How To Treat Bursitis In The Knee? | 5 Treatments, Causes, And Prevention

A knee bone with bursitis

Knee bursitis is fairly common. Most cases resolve on their own with some basic treatment. Others need stronger strategies. So, here’s a complete guide on how to treat bursitis in the knee.

But first, keep in mind that there isn’t a perfect knee bursitis treatment for everyone.

It will depend on your type of bursitis, your symptoms, and your medical history.

For example, some people may go by with home remedies. This is because most knee bursitis cases are mild.

But, other people may need antibiotics. Rare cases may only improve with surgery.

We’ll take a good look at each treatment so you know what to expect.

Here’s what we’ll discuss:

5 Treatments for knee bursitis

Bursae are small fluid-filled sacs. They reduce friction between bones, tendons, and/or skin during movement.

Now, bursitis is an inflammatory condition where the bursa gets swollen.

The diagnosis of bursitis tends to be straightforward.

There’s a lump where the bursa is, which may feel warm. It can be painful to touch for most people. The pain can limit your knee’s range of movement as well.

Your doctor will perform a physical exam to find signs of bursitis. After the diagnosis, the next step is making sure it isn’t infected.

If the bursa is infected, it needs antibiotic treatment.

This type of bursitis is called “septic bursitis.” The infection may cause other symptoms, like a fever.

In this case, your doctor may need a sample of bursa fluid. This will show which bacteria is present, to give you the right antibiotic. (1)

But, if there isn’t an infection, there are several treatments for knee bursitis:

1) Home remedies

PRICE to reduce knee swelling

PRICE stands for:

  • Protection. Protect the knee from further injury.
  • Rest. Avoid excessive movement to reduce the friction on the bursa.
  • Ice. Put an ice-pack on the swollen knee. For 10 minutes, 2-3 times per day.
  • Compression. A compressive wrap or sleeve can also reduce inflammation.
  • Elevation. Elevating the knees above your heart can reduce swelling as well.

This protocol can reduce swelling and pain during the first days of bursitis. It won’t be effective if there’s an infection, though.

If you don’t have ice packs at home, a bag of ice or frozen vegetables are good options.

Rest to decrease pain

Knee bursitis symptoms tend to get worse with excessive movement. Friction increases inflammation. The bursa fills with liquid, causing pain and swelling.

You need to rest to reduce pain symptoms. Icing your knees won’t be enough.

And yet, your bursa also needs some movement to recover. This makes bursitis treatment a little tricky.

The solution is to use your pain levels as a guide. Start by walking. If it increases your symptoms, rest. Try again later with fewer steps.

This can help: Will walking make your knee bursitis worse?

Wear knee pads to reduce pressure

People that are on their knees for a long period can develop bursitis.

The added pressure from hard surfaces can irritate the prepatellar bursa. That’s the bursa sitting on top of your kneecap.

Knee pads can reduce pressure on that bursa. Pads cushion the kneecap area.

Wearing them can help you recover and prevent another episode.

Try this: Home treatments for knee bursitis

2) Over-the-counter medications

Anti-inflammatory medications won’t get rid of an infection. But, they can reduce swelling and pain in non-infected bursitis.

Your doctor will recommend the best dose for you.

But, the anti-inflammatory drug may not be enough for some people.

If so, your doctor may prescribe medications with stronger effects. (2)

3) Go to a physical therapist

Yes, most cases of bursitis resolve on their own. But, physical therapy is one of the best treatments for knee bursitis.

A PT can speed up your recovery.

Physical therapy treatment can reduce pain and swelling. With cold therapy, manual techniques, and therapeutic exercise, for example.

A physical therapist can also improve flexibility and strength on your knees.

This is key for avoiding recurrent episodes of bursitis.

This can help: How physios help you heal knee bursitis

The best thing a physical therapist can do for you is to provide medical advice.

I know it sounds broad and unspecific. But, in real life this looks like:

  • Teaching you the best strategies to manage your symptoms.
  • Providing tools to avoid another episode of bursitis. According to your particular lifestyle.
  • Giving you specific exercises before your job, to prepare your knee joints for the effort.
  • Or specific stretches for your knee muscles. This will reduce the pressure on the bursa at the end of the day.

