Knee bursitis is irritation of one of the small, fluid-filled sacs that cushion the knee, causing pain and often visible swelling around the joint. It is frequently linked to kneeling, pressure or overuse — the front-of-knee form was once so common in domestic workers that it earned the name “housemaid’s knee”. It is usually a mechanical, manageable problem, though it is important to recognise the small number of cases that need medical attention. At Back in Action in Penwortham, we care for people across Preston and Lancashire with knee bursitis.
Understanding knee bursitis
A bursa is a small sac of fluid that sits between tissues to reduce friction and allow them to glide smoothly. Several bursae surround the knee — in front of the kneecap, just below it, and on the inner side of the joint. When a bursa becomes irritated, often through pressure, kneeling or overuse, it can fill with extra fluid and become painful and swollen, which is knee bursitis. The body produces this extra fluid as a protective response, which is why swelling is such a common feature.
Where the bursa in front of the kneecap is affected, the swelling can be quite obvious, sitting like a soft cushion over the kneecap. Most knee bursitis is mechanical and settles with sensible care. Occasionally, though, a bursa can become infected, which is why a hot, red, very tender knee with a fever needs prompt medical attention rather than routine care.
Different bursae produce slightly different patterns. The bursa in front of the kneecap is the one classically irritated by kneeling; one just below the kneecap can be aggravated by similar pressure; and a bursa on the inner side of the knee, lower down, is more often linked to overuse and can occur alongside other knee problems. Working out which is involved helps direct both the advice and the care.
What knee bursitis can feel like
Symptoms depend on which bursa is involved, but commonly include:
- Swelling around the knee, sometimes soft and obvious over the kneecap
- Pain or tenderness over the affected area
- Discomfort with kneeling, squatting or direct pressure
- A feeling of tightness or fullness in the knee
- Discomfort and visible swelling that may come and go with activity
- Pain that worsens with activities that load or compress the area
- Discomfort going up or down stairs, or rising from a kneeling position
The link between the symptoms and kneeling or pressure is often a useful clue that a bursa is involved, as is swelling that can be seen and felt at the surface rather than deep within the joint.
Common causes and risk factors
Knee bursitis usually develops from pressure or overload rather than a single dramatic injury, and the cause is often clear from a person’s work or hobbies. Common contributors include:
- Frequent or prolonged kneeling, common in certain trades and hobbies
- A direct knock or fall onto the front of the knee
- Repetitive activities or overuse of the knee
- Sometimes occurring alongside osteoarthritis or other knee problems
- Less commonly, infection, gout or an inflammatory joint condition
Part of our assessment is confirming that a bursa is the source, identifying what is irritating it, and satisfying ourselves that there is no sign of infection.
When to seek help
Most knee bursitis settles with sensible care, but some signs need prompt medical attention. Please see your GP or seek urgent care if the knee becomes hot, red and very tender, particularly with a fever or feeling unwell, as this can indicate infection that needs treatment. You should also seek advice if the swelling is large, follows a significant injury, or is not settling. An infected bursa is uncommon, but it is the one situation where this otherwise mechanical problem becomes a medical matter, so it is always worth keeping in mind.
How chiropractic care can help
It is also worth knowing that many cases of mechanical knee bursitis settle largely by removing the irritation — the kneeling, the pressure or the overload — and giving the area time. For mechanical knee bursitis, chiropractic care can be helpful once infection has been ruled out. The aim is to settle the irritation, reduce what is aggravating the bursa, and address any wider factors — such as how the knee is loaded and controlled — that may be contributing. Following a thorough assessment, our hands-on, drug-free care may include advice on reducing the pressure and activity irritating the bursa, soft-tissue work around the knee, mobilisation of the knee and surrounding joints where movement is restricted, and a graded rehabilitation programme to restore strength and control. Because we are a multi-practitioner clinic, we can also draw on physiotherapy. We will always be honest about what care can realistically offer, and we will refer you on without hesitation if anything suggests infection or another cause needing medical attention.
What to expect at Back in Action
Your first visit is mostly about understanding your knee swelling and pain. We will take a careful history — including your work, hobbies and any recent knock or change in activity — and carry out a physical examination of the knee, checking the affected area and satisfying ourselves about the likely cause. An important part of this is being confident there is no sign of infection, since that would change the advice entirely. We will explain what we have found in plain language and discuss whether chiropractic care is appropriate.
You can read more on our new patients page, with current charges on the fees page. Often the most valuable outcome of that first visit is a clear understanding of what is causing the swelling and a simple, practical plan for reducing what is irritating it. We will be realistic about the likely course of care and review your progress as we go.
Helping yourself: self-care and recovery
There is plenty you can do to help knee bursitis, much of it about reducing what irritates the bursa:
- Avoid kneeling and direct pressure on the knee while it settles, where you can
- Take regular breaks from any activity that involves prolonged kneeling
- Use protective knee pads if your work or hobby involves regular kneeling
- Reduce, rather than completely stop, the activities that aggravate it
- Keep the knee gently moving within comfortable limits
- Build strength around the knee gradually as symptoms allow
- Address any wider factors, such as how the knee is loaded during your work or sport
If you would like guidance tailored to you, we can build a safe, progressive exercise and self-care plan around your particular problem.
Related conditions and treatments
Knee bursitis is closely linked to knee and leg pain, knee tendonitis and osteoarthritis. The care we provide draws on approaches such as exercise and rehabilitation and chiropractic manipulation, and may form part of a wider plan alongside our chiropractic and physiotherapy services.
Take the first step
If a swollen or painful knee is getting in the way of your life, you do not have to simply put up with it. We are happy to talk it through and help you understand your options. You can get in touch to book an appointment, or to ask any questions before your first visit.