Knee Bursitis: Causes, Symptoms, and Treatment

If your knees are swollen, hurt when touched, and you’re between 40 to 60 years old, you might have knee bursitis. Many adults don’t know how to spot it, handle it, or when to see a doctor.

In this article, we’ll explain knee bursitis, give prevention tips, and tell you what to do if you think you have it.

What is Knee Bursitis?

Knee bursitis is all about these little “bursa” sacs in your body. These sacs are like tiny fluid-filled cushions between your skin and tendons or between tendons and bones. They protect different joints in your body. When these sacs become swollen, that’s knee bursitis.

Here’s how it happens: Fluid collects around your joint, called effusion. It’s like your body’s way of saying, “Hey, something’s not right here.” In your knee, these bursae (the plural of bursa) come into play when you rest your knee on a hard surface. They act as a cushion, reducing friction between the soft stuff inside your knee and the bone.

Now, remember, you have over a hundred of these bursae all over your body. But when you put too much pressure on them—either by doing the same movements repeatedly or by taking a direct hit—they can become inflamed and swell up, causing knee bursitis.

Common Types of Knee Bursitis

Knee bursitis can occur in any of the approximately eleven bursae around your knee joint. However, let’s focus on the six most common types:

  1. Prepatellar Bursitis (Housemaid’s Knee): This one occurs in front of your kneecap, just below the skin. It’s often seen in people who kneel a lot, like carpet layers or roofers. It causes pain and swelling at the front of the knee.

  2. Pes Anserine Bursitis: This bursitis develops on the inner side of your knee, nestled between the medial collateral ligament and certain knee tendons. Pes anserine bursitis is typically caused by overuse and is common among runners.

  3. Semimembranosus Bursitis (Baker’s Cyst): You’ll feel pain and swelling behind your knee, like a soft lump – that’s how it’s often described. It’s usually caused by knee injuries or arthritis and is located between a hamstring tendon and a calf muscle at the back of the knee.

  4. Infrapatellar Bursitis (Clergyman’s Knee): This one is located just below your kneecap and has two variations – the superficial one, between the skin and the patellar tendon, and the deep one, further inside, cushioning the patellar tendon from the shin bone. Swelling in either area is called infrapatellar bursitis.

  5. Suprapatellar Bursitis: You can expect discomfort and swelling in the lower thigh, just above your kneecap. It occurs due to overuse from activities like running, jumping, or kneeling and is situated between the quadriceps muscle tendon and the patella.

  6. Iliotibial Bursitis: This one is on the outer side of your knee, located between the iliotibial band and the outer shin bone, below the knee. It’s often confused with iliotibial band syndrome because it can cause inflammation in that area.

What Causes Knee Bursitis?

Knee bursitis usually starts with too much pressure on a joint. Here’s the scoop:

  1. Pressure Build-Up: The most common cause of bursitis is constant pressure on a joint. Each year, about 1 in 10,000 people deal with it in their knees or elbows.

  2. Excessive Kneeling: Many cases of knee bursitis come from lots of kneeling during activities. That’s why it’s often called “housemaid’s knee” – back when maids spent hours on their knees working.

  3. Occupational Risks: Some jobs put you at higher risk, like carpenters, tile installers, roofers, and gardeners – they’re more likely to get knee bursitis. Surprisingly, sitting at a computer for long periods can also increase your bursitis risk, according to 2018 research.

Other Possible Causes Include:

  • Direct Hits: Sometimes, a direct blow to the knee can trigger bursitis.

  • Bacterial Infection: Bursitis can also happen due to a bacterial infection.

  • Arthritis or Gout: If you have arthritis or gout, bursitis might show up as a complication.

So, it often boils down to pressure – whether from your job or other factors – that can lead to knee bursitis.

Knee Bursitis Symptoms

Symptoms of knee bursitis can vary depending on which bursa is affected and what’s causing the inflammation. Here’s what you might experience:

  1. Warmth, Tenderness, and Swelling: The area of your knee with bursitis might feel warm to the touch, tender when pressed, and visibly swollen.

  2. Pain: You may feel pain when you move your knee or even when you’re not moving at all. It’s not a pleasant sensation.

If you’ve had a direct blow to your knee, these symptoms may appear quickly. However, in most cases of knee bursitis, the discomfort arises from ongoing friction and irritation of the bursa. This often occurs in jobs that require frequent kneeling on hard surfaces. As a result, the symptoms tend to develop gradually and can worsen over time.

How Doctors Diagnose Knee Bursitis

Diagnosing knee bursitis usually starts with a visit to a medical professional, like an orthopedic surgeon or a sports medicine specialist. Here’s how they figure it out:

  1. Asking Questions: They’ll have a conversation with you about your medical history. They’ll want to know if your job or activities might be causing knee problems, how long you’ve been experiencing symptoms, and if you’ve had any direct injuries. They’ll also inquire about repetitive movements and if you’ve had any systemic symptoms like fevers and chills, which could indicate a bacterial infection in your knee.

