How To Treat Knee Bursitis? | 7 Evidence-Based Treatment Options

7 evidence-based treatment options

Knee bursitis is one of the most common types of bursitis. People of any age and occupation can have it. The good news is that it’s easy to treat. So, how to treat knee bursitis?

There are 7 treatments for bursitis on the knee joint that I will discuss in detail. But, most people will be good to go if they only do the first 4 (1, 2):

  • Rest.
  • PRICE protocol.
  • Medication.
  • Physical therapy.

Doing those treatments right will heal your bursitis. But, if they don’t work, don’t worry. There are 3 more treatment options you can try.

Let’s have a look at each treatment for the knee, shall we? Oh, and as a bonus, I’ll even give you an estimate about how long it will take you to recover!

7 knee bursitis treatment options

Bursitis happens when a bursa becomes inflamed. Bursae are small fluid-filled sacs. They reduce friction between bone, muscle, and/or the skin. Excessive friction irritates the bursa, causing bursitis.

The main symptoms are pain and swelling on the affected bursa. So, treatments focus on reducing friction to let the bursa heal. The most effective treatments for knee bursitis are:

1) Rest, rest, rest

The main cause of knee bursitis is excessive movement. Thus, the main treatment is rest. This will reduce the friction on the bursa and let it heal.

But, your body also needs movement to promote healing. This is where the treatment for knee bursitis gets tricky. The solution: use your symptoms as a guide.

For example, let’s suppose your bursitis hurts while walking.

That’s one of the signs that you must rest. Once you feel better, try walking again. Take fewer steps if necessary.

The process will take some trial and error, that’s normal and expected. Keep trying to find that sweet spot and let your symptoms guide you.

Another trick is resting before you feel like you need to. If you don’t feel pain while walking, don’t push it! Remember that excessive friction can cause setbacks.

Further reading: Is it okay to walk with knee bursitis?

2) PRICE protocol

This protocol can reduce pain and swelling. PRICE stands for:

Protection.

Protect the healing bursa. This will prevent the injury from getting worse. Also, protection will look different from person to person.

For example, a carpenter with prepatellar bursitis may have to wear knee pads to work. The soft padding will reduce the pressure on bursitis without cutting time off work.

Rest.

Yes, it’s twice. That’s how important it is for healing knee bursitis.

Ice.

Icing your bursitis can reduce swelling and pain. The cold temperature has an anesthetic effect on some people. Also, the cold constricts the blood vessels on the skin. This can reduce swelling.

Use an ice pack on the affected area. Do this 2-3 times per day, for 10 minutes at a time. This frequency is enough for most people with bursitis.

Compression.

This means applying pressure on the injured area. The compression can reduce swelling. But, this will only work if your bursitis isn’t infected. If it is, compression can foster bacterial growth, worsening the infection.

To do this, wrap the affected area with a compressive wrap. You can do this alone or with ice in the area. That combination will enhance the anti-inflammatory effect.

Elevation.

Elevate the injured leg above your heart. Gravity will help you reduce swelling. Combine this with the compression and/or ice for better results!

3) Medications

Medications can reduce the pain and swelling in your knee. But, your meds will also depend on the type of bursitis you have.

If it’s infected: antibiotics

After the diagnosis, there’s one priority. Figuring out whether your bursitis is infected or not. Septic and non-septic bursitis have similar symptoms, but the treatment is different.

If it’s infected, you’ll need antibiotics as soon as possible. Septic bursitis won’t get better without them. (1)

If it’s non-infected: Anti-inflammatory medications

Over-the-counter drugs can reduce inflammation and knee pain. Your doctor may suggest taking them during the first days of your bursitis. (1)

4) Physical therapy

Physical therapists can speed up your bursitis recovery. They will help you manage pain, swelling, and other symptoms. Treatment varies according to your symptoms, lifestyle, and goals. It may include exercises, strengthening your muscles, or a gentle stretch.

Physical therapy can also keep your knees healthy. A PT does this by giving you strategies to prevent bursitis flare-ups. This is key to avoiding recurrent bursitis.

We know that physios are the best allies for your recovery. And, should you need it, we’re prepared to help you find a qualified PT in your area.

5) Aspiration

This is a surgical procedure. Here, the doctor extracts the excess liquid with a syringe. This is an option for bursitis that doesn’t get better with medication.

PD: Don’t try to perform an aspiration on your own. You can worsen the symptoms.

6) Corticosteroid injection

This can help ease painful bursitis that’s not getting better after 1-2 weeks. But, these injections come with a risk. The syringe can introduce bacteria, triggering septic bursitis. (1)

That being said, make sure you go to a doctor you trust. A good doctor will only administer corticosteroids if there’s a confirmed infection. He/she will use the proper aseptic technique, at the right dose, and at the appropriate intervals. (4)

7) Surgery

This is rare and is almost exclusive for people with chronic bursitis. Here, the doctor often decides to remove the bursa. Your doctor will need imaging tests before surgery. You may also need physical therapy afterward.

Common types of knee bursitis and their recovery times

Prepatellar bursitis

This is kneecap bursitis. The bursa can become inflamed after prolonged kneeling. It can take a few weeks to heal. It may take longer if it’s infected.

Also, prepatellar bursitis is prone to recurrent episodes. It’s key to have strategies to prevent them. A physio can help you with that.

Infrapatellar bursitis

This affects the bursa on the tip of the shinbone. It can get swollen after repetitive kneeling. Due to the location of the bursa, this is a common injury in the clergy. Infrapatellar bursitis can become infected and/or chronic easily, like prepatellar bursitis.

As with kneecap bursitis, it can take a few weeks to heal. It can take longer if it’s a recurrent episode, or if there’s an infection.

Pes anserine bursitis

The pes anserine bursa is in the inner side of the knee. It’s sandwiched between three tendons, to reduce friction between them.

Pes anserine bursitis can be caused due to repetitive motions. The excessive friction causes inflammation on the bursa. That’s why this injury is common in running or jumping sports. People with knee osteoarthritis are prone to have it, too. (1)

The average recovery time is also a few weeks. Athletes with bursitis should check their technique and improve it. This will help prevent future episodes.

Related: Learn about the +10 bursae we have in the knee.

FAQs:

Does knee bursitis go away?

It goes away for most people. The key is to avoid activities that increase symptoms. This will let the bursa heal.

How long does knee bursitis take to heal?

It takes a few weeks. But, this depends on whether it’s infected or not. Infection can take longer to heal. Also, following your doctor’s recommendations will heal the injury faster.

What causes knee bursitis to flare up?

Movements that increase the friction on the bursa. Like kneeling often or repetitive motions. Also, some health conditions can cause a flare-up. Like rheumatoid arthritis or gout.

Conclusion: Treatments for knee bursitis

As you can see, it’s easy to treat knee bursitis. You can do it at home, by:

  • Resting enough.
  • Using the PRICE protocol.
  • Taking anti-inflammatories.

But, see a doctor if your bursitis isn’t improving after 1 or 2 weeks. You may need something else, like aspiration or injection.

Also, physical therapy can help you prevent future episodes. This will avoid chronic bursitis, which is often treated with surgery.

Resources

  1. Lohr, Kristine. “Bursitis: Practice essentials.” [Updated 2020 Dec 11]. 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/
  4. Holland, Christian et al. “Septic and aseptic complications of corticosteroid injections: an assessment of 278 cases reviewed by expert commissions and mediation boards from 2005 to 2009.” Deutsches Arzteblatt international vol. 109,24 (2012): 425-30. doi:10.3238/arztebl.2012.0425