right sided knee pain

Hi, I have right sided knee pain that is worse after I have driven for 45 minutes and it is painful to walk for the 1st 20 steps or so after I get out of the car then is ok. Also, my  right knee is very painful when walking up stairs but there is no pain when walking down stairs. What do you think may be wrong and should I be doing knee strenthening exercises? thanks!

[Michael L Gross, MD]

Pain with sitting for long periods of time combined with pain going up and/or downstairs is usually patellofemoral syndrome, also known as anterior knee pain syndrome.  This is very common in teenage female athletes, but is seen in both sexes and in all age groups.  It is associated with flat feet or excessive pronation as well as, patella malalignment. Most patients respond to quadriceps strengthening exercises to strengthen the Vastus Medialis Obliqus muscle and to lateral side stretching for the ITB, and the lateral retinaculum of the patella.  Sometimes bracing or taping is helpful. In patients with flat feet or excessive pronation, orthotic shoe inserts can be helpful.  Rarely surgery is necessary.