important part of correcting this problem. Rarely, this kind of pain can be from a joint infection. If you have fever, increasing pain, or any redness or heat to the joint, you should see your doctor immediately.
This answer is for general informational purposes only and is not a substitute for professional medical advice.
If you think you may have a medical emergency, call your doctor or (in the United States) 911 immediately. Always seek the advice of your doctor before starting or changing treatment. Medical professionals who provide responses to health-related questions are intended third party beneficiaries with certain rights under Zocdoc’s Terms of Service.

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