Otherwise known as knee effusion, water or fluid on your knees is a clear sign that something isn’t right. Moreover, there are several things that can cause this, such as arthritis and injuries, and how to get rid of fluid on the knee may depend on the underlying cause.
So, today, allow me to show you a few treatments and options, along with why you might want to go a certain route.
But, just so I’m sure we’re on the same page, let’s get our definitions straight.
Water on the Knee (Joint Effusion): What Is It?
First of all, you need to understand the basic anatomy of your knee.
It’s a synovial joint which means it allows a lot of movement. This degree of movement is made possible largely because of fluid within and around the bones (i.e. your shin bone, your thigh bone, your kneecap) and other soft tissue that make up your knee.
The synovial fluid in the knee basically reduces friction between the joint’s moving parts, similar to how gear oil helps your car to run smoother. It’s also what most people consider “water on the knee”.
So, if you’ve ever wondered, “is it bad if you have fluid in your knee?”
No, it’s not. Having fluid in the knee joint is actually normal. But, also like gear oil, the problem begins when you have too little or too much.
In this case, excess fluid in the knee is essentially what joint effusion is.
Research from the Journal of The Royal Society of Medicine says that knee effusion is more common than in any other joint because of 2 connected reasons:
- You bear weight on it, but
- Your knee joint isn’t as congruent as your other weight-bearing joints (i.e. your hips and ankles)
Soft tissues such as the menisci right in the middle of the joint, as well as the ligaments and joint capsule that tie them all together, make up for the incongruency.
That being said, you can basically group effusions into 2 kinds:
Small and large.
According to a study, small joint effusions don’t show any symptoms, can happen to anyone, and typically resolve on their own.
Large effusions, on the other hand, are what you have to watch out for (and are also what people typically refer to when they say they have a swollen knee) because they’re clear giveaways that something is wrong, which brings us to the next part of our discussion.
What causes knee effusion?
There are basically 2 things:
- Injury, and/or
If you break them down, however, a number of conditions come up. Here are a few examples:
Injuries that may lead to knee swelling
- Sprains (when there’s damage to your ligaments)
- Strains (when there’s damage to your tendons)
- Meniscal tears
- Overuse injuries
Diseases associated with knee swelling
- Rheumatoid arthritis
Needless to say, the gravity of some of these conditions is worse than others. For instance, malignant tumors are far worse than mild sprains, osteoarthritis is a localized issue whereas rheumatoid arthritis involves your entire immune system, and so on and so forth.
Now that we’ve got the basics covered, let’s move on to why you’re really here.
How to Reduce Fluid on the Knee
These range from simple home remedies and over-the-counter medication to more serious procedures like joint aspiration and surgery. Let’s talk about them.
As the University of Michigan says (and pretty much every other reputable source will tell you), the RICE method is used as soon as possible after injuries, most notably sprains and strains but arthritis sufferers and those who just underwent knee surgeries can also benefit from this method.
RICE is an acronym for:
- Rest. This is to prevent any more injuries but also so you have the time and opportunity to start the healing process.
- Ice. This slows down circulation to your knee, reducing inflammation. Also, the coolness helps numb the joint which, in turn, decreases pain. Do this for 15-20 minutes several times a day for the first 2-3 days.
- Compression. This helps channel fluids away from the knee, reducing inflammation. You can use elastic bandages (using the spiral wrapping method) or sleeves. Take the compression off when you’re icing your injury and when you sleep at night.
- Elevation. Ice, compression, and elevation all have the same goal which is to help guide fluids away from the site of injury, reducing swelling. Only, specifically for elevation, gravity is the one doing the work by means of making sure your knee rests higher than your heart.
Effleurage, deep strokes, and lymphatic drainage are the most commonly used massage techniques used to treat knee swelling.
They all sound complicated but, really, all they do is help drive excess fluid away from your knee. Effleurage, in particular, is gentle and easy, making it great for treating painful new injuries or arthritis flare-ups at home.
Now, just a disclaimer before we proceed: I’m not a professional massage therapist but I do have some training on effleurage as a physical therapist. If you’re uncomfortable doing this at home, it’s best you contact a therapist you trust.
That being said, here’s what I’d do:
- I sit on my bed with my swollen knee straight in front of me. The couch or the floor should work fine, too.
- I roll up a towel or blanket and put it right under my knee. This puts a slight bend on my joint which, in turn, also puts my leg in a more relaxed position.
- I then take a good amount of massage lube and rub it all over my palms and fingers. I personally prefer using massage oils but lotion and other lubes you have at home should work okay.
- I place either of my hands on my lower leg, making sure that my palm and/or my fingers are in contact with my skin.
- I then slowly glide my hands upwards, applying enough pressure that I feel is tolerable.
