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Bursitis knee: duration, symptoms

by Josephine Andrews
Published: Last Updated on 130 views

Some joints are particularly susceptible to bursitis : knee joints are one of them. There are several bursae on the knee that sometimes become inflamed as a result of incorrect or overloading. Accordingly, a distinction is made between, for example, prepatellar bursitis and infrapatellar bursitis. Some occupational groups are particularly susceptible to knee bursitis. Read more about the topic here!

ICD codes for this disease:

ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor’s letters or on certificates of incapacity for work.

M70 M71

What is knee bursitis?

If the doctor finds bursitis in the knee, the bursa in front of the kneecap or below the kneecap is usually affected. In the first case one speaks of prepatellar bursitis , in the second case of infrapatellar bursitis . However, there are other bursae in the area of ​​the knee joint that occasionally become inflamed (such as the bursa anserina).

However, the cause of pain in the knee area is not always bursitis. The hollow of the knee and the area of ​​the thigh near the knee do not house any bursa. The same applies to the region at the side of the joint gap. If pain occurs in these areas, another cause must be sought. For example, this may be a Baker’s cyst – a fluid-filled cavity in the back of the knee.

Prepatellar bursitis

In prepatellar bursitis, the bursa that lies directly in front of the kneecap (bursa prepatellaris) is inflamed. The affected bursa lies directly under the skin and guarantees the mobility of the kneecap in relation to the skin on the knee.

Bursitis in this region occurs particularly in people who subject their kneecaps to high pressure loads. These are, for example, tilers and carpet layers. Most work in these trades must be done while kneeling, which puts undue stress on the bursa in front of the kneecap.

In English, prepatellar bursitis is therefore also called “carpet layer knee”. Many professional organizations require knee pads to be worn at work to prevent knee bursitis.

Prepatellar bursitis also often occurs after gardening or after a fall on the knee.

Infrapatellar bursitis

Infrapatellar bursitis is inflammation of the bursa beneath the patellar tendon (just below the kneecap). This inflammation of the bursa is less common than prepatellar bursitis, but it is also often triggered by prolonged kneeling – for example when kneeling upright on a kneeler when praying. Therefore, infrapatellar bursitis is also known as clergyman’s knee.

Long, knee-straining sports activities sometimes also cause irritation of the bursa under the kneecap. In addition, infrapatellar bursitis sometimes occurs as part of another disease ( gout , syphilis ). However, this is rarely the case.

Inflammation of this bursa cannot be distinguished on examination from inflammation of Hoffa’s fat pad (Hoffaitis). This fat pad is also important for cushioning the tendon during movement and lies just above the bursa. Since both inflammations are treated in the same way, the exact distinction is usually not relevant for the patient.

Pes anserinus bursitis

Three tendons attach just below the knee on the inside of the shin. This attachment (superficial pes anserinus) is protected by a bursa (bursa anserina) to reduce friction between the mobile tendons and hard bone.

Even if the inflammation of this bursa sometimes results from pure overload, it is often related to a misalignment or joint inflammation of the knee (osteoarthritis). Since there are several other orthopedic causes for such an inflammation, you should always have them checked out by a doctor – especially if there are repeated infections in this region.

Inflammation of the bursa anserina is often difficult to distinguish from inflammation of the tendon attachments (pes anserinus tendinosis). But that is not important for the treatment. 

Which home remedies help?

Measures according to the so-called PECH scheme are recommended as first aid for sports injuries such as muscle strains, but are also useful for knee bursitis. The abbreviation PECH includes the following therapeutic measures:

  • P as in pause: protect and immobilize the knee joint
  • E like ice: place cool packs or ice cubes, each wrapped in a cloth, on the joint
  • C for compression (English = pressure): A compression bandage with an elastic bandage helps to reduce swelling
  • H for Elevation: Elevating the affected leg is also helpful to promote decongestion

The cold effect can also be achieved with cooling quark wraps . These are said to have a decongestant and pain-relieving effect on inflammation and sports injuries.

Curcumin is also said to have an anti-inflammatory effect. This is a herbal antioxidant from the turmeric plant that is responsible for the yellow color in curry powder. A recent study shows that curcumin, like cortisone, affects a specific protein (GILZ). This protein plays a decisive role in inflammation in the human body and is specifically produced in increased amounts by curcumin.

However, research on this is still in the basic phase; so this doesn’t mean that eating more curry will stop inflammation. Curcumin is difficult for the body to absorb. Therefore, research is currently being carried out into how to improve the bioavailability in dietary supplements. In addition, the goal is to develop drugs with no or fewer side effects than cortisone in the future.

Home remedies have their limits. If the symptoms persist over a longer period of time, do not get better or even get worse, you should always consult a doctor.

How long does knee bursitis last?

The duration of bursitis in the knee depends, among other things, on the cause of the inflammation and the further stress on the knee joint – for example due to a correspondingly stressful job. If the affected person relieves the knee and has it treated, the symptoms improve after a few days at best.

People who engage in heavy physical activity and thereby put excessive strain on their knee joint need longer sick leave for acute bursitis than those with a sedentary job in an office.

If, on the other hand, the bursitis is not treated and the knee continues to be strained, there is a risk, in the worst case, of the bursitis becoming chronic. Then the treatment becomes much more difficult than in the case of acute bursitis. Symptoms sometimes persist for months or even years.

If a bursectomy, i.e. the surgical removal of a bursa, is necessary, it is recommended to rest the knee for a few weeks and possibly wear an orthosis (support bandage) to support it. In general, those affected are on sick leave for up to four weeks, depending on their occupation.

What are the symptoms?

Depending on the location of the inflammation, different symptoms are described. Some similarities are:

  • swelling in the appropriate place
  • Reddening of the overlying skin
  • Overheating of the affected area
  • Pain, especially with movements that put stress on the affected area
  • Limited mobility of the knee

In prepatellar bursitis , a reddish swelling of the skin over the kneecap occurs within a few days after exposure. The actual knee joint is not affected. Due to the inflammation, however, bending the knee is particularly painful.

In the case of infrapatellar bursitis , a painful, red swelling can usually be felt just below the knee, usually on both sides of the patellar tendon. Overextending and bending the knee severely causes pain.

The well-known reflex examination of the knee is particularly uncomfortable: the patient sits and lets his legs hang loosely. The doctor then hits the patellar tendon with a small hammer, which normally causes the lower leg to reflexively shoot up (forward) (patellar tendon reflex, hamstring reflex). This test should not be attempted if knee bursitis is suspected because of the pain.

Patients with pes anserinus bursitis often report discomfort when climbing stairs. The pain is reported on the inside of the knee or slightly below. Obesity , joint inflammation and female gender are three important risk factors for knee bursitis.

While the symptoms of acute bursitis usually set in quickly and there is significant pain, in the chronic form the pain sometimes disappears temporarily or sometimes even completely – or it worsens as the inflammation lasts.

What medical treatment is there?

When treating bursitis on the knee, the same principles apply as for all other bursitis: rest, cooling, anti-inflammatory drugs or ointments, bandages or tapes to stabilize the joint, possibly surgery and more.

You can read more about this at Bursitis: Treatment .

The knee is stabilized by many muscles. If you train them specifically and stretch them regularly, you reduce the strain on the bursa and thus prevent (re)inflammation.

If the bursitis on the knee is only a sign of another disease or deformity, it must be treated accordingly. 

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