I'm going through some knee pain right now (since November). Just getting into the mystery as to what is causing it. I went to an orthepedic doctor in December who could barely look me in the eye and spent to minutes with me. Sent me out with meloxicam. X-rays showed arthritis, but I am 59. That's not the cause. Came on overnight, literally, and I can't think of what I would have done.
I've circled back with my GP because I am having a lot of other issues so we are trying to tackle the knee pain. I also have hip pain with it and lower back pain, all on the same side. Lumbar x-rays shows "markedly severe" disc narrowing in the lumbar area.
So in order to play detective, I will be now getting a lumbar MRI to rule out some sort of nerve compression that could actually be the cause of my hip and knee pain. If that's not clear, then I'll be going to a new ortho and trying to figure out the knee pain which will probably be yet another MRI.
As to the feet/shoes--I've had flat feet all my life. I had one foot reconstructed in 2021 (left side). My right side (where my knee pain is) has not been fixed and doesn't overly need that, but my gait/stance is definitely different since that 2021 surgery and sometimes I feel like I put a lot more weight or I lean into the right side/leg more than I used to. I wonder if this has caused some type of strain on the right side--almost like an overuse injury. I do believe shoes and foot position do play into the knee. But I've been wearing fantastic shoes for at least 5 years now with custom orthotics so I am control everything I can.
I agree with
@DLgal that if you're a pronator you are best to be in a stability/motion control shoe rather than a neutral shoe. I do wear neutral shoes now because my one foot has been fixed and no longer pronates, but they are augmented with some heavy duty orthotics. Otherwise, I'd not go for the neutral shoe. But overall, if you go from a cheap shoe to a good shoe, you'll likely see some improvements.