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Knee Bursitis
Dr. Ambrose Yung
Knee bursitis is an inflammatory condition affecting the bursae – small, fluid-filled sacs that provide cushioning between muscles, tendons, and bones in the knee.
When one or more bursae in the knee become irritated or inflamed, the area may swell, become tender, and cause pain, especially during movement. This condition is commonly seen in those who kneel for extended periods or engage in repetitive knee movements, such as athletes and manual labourers.
Symptoms of Knee Bursitis
Knee bursitis presents with several symptoms that may vary depending on the affected bursa and the degree of inflammation. Common symptoms include:
Swelling
Swelling is often the first sign of knee bursitis, visible as a rounded bump over the knee area. The affected area may feel warm and appear slightly red, especially if inflammation is significant.
Pain or Tenderness
Pain is commonly felt at the front, inner side, or back of the knee, depending on which bursa is inflamed. The pain may worsen with movement or direct pressure, such as kneeling or bending.
Limited Range of Motion
Swelling and pain may restrict knee movement, making it difficult to fully bend or straighten the knee. Stiffness in the knee joint may also develop, particularly after extended periods of inactivity.
Causes and Risk Factors
Knee bursitis results from inflammation of the bursae around the knee, which can be triggered by several factors. Common causes include:
- Prolonged Kneeling
Frequent kneeling, especially on hard surfaces, puts pressure on the knee bursae and can lead to irritation and inflammation. Occupations such as carpentry, plumbing, and gardening are at higher risk. - Repetitive Movements
Activities involving repetitive knee motion, such as running, squatting, or jumping, can also lead to bursitis. Athletes in sports that stress the knees, like basketball or football, are more susceptible. - Direct Trauma
A direct blow or impact to the knee, such as from a fall, can cause immediate inflammation of the bursae, resulting in pain and swelling. - Infection
In some cases, bursitis can occur due to infection, particularly if there is an open wound near the knee. This form of bursitis, called septic bursitis, requires immediate medical treatment.
Types of Knee Bursitis
Knee bursitis is classified based on which bursa is affected, as this determines the location and severity of symptoms.
Prepatellar Bursitis
Inflammation of the bursa located at the front of the knee, over the kneecap. This type commonly results from frequent kneeling or direct trauma and often leads to visible swelling.
Infrapatellar Bursitis
Affects the bursa located just below the kneecap, typically due to repetitive jumping or running. Pain is usually localised beneath the kneecap.
Pes Anserine Bursitis
Inflammation of the bursa on the inner side of the knee typically occurs in people who engage in activities that stress this area, such as running or stair climbing.
Suprapatellar Bursitis
Affects the bursa above the kneecap, often due to prolonged or repetitive knee movements. Pain and swelling occur at the top of the knee.
Diagnosis of Knee Bursitis
Diagnosing knee bursitis involves a physical examination and may include imaging tests or fluid analysis to confirm inflammation and rule out other conditions.
- Physical Examination: The doctor will examine the knee, checking for swelling, warmth, tenderness, and restricted movement. They may also ask about recent activities or injuries to identify possible causes of the inflammation.
- Imaging Tests: Imaging tests used to diagnose knee bursitis include X-rays, which help rule out fractures or arthritis that may be contributing to knee pain. Ultrasound can detect fluid build-up and provide a real-time view of the inflamed bursa, helping assess the extent of inflammation. MRI is used in more complex cases, offering detailed images of the soft tissues around the knee to aid in a comprehensive diagnosis.
- Fluid Analysis: In cases where infection is suspected, a sample of fluid may be taken from the bursa to check for bacteria or other infectious agents. This test helps diagnose septic bursitis, which requires prompt treatment.
Treatment Options for Knee Bursitis
Non-Surgical Treatment
Treatment for knee bursitis typically begins with non-surgical approaches to reduce inflammation and relieve symptoms.
Rest and Activity Modification
Reducing activities that place strain on the knee or avoiding high-impact exercises can help minimise irritation and give the inflamed bursa time to heal. Temporary changes to daily routines, such as avoiding prolonged standing or repetitive knee movements, are often necessary to aid recovery and prevent further aggravation.
Ice Therapy
Applying ice packs to the affected knee for 15-20 minutes at a time, several times a day can help decrease swelling and relieve pain. This method numbs the affected area and reduces inflammation, making it effective for treating acute symptoms.
Physical Therapy
A tailored physical therapy programme may be required for long-term relief and prevention of knee bursitis. Strengthening the muscles surrounding the knee joint provides better support, which reduces strain on the bursa. Therapy often includes exercises to improve flexibility and stability, ensuring the knee remains well-balanced and less prone to further injury.
Medication
Nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen, are commonly used to manage pain and reduce inflammation. They offer a practical solution for temporary symptom relief, especially when combined with other conservative treatment methods.
Corticosteroid Injections
Corticosteroid injections may be administered for persistent pain. They deliver anti-inflammatory medication directly to the affected bursa, providing temporary relief from pain and swelling. However, repeated use is limited due to potential tissue weakening.
Surgical Treatment
When symptoms persist despite non-surgical treatment, surgery may be necessary. These include:
Bursa Drainage
Bursa drainage (aspiration), is a procedure used to relieve pain and swelling by removing excess fluid from the inflamed bursa. A needle is inserted into the affected bursa to draw out the fluid, which often provides immediate symptom relief. Ultrasound guidance is commonly used to ensure the needle is accurately placed and to minimise the risk of complications. The fluid collected may be analysed for signs of infection or other underlying conditions.
Bursa Removal
Bursa removal (bursectomy) is a surgical procedure for chronic or recurrent bursitis. It involves removing the inflamed bursa, which helps eliminate pain and prevent future inflammation. It is often performed arthroscopically, using small incisions and specialised instruments. This minimally invasive approach typically results in less pain, fewer complications, and a shorter recovery period, with physical therapy often needed afterwards.
Preventing Knee Bursitis
Preventing knee bursitis involves making adjustments to reduce stress on the knee joint, especially for those regularly engaged in activities that put pressure on the knees.
Using knee pads can minimise direct pressure on the bursae, while taking breaks during knee-straining activities helps alleviate continuous pressure.
Regular exercise to strengthen the muscles around the knee improves joint stability and stretching or warming up before physical activity reduces the risk of irritation.
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Singapore 258499
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Singapore 329565
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Frequently Asked Questions (FAQ)
Is knee bursitis a serious condition?
Knee bursitis is not usually serious but can cause significant discomfort and restrict movement. If left untreated, it may lead to chronic pain or, in rare cases, develop into an infection that requires prompt medical attention.
Can knee bursitis heal without treatment?
Yes, mild cases of knee bursitis can improve on their own with rest and reduced activity. However, more persistent or severe cases often require medical intervention to fully resolve.
What is the recovery time for knee bursitis surgery?
Recovery from knee bursitis surgery, such as bursa drainage, typically takes about 2 to 3 weeks. For more extensive procedures like arthroscopic bursectomy, recovery may take around 4 to 6 weeks. Full recovery times can vary depending on individual healing rates and often include physical therapy to regain strength and mobility.