  2. Hands-On Examination: Next, they’ll closely examine your knee. They’re looking for signs of knee bursitis, such as swelling above, in front of, or below your kneecap, and near the inner side of your knee. They’ll also check for any swelling inside your knee joint, which could suggest a knee joint infection called septic arthritis.

So, it’s a combination of conversation and physical examination to determine what’s happening with your knee.

Knee Bursitis Treatment

Coping with knee bursitis pain, tenderness, and swelling can be tough. To find the right treatment, it depends on what’s causing your knee issues. Each knee has a sac filled with fluid, and sometimes these sacs get inflamed or infected. Here’s what to do:

For Inflamed Bursa:

  1. Rest: Take it easy for a few days. Avoid activities that make it worse, but you can still do gentle exercises like an easy walk or using a stationary bike.

  2. Ice: Apply an ice pack to your knee 3 to 4 times a day, or you can use a bag of frozen veggies. Keep it on for about 20 minutes each time.

  3. Medication: Think about taking over-the-counter anti-inflammatory drugs like ibuprofen or naproxen sodium.

  4. Elevate: Raise your sore knee when resting to reduce swelling. When sleeping, don’t lie on the side with the bad knee. If you sleep on your side, put a pillow between your knees to ease pressure on the sore joint.

For Stronger Treatment:

  1. Aspiration: Your doctor might use a needle to drain fluid from your knee in their office. This helps with swelling, but it might be a bit uncomfortable for a few days. You’ll wear a knee wrap to control swelling.

  2. Steroid Injection: Your doctor might give you a steroid shot directly into the swollen knee to quickly reduce inflammation. It can cause some pain and swelling in the knee for a few days.

  3. Physical Therapy: Your doctor might send you to a physical therapist who will teach you exercises and stretches to strengthen your knee and make it more flexible. You might also get a knee brace or sleeve for added support and to control swelling.

For Infected Bursa:

If there are signs of infection, your doctor will prescribe antibiotics. If antibiotics don’t work, they might use a needle to drain the infected fluid.

When Nothing Else Works:

If bursitis doesn’t get better with treatment or keeps coming back, surgery to remove the bursa may be an option. This is usually the last resort, and you and your doctor will discuss if it’s the right choice for you.

Preventing Knee Bursitis

You can avoid knee bursitis with these easy steps:

  1. Protect Your Knees: If you play sports, do chores, or anything that strains your knees, wear knee pads or supports. It’s like giving your knees a comfy cushion.

  2. Take Breaks: Don’t overdo it. Give your knees a rest now and then. Stretching helps keep them flexible. If one type of exercise hurts, try something gentler. After any activity, use ice to soothe your joints.

  3. Sit, Don’t Squat: When gardening, sit on a stool instead of squatting. It reduces knee pressure.

  4. Watch Your Weight: Maintaining a healthy weight is crucial. Extra pounds put more stress on your knees, which can worsen joint issues.

By following these tips, you’ll be on your way to keeping your knees happy and free from bursitis.

Tips for Easing Knee Bursitis Discomfort at Home

Here are some easy steps to help relieve the pain and discomfort of knee bursitis:

  1. Rest Your Knee: Stop the activity that triggered your knee bursitis and avoid movements that worsen the pain. Rest is crucial for recovery.

  2. Over-the-Counter Pain Relief: Consider using over-the-counter pain relievers like aspirin, ibuprofen (Advil, Motrin IB), or naproxen sodium (Aleve) for short-term pain relief. They can help reduce discomfort.

  3. Apply Ice: Use an ice pack on your knee for about 20 minutes at a time, multiple times a day. Continue until the pain lessens, and your knee is no longer warm to the touch.

  4. Use Compression: You can use a compressive wrap or a knee sleeve to reduce swelling around your knee, providing some relief.

  5. Elevate Your Knee: Raise your affected leg with pillows to decrease knee swelling. It’s a simple yet effective way to feel better.

By following these tips, you can make living with knee bursitis more comfortable while you recover.

FAQs about Knee Bursitis

1. Can I Walk with Knee Bursitis?

Yes, you can walk with knee bursitis, but it’s best to take it easy and avoid excessive movement when it’s in the acute stage until your symptoms improve.

2. What Triggers Flare-Ups of Knee Bursitis?

Flare-ups can occur for various reasons, including repetitive knee pressure, a direct knee injury, a bacterial infection, or underlying inflammatory conditions like gout or rheumatoid arthritis.

3. What Does Knee Bursitis Feel Like?

Knee bursitis typically causes pain in and around the knee joint, especially during movement. You may also notice warmth and tenderness in the affected area. If there’s a bacterial infection, you might develop a fever.

4. Does Knee Bursitis Ever Go Away?

Most people with bursitis can expect a positive outcome. With adequate rest, bursitis should heal within a few weeks. However, if you experience recurring flare-ups that don’t seem to resolve, it’s advisable to seek medical treatment.

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