Knee Bursitis

Knee bursitis, as the name suggests, refers to inflammation (painful swelling) of a bursa located near your knee joint. A bursa is a small fluid-filled, pad-like sac that acts as cushion thereby minimizing friction between pressure points at your bones, tendons, and muscles near your joints.

There are 11 bursae in each knee and any one of these can become inflamed. The most common bursitis occurs over the kneecap or on the inner side of your knee below the joint.

Knee bursitis is painful and can reduce your mobility. Self-care practices coupled with the doctor- administered treatments for pain alleviation and inflammation reduction from the major treatment strategy.

The extent of sign and symptoms of knee bursitis are dependent upon the bursa affected and the exact cause of inflammation. You may feel warmth, tenderness and swelling at the affected part of the knee upon application of pressure.

The pain can be precipitated even at rest or with slight movement. These symptoms appear rapidly when the knee receives a sharp blow. However, most bursitis cases worsen gradually over time and are a result of repetitive injuries like those caused due to long hours of kneeling.

The common causes of Knee Bursitis are:

• Repetitive and sustained pressure, such as from long hours of kneeling.
• A direct powerful impact to your knee.
• Bacterial infections of the bursa.
• Complications arising due to other conditions like osteoarthritis, rheumatoid arthritis or gout in your knee.

Doctors often can make a diagnosis of knee bursitis during a physical exam.

Your family physician, after an initial examination, may refer you to a rheumatologist - a doctor who specializes in arthritis and other joint disorders or an orthopedic surgeon.

What you can do? Make a list of all the information related to the condition which includes:

• Details of the symptoms.
• History of other health problems.
• Medical problems of your parents or siblings.
• Any medications and dietary supplements you are currently taking.

Questions you want to ask the doctor:

• Make a list of basic questions ask your doctor like:
• What could be the most probable cause of my symptoms?
• Any other possible causes?
• Do I need to have any test done?
• Any recommendation for a specific treatment approach?
• Any restriction on my activities?
• Are self-care measures helpful?
• Do you have any informational brochures I can take home with me?
• Any advice for websites to search related information?

What to expect from your doctor? After an initial examination, your doctor might ask you following questions to differentiate bursitis from other similar disorders.

• When did your pain start?
• Was it sudden or gradual?
• Do you think your work or recreational activities may affect your knees?
• Do activities like kneeling or climbing stairs precipitate or worsen your pain?
• Any event of fall, accident or blow to your knee?
• Did you try any homecare treatment?
• Was that treatment helpful?

Doctors often diagnose knee bursitis through physical examination. Your doctor will inspect both knees and apply gentle pressure to detect warmth, swelling and area of tenderness. In addition, your doctor determines a range of motion of the knees to identify the movement that causes pain.

You might have to go through various imaging tests like X-ray, Ultrasound and MRI to rule out the conditions that produce a similar set of symptoms. In cases when infection or gout is suspected, your doctor will go for aspiration to obtain the sample of bursa fluid.

Your doctor may recommend one or more treatment approaches for knee bursitis:

• Medications: Your doctor will prescribe a course of antibiotic if an infection is the cause of bursitis.
• Therapy: A physical therapist or specialist in sports medicine can train you for exercises that improve flexibility and strengthen muscles thereby alleviating pain and reducing your risk of recurring knee bursitis.
• Surgical and other procedures: Corticosteroid injection for persistent bursitis is recommended when the condition is not responsive to other treatments.
• Aspiration: Your doctor will insert a needle directly into the affected bursa and draw fluid into the syringe to reduce excess fluid and treat inflammation. Like corticosteroid injection, aspiration may cause acute pain and swelling. You may be recommended to wear a knee immobilizer for a short period after the injection to reduce the chance of recurrent swelling.
• Surgery: For severe chronic bursitis that doesn't respond to treatments above, your doctor may recommend surgical removal of the bursa.

Follow these tips to prevent knee bursitis or its recurrence:

• Wear kneepads: When working on your knees or participating in sports that risk your knees, use padding for cushion and protection.
• Take breaks: Stretch your legs and give your knees a rest when your knees are constantly under pressure for an extended period of time.
• Avoid excessive squatting to prevent excessively or repetitious bending of your knees.

Here are some tips to cope with knee bursitis:

• Ease pain and discomfort of knee bursitis with RICE.
• R-Rest your knee: Give your knees a rest at regular intervals.
• I-Ice: Apply an ice pack to your knee for 20 minutes at a time several times a day until the pain subsides and your knee no longer feels warm to the touch.
• C-Compression: Use a compressive wrap or knee sleeve to reduce swelling.
• E-Elevation: Elevate your knee by propping up your legs on pillows to reduce swelling.

The major risk factors for developing knee bursitis are:

• Excessive kneeling: Works that require kneeling for long periods of time like those of carpet layers, plumbers and gardeners increase the risk of developing knee bursitis.
• Participation in certain sports: Sports like wrestling, football and volleyball contribute to bursitis as the players are more likely to fall or receive blows on their knees. Likewise, runners may develop pain and inflammation in the anserine bursa, located on the inner side of your knee below the joint.
• Obesity and osteoarthritis: Being obese or overweight puts more pressure on the knees which can cause inflammation of anserine bursitis, affecting the inner side of your knee below the joint.