Knee Bursitis

Knee bursitis is a condition that causes pain, swelling, and tenderness around the knee joint due to inflammation of the bursae. Bursae are small, fluid-filled sacs that act as cushions between bones, tendons, muscles, and skin. When these sacs become irritated or inflamed, movement can become uncomfortable, and daily activities may be affected.

Knee bursitis is often seen in individuals who perform repetitive kneeling movements, engage in sports, or experience direct trauma to the knee. While it can be painful, early diagnosis and appropriate management can help most patients recover without long-term complications.

Understanding Knee Bursitis

There are multiple bursae in and around the knee joint. These sacs reduce friction and allow smooth movement of tendons and muscles over the bones. When one or more bursae become inflamed, the condition is called bursitis.

The knee contains several important bursae, but the most commonly affected are:

• Prepatellar bursa: Located in front of the kneecap, often inflamed due to frequent kneeling (commonly called housemaid’s knee).
• Infrapatellar bursa: Found just below the kneecap, often affected in athletes or workers who kneel frequently.
• Pes anserine bursa: Located on the inner side of the knee below the joint line, commonly inflamed in people with tight hamstrings, obesity, or arthritis.

Causes and Risk Factors of Knee Bursitis

Knee bursitis can develop from a variety of causes. Understanding these risk factors can help with prevention and treatment.

• Repetitive kneeling: Common among gardeners, plumbers, and athletes who put repeated pressure on the knees.
• Direct trauma: A blow or fall onto the knee can irritate the bursae.
• Overuse injuries: Activities involving frequent running, jumping, or squatting can contribute to bursitis.
• Pre-existing joint conditions: Osteoarthritis, rheumatoid arthritis, or gout increase the risk of bursitis.
• Infection: A cut or scrape near the knee can introduce bacteria, leading to septic bursitis.
• Muscle imbalance or tightness: Weak or tight muscles around the knee can increase stress on the joint.

Common Symptoms of Knee Bursitis

The severity of knee bursitis symptoms can vary depending on which bursa is affected and whether the inflammation is caused by infection. The most common symptoms include:

• Swelling or puffiness around the knee
• Pain and tenderness at the site of the affected bursa
• Warmth or redness over the skin in cases of infection
• Stiffness or discomfort when moving the knee
• Worsening pain during kneeling or bending activities

If the bursitis is due to an infection, symptoms may include fever, increased redness, and more severe pain. This requires prompt medical attention.

Diagnosing Knee Bursitis

A thorough evaluation by a knee specialist is important for an accurate diagnosis. The process may include:

1. Physical examination: The doctor checks for swelling, tenderness, and range of motion.
2. Medical history: Identifying activities or injuries that may have caused the inflammation.
3. Imaging tests: X-rays or ultrasound may be ordered to rule out fractures or other joint problems.
4. Fluid aspiration: If infection is suspected, the doctor may remove some fluid from the swollen bursa to analyze it for bacteria.

Non-Surgical Treatment Options

Most cases of knee bursitis respond well to non-surgical treatments that aim to reduce pain and inflammation while promoting healing. Common approaches include:

• Rest and activity modification: Avoiding movements that aggravate the knee helps the bursa recover.
• Ice therapy: Applying ice packs for 15–20 minutes several times a day can reduce swelling and discomfort.
• Compression and elevation: Wearing a knee sleeve and elevating the leg can minimize fluid buildup.
• Medications: Over-the-counter anti-inflammatory drugs may relieve pain and swelling.
• Aspiration: In some cases, the doctor may drain excess fluid from the bursa to relieve pressure.
• Physiotherapy: Gentle stretches, strengthening exercises, and posture correction can prevent recurrence.

Knee Bursitis Surgery

Surgery for knee bursitis is rarely needed and is typically reserved for severe or persistent cases that do not respond to conservative measures. Surgical options may include:

• Bursa removal: In chronic or infected bursitis, the inflamed bursa may be removed.
• Treatment of underlying issues: If bursitis is related to bone spurs or joint deformities, these may also be addressed during surgery.

Patients usually recover well and can resume normal activities after a rehabilitation program.

Preventing Knee Bursitis

Prevention is often possible by protecting the knees and maintaining overall joint health. Tips for reducing the risk include:

• Using knee pads or cushioning during activities that require kneeling
• Maintaining a healthy weight to reduce stress on the joints
• Taking breaks during repetitive activities and avoiding prolonged kneeling
• Performing regular stretching and strengthening exercises for the legs
• Treating minor cuts and scrapes promptly to avoid infections

By adopting these strategies, individuals can lower the risk of both first-time and recurrent bursitis.

Living with Knee Bursitis

Recovery from knee bursitis is often straightforward with the right care, but patience and adherence to treatment are important. Avoiding aggravating activities, following prescribed exercises, and returning to sports or work gradually can prevent flare-ups.

For most patients, symptoms improve within a few weeks, though chronic bursitis or infections may require longer recovery periods. Regular follow-ups with a healthcare provider ensure proper healing and minimize complications.

FAQs About Knee Bursitis

How long does knee bursitis take to heal?

Most mild cases improve within two to four weeks with rest and proper care. Severe or infected bursitis may take longer and require medical intervention.

Can knee bursitis come back?

Yes, bursitis can recur if the activities that caused it are continued without protective measures. Using knee pads and modifying movements can help prevent recurrence.

How do I know if my knee bursitis is infected?

Signs of infection include warmth, redness, increased swelling, severe pain, and fever. If these symptoms appear, seek medical attention promptly.

Can I exercise with knee bursitis?

High-impact or kneeling exercises should be avoided during the acute phase. Gentle, low-impact activities like swimming or cycling may be safe once pain decreases, under guidance from a physiotherapist.

When should I see a doctor for knee bursitis?

See a doctor if pain and swelling persist for more than a week, worsen despite rest, or are accompanied by signs of infection like fever or redness.