Joint Or Bursal Aspiration
When a patient has a swollen knee, a doctor may want to verify or rule out certain diagnoses by analyzing the accumulated fluid. To do this, the doctor will remove fluid from the affected knee joint capsule or bursa using a needle and syringe. When performed on a joint capsule, this process is called joint aspiration or arthrocentesis. When performed on a bursa, this process is called bursal aspiration.
The doctor will take note of the aspirated fluids color and viscosity and may send it to a lab for further analysis. Determining the contents of the fluid can lead to an accurate diagnosis. For example, uric acid crystals in the joint fluid indicate gout, and bacteria in the fluid indicate infection.
Aspiration and examination of the fluid are important diagnostic steps because the underlying cause of knee swelling will determine the appropriate medical treatment.
Aspirated fluids are not always sent to a lab for analysis. If a diagnosis is already known, a physician may perform an aspiration to improve joint function and patient comfort.
How To Care For A Swollen Knee
When does a swollen knee require medical care, and when can it be treated at home? Mild to moderate knee swelling and knee effusionsometimes called water on the kneecan usually be treated at home. Medical attention is recommended if the knee is persistently swollen or accompanied by severe pain or other serious symptoms.
Read on to learn when to contact a doctor, how to treat a swollen knee at home, and how doctors can remove fluid from a knee using a process called aspiration.
Different Types Of Arthritis
The knee is the joint where the bones of the lower and upper legs connect. It moves like a hinge, allowing you to sit, squat, walk or jump. The basic anatomy of the knee consists of three bones: the femur, tibia, and patella. The ends of the bones are covered with a layer of cartilage – a slick, elastic material that absorbs shock and allows the bones to glide easily against one another as they move. Different types of arthritis affect this joint differently.
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Synovial Fluid Accumulated In The Bursae Around The Knee Joint
Doctors in Taiwan publishing their study in the medical journal Experimental Gerontology examined the effects of Platelet Rich Plasma on synovial fluid volumes, protein concentrations, and severity of pain in patients with knee osteoarthritis. Here is their research summary:
- Patients with knee osteoarthritis are often complicated with joint soreness, swelling, weakness, and pain. These complaints are often caused by the excessive amount of synovial fluid accumulated in the bursae around the knee joint.
- They examined the effectiveness of platelet-rich plasma in treating patients with minor to moderate knee osteoarthritis combined with supra-patellar bursitis.
- Twenty-four elderly patients with minor to moderate knee osteoarthritis combined with supra-patellar bursitis were recruited.
- Aspiration of the synovial fluid was performed under ultrasound followed by subsequent PRP injections.
- Three monthly PRP injections were performed to the affected knees for a total of 3 months.
- Approximately after the 2nd PRP injection, significant decreases in synovial fluid total protein concentrations and volumes , and Lequesne index values were observed.
- Therefore, at least two monthly PRP injections may be beneficial for treating patients with minor to moderate knee osteoarthritis combined with supra-patellar bursitis.
When Should I See A Doctor
If you ask me, its always best to see a doctor or other reputable health and wellness professionals if youre experiencing anything thats out of the ordinary.
However, I also understand that hiring these wellness professionals is expensive. I dont even follow my own advice because of financial constraints if Im being honest.
So, below is a list of what research considers red flags. If you experience any of them, be sure to get your symptoms reviewed by medically trained folk you trust.
- Losing pulse below your knee
- Partially or fully losing sensation below the knee
- Losing the ability to bear weight on your lef
To add, you should also seek your physicians help if neither of the home remedies and OTC meds works.
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What If You Ice Your Knee
Putting an ice pack on top of your knee is one of the most common home remedies to manage the swelling and other symptoms of a fresh injury.
Its become popular due to the RICE method: Rest, Ice, Compression, and Elevation. Nowadays, athletes use cold therapy after games to help with recovery.
However, some research suggests that this might suppress the immune systems response that heals the tissues in the first place. So, it might be best to use ice only if youre experiencing severe pain.
Do this in bouts of ~10 minutes, 2-3 times per day to allow your tissue-repairing cells to do their job.
But if you have knee osteoarthritis, try using a heating pad instead.
Ways To Treat Swollen Knees At Home
All of the treatment options listed below are tried and true options for getting relief from pesky knee pain and stiffness. Whether youre dealing with a sports injury, overuse, rheumatoid arthritis, bursitis, arthritis, or something else, these remedies can help. Typically, finding time to incorporate all of these treatments into your daily routine will give you the best possible chance for recovery.
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Home Treatment For Swollen Knees
It is important to consult with your physician before choosing a treatment plan. If advised by your doctor, over-the-counter anti-inflammatory medications can aid in treating minor cases of knee swelling. Usually, these cases are due to knee osteoarthritis, non-septic knee bursitis, or a minor injury.
