Knee bursitis is inflammation of the bursa that is found between the front of the kneecap (patella) and the skin. A bursa is a fluid-filled sac that operates as a gliding surface to minimize friction between moving tissues of the body and includes areas between two bones, between a tendon or ligament and a bone, and between bone and skin such as elbows, knees, shoulders, and hips.
Knee bursitis is usually not infectious but the bursa can become infected. The most common cause of knee bursitis is direct trauma to the front of the knee and occurs from prolonged periods of kneeling. Knee bursitis is often referred to as “roofer’s knee”, “housemaid’s knee”, and “carpet layer’s knee”. Knee bursitis may also be caused by rheumatoid arthritis and from deposits of crystals as seen in individuals with pseudogout and gouty arthritis.
Bursitis can lead to varying degrees of tenderness, swelling, warmth, and redness in the overlying area of the knee. It is usually mildly painful and is mostly associated with increased pain when kneeling and can cause pain and stiffness with walking.
Knee bursitis can be caused by a number of different repetitive motions of the knee. One of the most common causes of this condition is kneeling, especially on hard surfaces. Another common cause is being overweight or obese. The extra weight that is put on the knees can cause inflammation in these cases. When a patient has osteoarthritis or arthritis, they are more likely to get knee bursitis. Sports injuries can cause it, as can the overuse of the knees while playing sport. Falling on to the knee joint or receiving a blow there can also lead to this condition. During exercising, too much hiking, stair climbing, jumping and running can cause it. When the bursa is infected by bacteria or there is gout or rheumatoid arthritis in the knee, these conditions can also lead to knee bursitis.
Treatment will depend on whether or not there is an infection.
Aseptic prepatellar bursitis can be treated with rest, ice compresses, and anti-inflammatory and pain medications. Sometimes treatment requires aspiration of the bursa fluid which involves using a needle and syringe under sterile conditions in a doctor’s office. If there is no infection knee bursitis may also be treated with an injection of cortisone into the swollen bursa.
To prevent knee bursitis, avoid kneeling too often or kneeling on hard surfaces. If you must kneel for work, wear soft knee pads so that your weight can be distributed more evenly. Avoid the overuse of the knees during exercise by engaging in exercises that don’t require the knees to be bent much or at all. This may include using a glider or doing arm and torso exercises instead. Wear knee pads when playing a contact sport like soccer or football. One of the best ways to avoid this condition is to stay at a healthy weight. Make a plan with your doctor to lose excess weight in order to relieve some of the pressure on your knees. Strengthening your leg muscles can also be helpful in avoiding this condition. This can allow your muscles to take on more of the action of the leg instead of putting that pressure on the knee.