After a bursitis diagnosis, a physical therapist can be the best ally for your recovery.

PS: We can connect you with a qualified physical therapist in your area.

4) Cortisone injections

A cortisone injection can help if your bursitis isn’t getting better after 7-14 days.

Corticosteroid drugs treat inflammation fast. They may provide short-term pain relief as well. (1)

But, the injection can introduce bacteria. This can trigger septic bursitis, making your symptoms worse.

Talk to your doctor about the pros and cons of this injection.

5) Surgery

Surgery for bursitis is rare. Most people don’t need it. But, some specific cases can get better after surgery (1, 2):

People with an infected bursa that’s not responding to treatment.

If the infection is resistant to antibiotics, your doctor may recommend surgery.

The surgeon could perform a surgical aspiration or drainage of the bursa fluid.

People with chronic bursitis.

This happens when bursitis persists over time. It’s common in people that kneel often.

The affected bursa adapts to the pressure and gets thicker.

Your doctor may suggest removing the inflamed bursa altogether. Orthopaedic surgeons perform this procedure.

They have to do some imaging tests first to see the size of the swollen bursa.

What causes knee pain from bursitis?

There are several types of knee bursitis. But their causes are fairly similar.

Most bursitis can be caused by (1, 2):

  • Repetitive motions. The friction causes inflammation.
  • Prolonged kneeling. The pressure irritates the bursa.
  • A sharp blow to the bursa.

The most common type of knee bursitis is prepatellar bursitis.

This is known as “housemaid’s knee,” as it’s a common problem in this occupation.

Here, the prepatellar bursa gets swollen due to prolonged kneeling. (3)

Another common type of knee bursitis is infrapatellar bursitis, also called “clergyman’s knee.”

It affects the bursa below the kneecap. It’s also due to kneeling.

Athletes are prone to develop pes anserine bursitis. This causes pain on the inner side of the knee.

It commonly occurs due to repetitive motions, like running or jumping.

Go deeper: The 7 types of knee bursitis and their treatments

Risk factors for knee bursitis

Certain sports and occupations can make you prone to knee bursitis.

For example, kneeling and developing inflammation on the prepatellar bursa.

Some health conditions can also predispose you to bursitis (1, 2):

  • Rheumatoid arthritis.
  • Osteoarthritis.
  • Obesity.
  • Gout.

In this case, the treatment should focus on the underlying health condition.

How to prevent knee joint bursitis?

The prevention will depend on your medical history. Also, on any previous joint problems you may have.

A physical therapist can give you the best advice on this topic.

Yet, most people can do these to prevent knee bursitis:

  • Maintain a healthy weight.
  • Avoid kneeling for long periods.
  • Take regular breaks from kneeling.
  • Resume your normal activities gradually.

FAQs:

Is walking good for knee bursitis?

Yes, if walking helps you with your symptoms.

How long does it take for knee bursitis to heal?

It can take a few weeks if it’s not infected. You must follow your doctor’s recommendations as well.

What causes knee bursitis to flare up?

A bout of exercise that irritates the bursa, a direct hit, or kneeling often.

Some health conditions can trigger a flare-up. Like rheumatoid arthritis, gout, or alcoholism.

Conclusion: What to do for knee bursitis?

If it’s not infected, the treatment essentially comes down to:

  • Rest the affected area to reduce knee pain and swelling.
  • Resume your normal movement or athletic activity slowly.
  • Strengthen your knees to prevent future episodes.

And, go to a physical therapist to recover faster!

Resources

  1. Lohr, Kristine. “Bursitis: Practice essentials.” Medscape. Retrieved on August, 2021 from: https://emedicine.medscape.com/article/2145588-overview
  2. Williams C H et al. “Bursitis.” StatPearls. Retrieved on August, 2021 from: https://www.ncbi.nlm.nih.gov/books/NBK513340/
  3. Rishor-Olney Colton B. “Prepatellar Bursitis.”StatPearls. Retrieved on August, 2021 from: https://www.ncbi.nlm.nih.gov/books/NBK557508/