- Without breaking contact, I glide my hands back down below my knee, making sure not to apply any pressure.
- Repeat steps 5-6. Make sure to work the entire knee.
Basically, isometric (or setting) exercises are when you contract a muscle without actually moving your joint.
This accomplishes 2 important things:
- First, it helps prevent your muscles from getting weaker while you rest. This is important because you want to come out of the swelling just as, if not stronger than before it happened.
- Second, and perhaps more importantly to our discussion, the Journal of Physiological Anthropology says that isometric exercises can promote blood flow which, in turn, helps prevent fluid from pooling around your knee.
Here are a couple of easy isometric exercises you can do on your own:
As the name implies, this works your quadriceps muscle, or the muscle right in front of your thigh. It’s the muscle responsible for straightening your knee.
- Sit on your bed or couch with your knee straight in front of you.
- Place a rolled towel or blanket right underneath your knee. This puts your knee at a slight bend and also gives you a target and a cushion.
- Press your knee down towards the rolled towel. Hold the contraction for 3 seconds then relax.
- Repeat the 3rd step 10 times. Remember to breathe through every repetition and never hold your breath.
This works, well… your hamstrings. Or, the huge slab of muscle right under your thighs (and below your butt). It’s also the main muscle responsible for bending your knee.
- Sit on your bed or couch with your knee in front of you.
- Bend your knee to about 30-45 degrees.
- Press your heel straight down. Hold the contraction for 3 seconds then relax.
- Repeat the previous step 10 times. Again, breathe through every repetition and never hold your breath.
P.S.: Holding your breath while you do isometric exercises may cause your blood pressure to spike up and you don’t want that. So, again: Breathe.
If home remedies didn’t work, then it might be best to visit your physical therapist (PT).
That being said, your PT should know how to get rid of fluid on the knee naturally. The methods we just talked about can and likely will be a part of your program but they might also use other modalities, tools, techniques, exercises, and stretches to improve your range of motion.
These will not only help reduce pain and swelling but also get you ready for when you return to your normal life.
OTC pain relievers, NSAIDs, and topical salicylates
Over-the-counter medications (OTC meds) are also options. You can buy them virtually anywhere without needing a doctor’s prescription and come in various brands and types.
Per MedlinePlus, there are 2 main types of oral OTC pain relievers you can buy:
- Acetaminophen (otherwise known as paracetamol), and
- NSAIDs (NonSteroidal Anti-Inflammatory Drugs)
Acetaminophen has no anti-inflammatory properties but it does help you manage the pain. Popular examples include Tylenol and Panadol.
NSAIDs, on the other hand, have anti-inflammatory properties as well as pain-relieving properties. Examples include Advil, Aleve, Celebrex, and several others.
Apart from oral medication, you could also get topical salicylates.
Topical salicylates are technically still considered NSAIDs, so they can also help reduce pain and swelling.
For those of you whose stomachs don’t react well to oral NSAIDs, these topical alternatives may be the better option.
However, Harvard says that topical NSAIDs aren’t as effective as their oral counterparts because your body absorbs less of the medicine. So, you might not feel the same exact relief. Also, don’t apply these on wounds or rashes.
If OTC drugs don’t work, then perhaps ones that you can’t get without a prescription from your doctor will.
Just to give you a bit more perspective, though, the OTC meds I just talked about can also be described by your physician. However, the “doctor-prescribed medications” I’m referring to here are generally stronger and more specific to your condition.
That being said, you’re looking at corticosteroids and antibiotics.
According to the NHS, corticosteroids (or steroids) are man-made hormones that can fight off inflammation and suppress the immune system.
Consequently, your doctor may prescribe this if the cause of the swelling and pain around the joint is because you lack certain hormones or if your immune system is attacking your own body. Examples of these conditions include rheumatoid arthritis and Addison’s disease.
Steroids can also be administered in various ways, including:
- Orally (through tablets)
- Parenterally (through injections)
- Respiratory (through inhalers), or
- Topically (through the skin)
In any case, always – and I mean always – stay within the prescribed dose as long-term use of corticosteroids can come with significant side effects.
Per the NHS definition, antibiotics are used to treat bacterial infections and don’t work on viruses. However, I don’t believe that trustworthy health practitioners will prescribe antibiotics for any and all bacterial infections.
They will only give these to you under the following conditions:
- If the infection can spread to other people
- If the infection is taking too long to heal
- If they know your body can’t clear the bacteria on its own, or
- If there can be serious implications if they don’t
With that said, these infections can develop into infectious arthritis (also known as bacterial or septic arthritis) and cause pain and inflammation. According to Harvard, some examples of these bacterial infections include:
- Lyme disease
- Staphylococcus (staph)
These range from minimally invasive procedures to full-on knee replacement. Let’s start our talk with the former.
