Knee pain after Prolonged Standing

Patient

Q: I recently took a job that requires I stay on my feet 7-10 hours per day, often involving lifting. I found that the orthotics in my shoes made my shoes too tight which caused me pain in my foot radiating up through my knee, so I bought new shoes (and discontinued use of those orthotics). The pain has diminished, but for the pain in my left knee. It is a dull aching pain, brought on after a work shift, and lasts for days afterward (too long to go away completely before next shift). Pain is similar to a "stiff" joint, whereby prolonged periods of immobility make initial movement more painful. Pain is on the back side of my left knee; if my left knee were to be cross-sectioned, the pain would be at about the 7-8 o'clock position (assuming 12 o'clock is the knee-cap). Pain is about an 8/10 at its worst after driving an hour home from a work shift, and normally is about a 3-4 during the day. I started using a heating pad, and that seems to temporarily help, but usually isn't long lasting. 600mg Ibuprofin doesn't seem to help much. What is this ailment, and how might it be remedied?

Doctor

A:   Thank you for your questions and thank you for your excellent history of Knee pain.  As you know, we can not provide a diagnosis over the Internet - that would require an appropriate physical exam to be done - but there are some things in your history that make me a little less worried.
It does not sound like the pain occurs at rest. It appears to be activity related and even then, only when excessive activity is done. This almost always suggests an over use or wear and tear type issue.
This does not mean you have to stop using your knee, but we have to reduce the amount of stress your knee joint is experiencing on a dialy basis.
In the short term this means you may have to reduce your activity, increase your periods of rest and consider the possibility of pain medications.
In the long term this means that in order to reduce the stress on your knee joint, we have to make the muscles surrounding your knee as strong as possible so that they are able to do what you ask of them.  This is best done through a trained physical therapist.  As the muscles become stronger, the weight of gravity on the knee joint becomes less and the pain subsides.
Orthotics also aid in redistributing the stress of gravity and you have to consider finding a pair of shoes that can accommodate them.
I hope this helps

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