What is Knee Bursitis? Symptoms, Causes, & Treatment

Knee bursitis happens when the small fluid-filled sacs around your knee joint become swollen and irritated. These tiny cushions, called bursae, normally help your knee move smoothly by reducing friction between bones, tendons, and muscles. When they get inflamed, you might notice pain, swelling, and stiffness that can make everyday activities uncomfortable.

What is knee bursitis?

Knee bursitis is inflammation of one or more bursae in your knee area. Think of bursae as nature's shock absorbers - they're small, slippery pouches filled with fluid that sit between your bones and soft tissues. Your knee has several of these protective cushions, and when they become irritated or inflamed, the condition is called bursitis.

The most commonly affected bursa is the prepatellar bursa, which sits right in front of your kneecap. You might also hear this called "housemaid's knee" or "carpet layer's knee" because it often develops from prolonged kneeling. Other bursae around your knee can also become inflamed, each causing slightly different symptoms depending on their location.

What are the symptoms of knee bursitis?

The symptoms of knee bursitis can range from mild discomfort to significant pain that affects your daily routine. Most people first notice pain and swelling around their kneecap, especially when they kneel, climb stairs, or bend their knee.

Here are the main symptoms you might experience:

• Pain and tenderness around the kneecap or other areas of the knee
• Swelling that may feel warm to the touch
• Stiffness and reduced range of motion in the knee
• Pain that worsens with kneeling, squatting, or climbing stairs
• A feeling of fullness or pressure in the knee
• Difficulty sleeping due to pain when lying on the affected side

In some cases, you might notice the swelling is quite visible, creating a noticeable bump over your kneecap. The pain often gets worse with activity and may improve with rest, though some people experience aching even when they're not moving.

What are the types of knee bursitis?

There are several types of knee bursitis, each affecting different bursae around your knee joint. The location of the inflamed bursa determines the specific type and where you'll feel the most discomfort.

The main types include prepatellar bursitis, which affects the bursa in front of your kneecap and is the most common form. Infrapatellar bursitis involves the bursa below your kneecap, often called "clergyman's knee." Pes anserine bursitis affects the inner side of your knee, about two inches below the joint line.

Less commonly, you might develop suprapatellar bursitis, which affects the bursa above your kneecap, or iliotibial band bursitis on the outer side of your knee. Each type has slightly different symptoms and may require specific treatment approaches based on the affected area.

What causes knee bursitis?

Knee bursitis develops when the bursae become irritated, inflamed, or infected due to various factors. Understanding these causes can help you recognize why your symptoms developed and how to prevent future episodes.

The most common causes include:

• Repetitive kneeling or prolonged pressure on the knee
• Direct trauma or injury to the knee area
• Overuse from activities like running, jumping, or cycling
• Bacterial infection entering through a cut or scrape
• Underlying conditions like rheumatoid arthritis or gout
• Age-related wear and tear on the joint structures

Occupational factors play a significant role too. People who work in professions requiring frequent kneeling, such as carpet installers, plumbers, or gardeners, are at higher risk. Athletes who participate in sports with repetitive knee movements or potential for knee trauma also face increased risk.

Sometimes, knee bursitis can develop without an obvious cause, particularly in older adults where general wear and tear contributes to inflammation. Certain medical conditions like diabetes or a weakened immune system can also make you more susceptible to developing bursitis.

When to see a doctor for knee bursitis?

You should see a doctor if your knee pain and swelling don't improve with rest and home care within a few days. While mild bursitis often resolves on its own, certain symptoms warrant medical attention to prevent complications and ensure proper treatment.

Seek medical care promptly if you experience fever along with knee swelling, as this could indicate an infection. Red streaks extending from the knee, excessive warmth, or pus-like drainage are also signs that require immediate attention. If your pain is severe or prevents you from bearing weight on your leg, don't delay getting professional help.

You should also consult a healthcare provider if your symptoms keep returning or if you have underlying health conditions like diabetes or rheumatoid arthritis. These conditions can complicate bursitis and may require specialized treatment approaches to prevent more serious problems.

What are the risk factors for knee bursitis?

Several factors can increase your likelihood of developing knee bursitis, though having these risk factors doesn't guarantee you'll develop the condition. Being aware of them can help you take preventive measures and recognize symptoms early.

Common risk factors include:

• Occupations requiring frequent kneeling or crawling
• Participation in sports with repetitive knee movements
• Previous knee injuries or surgeries
• Age, as bursae become less flexible over time
• Autoimmune conditions like rheumatoid arthritis
• Obesity, which increases pressure on knee joints
• Diabetes or other conditions that affect healing

Your risk also increases if you have poor knee flexibility or muscle weakness around the joint. People with a history of gout or other inflammatory conditions are more susceptible to developing bursitis. Additionally, if you've had knee bursitis before, you're more likely to experience it again.

What are the possible complications of knee bursitis?

Most cases of knee bursitis resolve without serious complications when treated appropriately. However, understanding potential complications helps you recognize when to seek additional medical care and why following treatment recommendations is important.

The most serious complication is infection of the bursa, called septic bursitis. This can occur when bacteria enter through a break in the skin or spread from another infection in your body. Signs include increasing pain, fever, red streaks from the knee, and warmth that seems excessive.