The RICE formula can also work. RICE is rest, ice, compression, and elevation.
- Rest: Rest for a period of 24 hours or longer to give the joint time to recover.
- Ice: Icing the area for 20 minutes three to four times per day can help decrease swelling and aid in healing. It is important to avoid putting ice directly on the skin.
- Compression: Wrapping the knee with an elastic bandage can help to limit swelling, but make sure it is not too tight.
- Elevation: Elevate the knee to help reduce blood flow to the area, which can help to reduce the swelling.
With RICE, swelling often goes down in one to three days.
What Are The Signs And Symptoms Of Arthritis Of The Knee
There are many signs and symptoms of arthritis of the knee:
- Creaking, clicking, grinding or snapping noises .
- Difficulty walking.
- Joint pain that changes depending on the weather.
- Joint stiffness.
- Knee joint pain that progresses slowly or pain that happens suddenly.
- Skin redness.
- Your knee locks or sticks when its trying to move.
- Warm skin.
Pain and swelling are the most common symptoms of arthritis of the knee. Some treatments might reduce the severity of your symptoms or even stall the progression. See your healthcare provider if you have symptoms of knee arthritis.
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The Problems Of Excess Weight And Obesity Causes More Inflammation
When we suggest to the patient that their knee can benefit from weight loss, we typically hear, I know, I know, or I have been trying. These are the typical responses of someone who has tried to lose weight and is tired of being lectured. Weight gain, like knee osteoarthritis, is a slow methodical problem that cannot be made to go away overnight. To lose weight you must find the inner motivation to do so. Maybe research can help.
In July 2020, researchers writing in the medical journal Skeletal Radiology looked at three patient groups. All the patients had knee osteoarthritis. The three groups were: people with normal weight people who were overweight people who were obese. What they were looking for was a relationship between excess weight and increases knee inflammation. Here are the results:
- Being overweight or obese was significantly associated with a greater prevalence and severity of synovial inflammation imaging biomarkers. Substantial reproducibility and high correlation with knee structural, cartilage compositional degeneration, and pain scores validate the synovial inflammation biomarkers used in this study.
What does all this mean? The more weight, the more inflammation, the more pain, the greater the need for medication, the greater the knee pain, the greater the eventual need for knee replacement.
At What Age Do Knee Problems Start
Muscles provide power, allowing us to move and supporting our knees and other joints. Muscle strength peaks around the age of 25 and plateaus in our 30-40s. After that, it starts to decline and can do so rapidly without exercise. By the age of 65, our muscles can produce about 75 percent of peak force.
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What Exercise Is Best For Knee Pain
5 Exercises to Reduce Knee Pain Clamshells. Lay on your side and support your neck using a pillow or a towel roll. Bridging. Lay on your back and bend your knees so your feet are flat. Hip Abduction. Lay on your side and bend your bottom knee to give you better balance. Straight Leg Raise. Quadruped Hydrant.
When To Contact A Medical Professional
- You cannot bear weight on your knee.
- You have severe pain, even when not bearing weight.
- Your knee buckles, clicks, or locks.
- Your knee is deformed or misshapen.
- You cannot flex your knee or have trouble straightening it all the way out.
- You have a fever, redness or warmth around the knee, or a lot of swelling.
- You have pain, swelling, numbness, tingling, or bluish discoloration in the calf below the sore knee.
- You still have pain after 3 days of home treatment.
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What Causes A Swollen Knee
There are many causes of swelling in the knee, but often it is due to an injury. Damage to ligaments, especially the anterior cruciate ligament, or ACL, causes fluid to build up around the knee. Tearing the cartilage, overuse, and breaking bones can also cause fluid buildup.
However, other underlying conditions like osteoarthritis, rheumatoid arthritis, infection, gout, pseudo-gout, bursitis, cysts, and tumors, can also cause swelling.
What Are The Most Common Causes Of Joint Effusion
There are several reasons why your knee or other joints might swell with fluid. The most common reasons include:
- Infection. An infection in your joint is called septic arthritis. Septic arthritis is a serious disease that can damage or even destroy your joint. You might need a joint replacement a type of surgery because of it. When you have an infection, your joint tissues can fill with pus. Pus is a protein-rich liquid thats full of dead white blood cells.
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Everything In The Knee Affects The Ligaments And The Ligaments Affect Everything In The Knee Undetected Micro Ligament Damage Causes Swelling
Ligaments function primarily to maintain smooth joint motion, restrain excessive joint displacement, and provide stability across the knee joint. When the forces to which ligaments are subjected are too great , failure occurs, resulting in drastic changes in the structure and physiology of the joint. In your knee, it is causing a lot of swelling and functional instability.
