A synovial bursa is a fluid filled sac a bit like a water cushion and is found over bony prominences or around moving parts to provide protection and reduce friction. Bursae are found around most major joints in the body.
There are 11 bursae around the knee and 4 bursae in the front of the knee joint which can be prone to bursitis, the most common is the inflammation of the bursae in front and above the knee cap.
Causes of bursitis include a direct blow to the knee, a bacterial infection of the bursa, frequent or sustained pressure through the knees such as kneeling for a long period or it may also arise as a secondary complication from Osteoarthritis, Rheumatoid Arthritis or Gout.
When bursitis occurs the knee becomes swollen, there may be a redness of the skin known as erythema. There is pain on movement and especially on pressure over the bursa. The knee will feel stiff and there will be some loss of range of movement.
Immediate treatment for Bursitis is to rest the knee and use frequent ice packs to reduce the swelling. An elastic tubigrip around the knee will provide compression to also help reduce the swelling. Over the counter anti-inflammatories and analgesics will help control the pain and inflammation.
If the bursitis persists and does not respond to home treatment then physiotherapy can be of benefit in the form of a graded stretch routine, ultrasound, ice treatment and interferential diathermy.
If the symptoms do not improve it is wise to seek medical attention to check that there is no infection. Infectious bursitis is rare but needs to be treated with anti-biotics and occasionally surgery.
Occasionally an appointment with an orthopaedic specialist may be needed to aspirate the bursa and reduce excess fluid. Recurring or chronic bursitis might also benefit from an injection of corticosteroid.
The Physiotherapy Centre
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