have you thought about trying cycling?

Maybe do strength training and stretching exercise first that target the leg muscles. A lot of knee pain comes from imbalanced leg muscles. Like when one side of the leg is too stiff or too weak.

Running is in most cases good for knee health in the long term. It could be that you just need to take it slower to build up the knee strength.

Important: If you feel pain, stop and wait for it to recover.

https://youtube.com/@thekneesovertoesguy

Check out this guy. Now full transparency I've never checked his stuff out, but people who know far more than I do say he is legit and I know a few people who have used his videos to work through injuries and improve their range of motion and it worked.

Theres also some "Performance enhancing compounds" that can supposedly improve longevity and recovery that can help with joint issues but thats a whole rabbit hole and the research just isnt definitive, I've dabbled and I feel like they worked and know stuff but I'm not trying to advertise for that sort of thing.

It depends. Do they hurt because the cartilage is gone? Then I'm pretty sure you are boned and have to pick one of the other three midlife crisis. Otherwise try physiotherapy. Lots of things cause knee pain: imbalance of muscle strength, muscle tightness, poor running style, bad shoes. Don't power through on pain killers - you don't want to also be in pain when you aren't running. Oh, and bad shoes is the last thing to look at out of those four. People can generally run in anything. A shoe that compensates for one of the other three problems is not a good shoe.

I used to always run for fun. I was a go run a "real quick" 10k to hatch a pokemon egg kind of guy. I can't run anymore because of my knees, my doc said I need surgery, but I'm waiting until I feel that I need it.

Btw if I were you and my doctor said something dumb like that, I'd find another doctor.

My advice is to use an elliptical to test the waters. They are when used correctly low impact on the knees.

Have you tried insoles? Mine started to hurt and it was from my knees turning in because of bad arch support in my shoes

Don't use drugs to solve a problem like this. You'll just build a tolerance and solve nothing.

Look into strength training as others suggested. Start with bodyweight exercises before moving on to weights. It'll take a while though as you'll need to experiment to find what works, and ofc exercise isn't an overnight thing.

Maybe also consult a physical therapist.

And if all of that is too much, running isn't the only effective cardio exercise. Cycling, swimming and less obvious/weird ones like slideboard mountain climbers, which should all be easier on the knees

I get pain in my shins when I run outside. I exclusive run on the treadmill now and that works for me.