DEAR DR. ROACH: I am 66 years old and have had highly episodic and infrequent shooting pains in my outer right knee on and off for the past five or six years. It’s like an intense burning sensation or electric shock to the bony outer part of my tibia directly below the knee, and it only lasts for a few seconds.

But when it occurs during sleep, it wakes me up and “burns” six or eight times in half an hour, then completely stops. Sometimes it feels like someone is pointing a laser beam at this very specific spot on the outside of my lateral condyle. (I looked up the name.)

I played basketball in high school and college but not since. About three years ago, because of hip arthritis, I stopped biking two or three days a week for exercise (only modest exertion — never long trips). I don’t currently exercise, although I do yard work and gardening. I have not had surgery or hurt my knee in the past.

I have no restriction of movement; there is never any swelling or tingling, and it had only been an annoyance until recently. It seems to be happening more frequently now. Nothing I do seems to provoke it. It just comes out of the blue. In the past, I might go six or eight months without any recurrence. My doctors have no clue what it is. Any idea what it could be and how to make it stop? — V.F.

ANSWER: Burning pain in a specific area of the body is highly suggestive of a neuropathy. “Neuropathy” isn’t a diagnosis; it’s a general term to describe something wrong with the nerve. In this case, the nerve in the outside (lateral) knee is likely the common peroneal nerve (also called the fibular nerve) or one of its smaller branches.

This nerve is commonly damaged by trauma or injury to the knee. Pressure directly on the nerve can happen with certain items of clothing, during surgery, or even by keeping your legs crossed for a long time. I also wonder if you have some bony protruberences in your knee as a result of arthritis, which can put the nerve into a vulnerable position. (People with hip arthritis usually have knee arthritis as well.)

This isn’t a common problem for regular doctors to manage, so I suggest that you see a physiatrist or a neurologist. They can confirm (or refute, maybe) my suspected diagnosis, figure out why it may be happening, and suggest treatment. Since it can be so infrequent, I don’t recommend continuous treatment like medication, but maybe therapy could help get pressure off the nerve.

Most people find exercise like bike riding helps symptoms of hip arthritis.

DEAR DR. ROACH: I was interested in the letter from the woman who kept getting bladder infections. I have found that avoiding pants that are slightly too tight stopped my bladder infections. There may be no scientific studies to back this up, but it worked for me. With whatever mechanism might be at play, your reader should see if this is a consideration for her. — P.G.

ANSWER: I appreciate your writing. There aren’t any studies I could find to back this up, but it’s possible that too-tight clothing changed the living bacteria on your skin. It may not help everybody, but it will not hurt to try.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. (c) 2025 North America Syndicate Inc. All Rights Reserved