Knee Bursitis

Overview

Knee bursitis is an inflammatory condition that affects the small fluid-filled sacs (bursae) near the knee joint. Bursae help to reduce friction and cushion the pressure points between bones, tendons, muscles, and skin. When a bursa in the knee becomes inflamed, it can cause pain and limit mobility. Knee bursitis can occur on the kneecap or on the inner side of the knee below the joint. Common symptoms include pain, swelling, and tenderness in the affected area, especially when pressure is applied.

Understanding the disease

Symptoms

The symptoms of knee bursitis may include:

• Warmth, tenderness, and swelling in the affected knee when pressure is applied
• Pain that worsens with movement or even at rest
• Stiffness in the knee joint
• Redness and inflammation around the affected area If you experience severe knee pain, difficulty moving the joint, or notice signs of infection like fever, it's important to consult a doctor.

Risk Factors

The risk factors for developing knee bursitis include prolonged kneeling, participation in certain sports that result in direct blows or frequent falls on the knee, and obesity. People who work on their knees for long periods, such as carpet layers, plumbers, and gardeners, are at increased risk. Additionally, women with osteoarthritis who are obese are more likely to develop pes anserine bursitis, which affects the inner side of the knee below the joint.

Development

Knee bursitis can develop due to several factors. Inflammation occurs in a small fluid-filled sac (bursa) situated near the knee joint. Bursae reduce friction and cushion pressure points between bones, tendons, muscles, and skin near joints. Inflammation can be caused by:

1. Frequent and sustained pressure: Prolonged kneeling on hard surfaces can lead to knee bursitis, as it puts continuous pressure on the knee joint.
2. Overuse or strenuous activity: Engaging in activities that put excessive stress on the knee joint can cause bursitis, such as running, jumping, or participating in sports like wrestling, football, and volleyball.
3. Direct blow to the knee: A sudden impact or forceful collision can cause bursitis, as it may result in injury or irritation to the bursa.
4. Bacterial infection: In some cases, bursitis can be caused by bacterial infection in the bursa, which may lead to complications if left untreated.
5. Complications from osteoarthritis, rheumatoid arthritis, or gout in the knee: Inflammatory conditions like osteoarthritis, rheumatoid arthritis, and gout can contribute to the development of knee bursitis.

Assessment and Diagnosis

Triage

You should see a doctor if knee bursitis is suspected when you experience disabling joint pain, sudden inability to move a joint, fever in addition to pain and swelling in your knee, or if the affected knee is red and warm to the touch.

Diagnosis

To diagnose knee bursitis, doctors typically rely on a medical history and physical exam. They will compare the condition of both knees, press gently on areas of your knee to detect warmth, swelling, and the source of pain, inspect the skin over the tender area for redness or other signs of infection, and carefully move your legs and knees to determine your knee's range of motion and whether it hurts to bend or flex it. Imaging tests, such as X-rays or MRIs, might be requested to rule out other causes of pain or discomfort. If necessary, blood tests or an analysis of fluid from the inflamed bursa may be ordered to pinpoint the cause of joint inflammation and pain.

Management and Treatment

Complications

Potential complications of knee bursitis may include:

1. Chronic inflammation: If left untreated, the inflammation in the bursa may persist, leading to a chronic condition.
2. Infection: In rare cases, bursitis can lead to bacterial infection, causing the bursa to fill with pus and potentially spreading to other parts of the body.
3. Tissue damage: Prolonged inflammation and irritation from knee bursitis can cause damage to the surrounding tendons, muscles, or ligaments.
4. Reduced mobility: Severe knee bursitis can limit mobility and make it difficult to perform daily activities or engage in sports.
5. Recurrent flare-ups: Bursitis can have a tendency to recur after initial treatment, especially if the underlying cause, such as repetitive motions or improper techniques, is not addressed.

Prevention

knee bursitis can be prevented through certain measures like wearing kneepads, taking regular breaks when kneeling for extended periods, avoiding excessive squatting, and maintaining a healthy weight. These steps can help reduce the risk and prevent recurrence of knee bursitis. Remember to always consult with a healthcare professional if you experience persistent or severe symptoms.

Home Remedies

There are several home remedies suggested for knee bursitis, including:

1. Rest: Avoid activities that aggravate your knee bursitis, and rest the affected knee as much as possible to help it heal.
2. Ice: Apply ice packs to the affected area for 15-20 minutes, several times a day. This can help reduce pain and inflammation.
3. Compression: Wearing a compression bandage or knee brace can help reduce swelling and provide support to the knee joint.
4. Elevation: Elevate your knee above the level of your heart to help minimize swelling.
5. Over-the-counter pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help alleviate pain and reduce inflammation.
6. Gentle stretching: Perform gentle stretches to improve flexibility and reduce stiffness in the knee joint.
7. Warm baths: Soaking in a warm bath can help relax the muscles and alleviate pain.
8. Knee pads: Wearing knee pads can help cushion and protect your knees during activities that put them at risk.
9. Exercise: Engage in low-impact exercises, such as walking, swimming, or biking, to maintain joint mobility and strengthen the muscles surrounding the knee.
10. Maintain a healthy weight: Lose any excess weight to reduce the pressure on your knee joint and minimize the risk of recurrence. Please note that if your knee bursitis is severe or persists despite home remedies, it is important to consult with a healthcare professional for proper evaluation and treatment.

Treatment

Treatment for knee bursitis typically includes a combination of self-care practices and doctor-administered treatments to alleviate pain and inflammation. Self-care practices:

1. Rest: Avoid activities that cause pain or discomfort in the affected knee.
2. Ice: Apply ice packs to the affected area for 15-20 minutes, several times a day, to reduce pain and inflammation.
3. Compression: Wearing a compression bandage can help reduce swelling.
4. Elevation: Elevate your knee above the level of your heart to help reduce swelling.
5. Pain relief: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help alleviate pain and reduce inflammation.
6. Stretching: Gentle stretching exercises can help improve mobility and reduce stiffness. Doctor-administered treatments:
7. Corticosteroid injections: These injections can help reduce pain and inflammation in the affected area.
8. Physical therapy: A physical therapist can provide exercises and tips to improve knee strength, flexibility, and mobility.
9. Ultrasound therapy: This treatment uses sound waves to promote healing and reduce pain and inflammation. In some cases, surgery may be necessary if the bursitis is severe or chronic, but this is rare. It is essential to consult with a doctor if you experience disabling joint pain or sudden inability to move a joint.

Preparing for medical consultation

To prepare for an appointment for knee bursitis, make a list that includes:

1. Detailed descriptions of your symptoms and when they began
2. Key personal information, including major stresses and your and your family's medical history
3. All medications and dietary supplements you take, including doses
4. Questions to ask the doctor For bursitis, questions to ask your doctor include: a. What is the most likely cause of my symptoms? b. Are there other possible causes? c. What tests will I need? d. What treatment do you recommend? e. Will I need to limit my activities? f. Are there self-care measures I can try? g. Are there brochures or other printed material I can have? What websites do you recommend? Remember to take a family member or friend along, if possible, to help you remember the information you're given.