Knee bursitis is inflammation of a bursa located near your knee joint.
A bursa is a small fluid-filled, pad-like sac located near your joints. It reduces friction and cushions the pressure between your bones and tendons.
There are 11 bursae in each knee. The most common bursa to become inflammed are the ones located over the kneecap.
Symptoms
The main symptoms you may experience in your knee include:
- A hot knee
- A swollen appearance that occurs quickly
- A painful knee, especially when moved or when pressure is put on it
When to see your doctor
The bursa that lies over your kneecap can sometimes become infected. Call your doctor if you have a fever in addition to pain and swelling in your knee.
Causes
It can result from:
- A direct force to your knee
- Frequent falls on your knee
- Too much kneeling
- Bacterial infection of the bursa
- Existing osteoarthritis, rheumatoid arthritis or gout in your knee
Risk Factors
You can be at increased risk of developing knee bursitis due to:
- Excessive kneeling – People who work on their knees a lot of the time, like gardeners and plumbers, are at increased risk of knee bursitis. Some common nicknames for this condition include Housemaid’s knee and Vicar’s or preacher’s knee.
- Obesity and osteoarthritis – Often obese women with osteoarthritis are more likely to develop knee bursitis
- Certain sports – Those that involve a lot of falling, especially on the knee. These include volleyball and wrestling
- Impaired immune system – If you’re immune system is weak either due to disease or medications, you can have a greater risk of infectious (septic) knee bursitis. Some conditions include cancer, HIV, diabetes and systemic lupus erythematosis (SLE)
Investigations
Usually your doctor can diagnose Knee Bursitis without any imaging. However, tests may be done to rule out other conditions.
Imaging tests
These tests may be ordered for you
- X-ray – This can’t be used to look at bursa but can detect a fracture, tumour or arthritis.
- Magnetic resonance imaging (MRI) – This can be used to look at the soft tissue in your knee (eg ligaments, tendons)
- Ultrasound – This can be used to visualize swelling in your knee
Aspiration
This can be done if your doctor believes you may have an infection or gout in the bursa. Your doctor will use a needle to drain some fluid for testing.
Complications
There is a very small chance that an inflamed bursa can become infected. Infection of the bursa is quite rare but it is an important complication that can arise. If you have an infected bursa you may experience redness, swelling, pain and heat in the area. If this occurs you need to contact your doctor immediately.
Complications of traumatic bursitis can include repeated irritation or injury, and persistent pain.
Treatment
There are a few options for treatment. The first steps include:
- Resting your knee
- Applying ice
- Applying compression
- Elevating your knee
Some active treatments consist of the following.
Medications
- Corticosteroid injection – This can be injected directly into the affected site to reduce inflammation.
- Antibiotics – The doctor may prescribe you antibiotics if infection is suspected.
Allied Health
- Aspiration – Your doctor may directly drain the bursa with a needle and syringe to reduce excess fluid and treat inflammation.
- Physiotherapy – You may be referred to a physiotherapist to have some exercise therapy which may alleviate pain and reduce your risk of having recurring episodes of knee bursitis.
Surgery
This option may be chosen if you have severe chronic bursitis which hasn’t responded to other treatments. This involves surgically removing your bursa.
Seeking Advice
Your Family Doctor (GP)
Your Family Doctor will be able to diagnose and help treat your problem. He or she will be able to
- tell you about your problem
- advise you of the best treatment methods
- prescribe you medications
- and if necessary, refer you to Specialists (Consultants) for further treatment
While you may initially consult your family doctor (GP), he or she may refer you to a rheumatologist — a doctor who specializes in arthritis and other joint disorders — or an orthopaedic surgeon.
Bring along information about yourself
It can be a great help for your doctor if you bring along the following information about yourself
- A list of your medications, including the name and dosage.
- Information about your medical problems and past treatment
- Previous investigation results, such as xrays and blood tests.
Prepare a list of questions for your doctor
You may want to write a list that includes:
- Detailed descriptions of your symptoms
- Information about medical problems you’ve had
- Information about the medical problems of your parents or siblings
- All the medications and dietary supplements you take
- Questions you want to ask the doctor
What to expect from your doctor
Your doctor will conduct an examination to determine the cause of knee pain. He or she may begin with questions that can help distinguish bursitis from other disorders:
- When did your pain begin?
- Did it begin suddenly or gradually?
- What kind of work or recreational activities do you do that may affect your knees?
- Does your pain occur or worsen when doing certain activities, such as kneeling or climbing stairs?
- Have you recently fallen, been in an accident or suffered a blow to your knee?
- What kind of treatments have you tried at home?
- What effect did those treatments have?
Your doctor will inspect your knee by:
- Comparing the condition of both knees, particularly if only one is painful
- Gently pressing on different areas of your knee to detect warmth, swelling and the source of pain
- Carefully moving your legs and knees into different positions to determine the range of motion in your knee joint and identify movement associated with pain
Prevention
You can take a number of steps to avoid knee bursitis or prevent its recurrence:
- If you are in a job where you kneel a lot, try to take breaks and give your knees a rest.
- You can wear protective gear if you’re working on your knees or participating in sports that put your knees at risk. These include knee pads which provide adequate cushioning for your knee.
- You can also put ice on your knees and elevate your legs after a workout as this can help prevent the occurrence of bursitis.
F.A.Q. | Frequently Asked Questions
I’m not sure if I have bursitis or not, when should I go see my doctor?
If you are not coping well at home with at home treatment you should see your doctor. You should always contact your doctor is the pain is disabling or if it last more than 10 consecutive days.
After treatment what should I expect?
This condition usually responds well to treatment. Athletes may have to continue a program of stretching and muscle training. Protective gear for the knee may be needed for those who do contact sports, nevertheless, in most cases, symptoms are gone and no longer aggravated by certain activities.