Chronic bursitis can develop if the condition isn't properly treated or if you continue activities that irritate the bursa. This leads to ongoing pain and swelling that may require more intensive treatment. In rare cases, the bursa may need to be surgically removed if it becomes severely damaged or infected.

Without proper treatment, knee bursitis can also lead to decreased mobility and muscle weakness from avoiding movement due to pain. This can create a cycle where your knee becomes stiffer and weaker, making recovery more difficult.

How can knee bursitis be prevented?

Preventing knee bursitis involves protecting your knees from excessive pressure and repetitive stress. Simple modifications to your daily activities and work habits can significantly reduce your risk of developing this condition.

If your work or hobbies require kneeling, use knee pads or cushions to distribute pressure more evenly. Take regular breaks to stand and stretch your legs, and try to alternate between kneeling and other positions when possible. When gardening or doing household tasks, consider using a small stool or kneeling pad.

Maintaining good overall knee health through regular exercise helps strengthen the muscles around your knee joint. Focus on low-impact activities that don't put excessive stress on your knees, such as swimming or cycling. If you participate in sports, make sure to warm up properly and use appropriate protective gear.

Keep any cuts or scrapes around your knees clean and covered until they heal completely. This prevents bacteria from entering and causing infection. If you have underlying health conditions like diabetes or arthritis, work with your healthcare provider to manage them effectively.

How is knee bursitis diagnosed?

Diagnosing knee bursitis typically begins with your doctor asking about your symptoms and examining your knee. They'll look for signs of swelling, tenderness, and reduced range of motion, and may ask you to move your knee in different ways to assess pain and function.

Your doctor will want to know about your recent activities, occupation, and any injuries that might have contributed to your symptoms. They'll also check for signs of infection, such as excessive warmth, redness, or fever, which can help determine the best treatment approach.

In some cases, additional tests may be needed to confirm the diagnosis or rule out other conditions. An ultrasound can show fluid accumulation in the bursa, while X-rays might be taken to check for bone problems or foreign objects. If infection is suspected, your doctor may use a needle to remove a small sample of fluid from the bursa for testing.

Blood tests aren't usually necessary for simple bursitis, but they might be ordered if your doctor suspects an underlying inflammatory condition or if you have signs of systemic infection.

What is the treatment for knee bursitis?

Treatment for knee bursitis focuses on reducing inflammation, managing pain, and addressing any underlying causes. Most cases respond well to conservative treatments, though the specific approach depends on the severity of your symptoms and whether infection is present.

Initial treatment typically includes rest, ice application, and over-the-counter anti-inflammatory medications like ibuprofen or naproxen. Your doctor may also recommend wearing a knee brace or using crutches temporarily to reduce pressure on the affected area.

For more persistent cases, your doctor might suggest a corticosteroid injection directly into the bursa to reduce inflammation quickly. Physical therapy can help improve flexibility and strengthen the muscles around your knee, which supports healing and prevents recurrence.

If the bursitis is caused by bacterial infection, antibiotic treatment will be necessary. In severe cases where the bursa is severely damaged or infected, surgical removal might be recommended, though this is relatively uncommon.

How to manage knee bursitis at home?

Home treatment plays a crucial role in managing knee bursitis and can often help resolve mild cases without needing medical intervention. The key is starting treatment early and being consistent with your care routine.

Apply ice to your knee for 15-20 minutes several times a day, especially after activities that might aggravate your symptoms. Wrap the ice in a thin towel to protect your skin. Rest is equally important - avoid activities that worsen your pain, particularly kneeling or prolonged walking.

Elevate your leg when sitting or lying down to help reduce swelling. Over-the-counter pain relievers like ibuprofen can help manage both pain and inflammation, but follow the package directions and don't exceed recommended doses.

Gentle range-of-motion exercises can help maintain flexibility as your symptoms improve. Start with simple movements like slowly bending and straightening your knee, but stop if you experience increased pain. As you feel better, gradually return to your normal activities.

How should you prepare for your doctor appointment?

Preparing for your appointment helps ensure you get the most accurate diagnosis and effective treatment plan. Take some time before your visit to organize your thoughts and gather relevant information about your symptoms.

Write down when your symptoms started, what activities might have triggered them, and how they've changed over time. Note which movements or positions make your pain worse or better, and keep track of any treatments you've already tried at home.

Bring a list of all medications you're taking, including over-the-counter drugs and supplements. If you have any underlying health conditions or previous knee injuries, make sure to mention these to your doctor. Consider bringing a family member or friend who can help you remember important information discussed during the visit.

Prepare questions you want to ask, such as how long recovery typically takes, what activities you should avoid, and when you can expect to return to normal function. Don't hesitate to ask for clarification if you don't understand something your doctor explains.

What's the key takeaway about knee bursitis?

Knee bursitis is a manageable condition that typically responds well to appropriate treatment and rest. While it can be painful and limit your activities temporarily, most people recover completely with proper care and patience.

The key to successful treatment is recognizing symptoms early and taking steps to reduce inflammation and protect your knee from further irritation. Simple measures like rest, ice, and over-the-counter medications can be very effective for mild cases.

Prevention is equally important, especially if your work or activities put you at higher risk. Using protective gear, taking regular breaks, and maintaining good knee health through exercise can help prevent future episodes. Remember that while knee bursitis can be frustrating, it's a treatable condition that doesn't typically cause long-term problems when managed appropriately.