Minimally invasive procedures
There are 2 kinds you need to be aware of:
- Aspiration, and
Aspiration, otherwise known as arthrocentesis, involves inserting a syringe through your knee and sucking out the excess fluid. This makes it one of the methods to quickly reduce swelling in the knee.
The extracted fluid can also be used to diagnose certain diseases. So, it’s actually both a treatment and a diagnostic tool. Some conditions that may need arthrocentesis include:
- Several types of arthritis
- Lupus and other autoimmune disorders
- Soft tissue injuries
- All sorts of bursitis (e.g. prepatellar bursitis, pes anserine, etc.)
Arthroscopy, on the other hand, is essentially surgery needing only a small incision. According to the American Academy of Orthopaedic Surgeons, this method is also done for both diagnostic and treatment of certain issues, including:
- Meniscus repair
- ACL reconstruction
- Bone and/or cartilage removal
Knee replacement surgery
I believe the Mayo Clinic says it best when they said that your physician will consider replacing your joint if weight-bearing becomes impossible.
This surgery is also typically done with people suffering from all kinds of arthritis, including osteo-, rheumatoid, and traumatic arthritis.
That being said, there are, again, 2 kinds to be aware of:
- Partial knee replacement
- Total knee replacement
Let’s talk about them both very quickly:
Disclaimer: All the info below came from the American Association of Hip and Knee Surgeons.
Partial knee replacement
- Done on younger folk with issues on only one part of the knee
- Requires less time in surgery and you retain more of your tissue
- Faster recovery and less physical therapy
- Less risk of complications
- Costs less
- Replacement parts have shorter lifespans
- You can still get meniscal tears and arthritis
Total knee replacement
- Implants last longer (10-15 good years)
- Candidates are generally more satisfied with their quality of life
- Candidates generally end up more functional than they were prior
- Surgery takes longer
- More risk of complications
- More expensive
- More time doing physical therapy (and your knee never feels “natural”)
The last couple of methods we discussed involved doctors. So, you might be asking:
When should I see a doctor?
If you ask me, it’s always best to see a doctor or other reputable health and wellness professionals if you’re experiencing anything that’s out of the ordinary.
However, I also understand that hiring these wellness professionals is expensive. I don’t even follow my own advice because of financial constraints if I’m being honest.
So, below is a list of what research considers red flags. If you experience any of them, be sure to get your symptoms reviewed by medically trained folk you trust.
- Losing pulse below your knee
- Partially or fully losing sensation below the knee
- Losing the ability to bear weight on your lef
To add, you should also seek your physician’s help if neither of the home remedies and OTC meds works.
Is it bad if you have fluid in your knee?
Synovial joints (e.g. your knee joint) normally have fluid in them. This helps reduce friction between the several parts of your joint.
What’s bad is when you have too much or too little fluid. In both cases, your joints aren’t properly lubricated, leading to pain.
Will fluid on the knee go away?
Yes, it can. In some cases, it can go away on its own. Other times, it might take a few home remedies, physical therapy, and/or your doctor’s intervention.
For reference on when you need to see a professional, scroll a little further up from this page.
How to drain fluid from knee at home
While you technically can’t drain fluid without the help of a professional, there are a few home remedies that can reduce inflammation at the site of your injury. These include the following:
RICE method (Rest, Ice, Compression, and Elevation)
Massage (effleurage), and
Isometric exercises (quad setting and hamstring setting)
For more information on how to drain fluid from knee at home, there’s a section near the top of this page that describes these methods in detail.
What is the best way to get rid of fluid on the knee?
This is purely situational. What’s “best” for you may be different for someone else.
The RICE method is essentially first-aid for fresh injuries.
Oral over-the-counter medications like pain relievers and NSAIDs are solid options but topical salicylates may be better if the former give you gastric distress.
Corticosteroids may also be prescribed if OTC options don’t work or if the knee swelling is caused by autoimmune disorders
Your doctor may also order antibiotics if bacterial infections are what caused the swelling and knee pain.
Knee joint aspiration can also be an option to quickly evacuate the “water” inside your knees.
Minimally invasive and extensive knee surgeries may be required if structures in and around your joint need repair.
Just to give you a summary, getting rid of “water” on the knee depends on what caused it in the first place. But, here are your options:
- Home remedies (RICE, effleurage, isometric exercises)
- Medication (OTC pain relievers, NSAIDs, doctor-prescribed corticosteroids, and antibiotics)
- Minimally invasive procedures (joint aspiration and arthroscopy)
- Extensively invasive procedures (partial and total knee replacement surgeries)
If you’re unsure of which route you should take, it’s always best to consult your doctor.