Knee bursitis

A bursa is a small, fluid-filled sac that sits near a joint. It acts as a cushion between the bones, muscles and ligaments. It protects a joint from shock and impact.

The bursa reduces the friction between these structures and allows them to slide past one another when a joint is moved. When a bursa becomes inflamed or irritated, it is called bursitis. While bursitis will often resolve itself naturally after a couple of weeks, more severe or long-lasting cases may require treatment with a specialist. 

Inflammation of one or more of the bursae in your knee joint is referred to as knee bursitis. This medical condition can cause swelling and pain.

If you are suffering with painful or swollen knee that is affecting your mobility, it may be wise to have an assessment with an orthopaedic consultant. They will be able to accurately diagnose the cause of the problem and discuss any appropriate pain relief and treatment options for you.

Bursae can become inflamed due to infection or injury. Should this happen, the inflamed bursa will put increased pressure on nearby structures and tissues, causing pain and swelling.

Risk factors for developing bursitis in the knee include:

Age

The risk of developing knee bursitis increases with age

Kneeling

if your knees often experience pressure, from kneeling on a hard surface For example, you are more likely to develop bursitis in your knee. Certain jobs such as builder, plasterer, painter, nursery assistant and pre-school teacher can involve a lot of kneeling as part of the regular working day. People in these professions can be more prone to knee bursitis.

Impact to the knee

Although physical activity is good for improving your general health, it may increase your risk of developing knee bursitis. This is especially an issue when a direct impact to your knee is possible in some sports, such as rugby or football.

Your knee contains a number of bursae and the location of the affected bursa, as well as the degree of inflammation, will determine the exact symptoms you experience.

Common bursitis of the knee symptoms include:       

• Pain, although this will often be more of an ache than a sharp, severe pain       
• Swelling in the affected knee     
• Your knee may be unusually tender when touched or moved
• Reduced movement in the affected knee. You may also find that you have a reduced range of movement, such as finding it difficult to bend or extend your leg without making the pain worse.

Because many of the symptoms overlap with those of other conditions and injuries of the knee, it can often be a challenge to self-diagnose knee bursitis. This is where an examination with a consultant who is highly experienced in problems of the knee joint can be of particular value.

Bursitis in the knee may resolve itself naturally within a couple of weeks. However, the first course of action to treat a knee bursitis is to tackle the pain. This can be done with over-the-counter pain medication. Nonsteroidal anti-inflammatory drugs (NSAIDs) can help treat knee pain relief.

Then next step is treat the knee bursitis causes. So if the pain is aggravated during sport then it is best to cease that particular activity while you allow the bursa to heal itself.

However, if the bursitis is causing long-term or severe pain and you are also experiencing a loss of movement in your knee, then a range of treatments are available. These include:

Rest

Often, the best thing you can do to aid recovery from knee bursitis is to rest the affected knee for a period of time. This helps to reduce the risk of additional strain, aggravation or injury to the joint. While some walking is good for knee bursitis as a form of exercise, if the symptoms are aggravated then you should limit the amount of walking that you do.

Ice

Placing a cold ice pack on the affected knee can sometimes help to reduce any swelling and knee pain bursitis.

Bursitis knee brace

Wearing a knee brace for bursitis will help apply warmth and compression to the area which can help relieve pain and provide stability.

Physiotherapy

Your consultant may recommend that you see a physical therapist to help you in your recovery. A physiotherapist will also be able to show you mobility and strengthening exercises to help improve your flexibility. Knee bursitis exercises will help to increase the range of motion in the affected knee without aggravating the condition.

Aspiration and steroid injection

Aspiration is used to take the bursa fluid out of a swollen joint, while steroid injections aim to reduce pain and inflammation. These methods can be used provided it is clear that the bursitis is infective in its origin.

Surgery

While fairly uncommon, there are times when surgery may be required to drain an infected (septic) bursitis of the knee. Even more rarely, the bursa will need to be removed completely. Should any bursitis knee infection require surgery, this will be explained in detail by your consultant. You will have the chance to ask them any questions you may have about the procedure and your recovery from the surgery.