Above we discussed research that suggested that the patient did not realize how bad their knee was and that is why they had chronic swelling. Knee instability and swelling can be caused by microdamage which causes instability that is not easily seen on MRI and is difficult to determine in a knee examination? Why because when the whole knee is in failure, it is hard to see the little things. Like micro-tearing of the knee ligaments. One thing is easy to see however, that is the result of micro ligament damage also referred to as ligament laxity.
Research: Patients Do Not Know How Bad Their Inflammation Is Or How Destructive It Is To Their Knees
This is really something that is hard to imagine. The patient does not know how bad swelling is for their knee. Knee osteoarthritis and the eventual development of bone on bone knees do not usually happen overnight. We say usually because there is the phenomenon of rapidly accelerated knee osteoarthritis where a patient can go from stage 1 to stage 4 osteoarthritis in a matter of months or a few years. So even in this rapid stage, bone on bone does not occur overnight. As this is a gradual progression it is easy to stay with the same management routine day after day, month after month, year after year of painkillers, anti-inflammatories, and knee braces. You know all the while your knees are getting worse but you need to work or be a caregiver or do the things you need to do so you manage your knees on a daily as needed basis. On a daily basis, unless there is an acute event, it is difficult to see how your knees are moving forward to a degenerative disease requiring knee replacement.
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Why Does Knee Swelling Happen
Swelling is one of the ways our bodies respond to damage. Its there to help increase the blood flow to the injured area which, in turn, also brings in more of your bodys cells that promote recovery.
In people without health issues, knee swelling can happen because of:
- Falling on the knee joints.
- Changes in your workout.
- Standing and/or walking more than youre used to.
- After doing intense physical activity, like moving to a new place.
- A knee injury, like a ligament tear. This may require an X-Ray or MRI to evaluate the size of the injury and plan your recovery.
Identify the root cause of the inflammation so you can treat it properly.
To Understand Your Inflammation Is To Understand That Your Knee Is Or Has Become Unstable But Is Your Unstable Knee Causing Inflammation Or Is It Inflammation Causing Your Unstable Knee Something Needs To Get Fixed
Research is busy asking the question, what comes first, the inflammation or the degenerative knee disease? On the surface that seems pretty straightforward, inflammation and degeneration cause knee erosion. But not so fast
Doctors at the University of Calgary, publishing in the medical journal Osteoarthritis and Cartilage, suggest that knee joint instability leads to destructive alterations in the synovial membranes and cartilage. So in this research, the knee instability came first, then inflammation, then osteoarthritis.
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Treatment For Fluid In Knees
As with any injury, itâs important to consult your doctor for the appropriate treatment for your situation. Here are some treatments and pain management options you may expect for fluid on the knee:
Aspirationâ Your doctor may drain the knee to relieve the pressure of the knee fluid. If blood is present, then it is often sent to the lab to analyze the fluid to ensure that infection is not present. The knee may continue to fill with fluid after being aspirated.
PRICE Methodâ If knee trauma or injury is the cause of the knee fluid, then your doctor may recommend that you use the PRICE method of Protection, Rest, Ice, Compression and Elevation. The combination of these is often used as first aid treatment to minimize fluid in the knee after a traumatic injury.
Medicationsâ There are different types of medications that may be used to treat the excess of knee fluid, depending on the cause of the issue. For example:
- Over-the-counter medications â Pain medications such as ibuprofen or aspirin may be used to help reduce inflammation
- Steroids â These may be taken orally or injected directly into the knee joint. This may be used if over-the-counter medications are not effective at reducing pain.
- Antibiotics â If your knee fluid is caused by infection, then antibiotics may be necessary to fight the bacteria
Why Is Your Knee Always Swollen
The simple answer to why is your knee is always swollen is because it is in a constant state of injury. Your immune system is constantly sending fluids to help cushion your knee and repair damaged tissue and remove dead tissue. The problem is, the knee is beyond its ability to repair the damage in your knee and the fluids remain constant.
So then, why is your knee always swollen?
- You have swelling because your knee lives in a toxic, inflammatory environment and that toxic inflammation runs deeper than conservative anti-inflammatory care can handle.
- The swelling is a toxic soup. It bathes your knee in a constant inflammation that causes knee breakdown.
- As your knee is in a corrosive state where it is breaking down faster than your body can repair it you get caught in a cycle breaking down causing swelling, swelling causing breakdown.
- The inflammatory process is corrosive. This is why there is an urgency to shut down the inflammation to stop knee destruction.
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When Should You Use Heat
When you use a heating pad or hot water bottle, blood flood increases. This makes it easier for oxygen and nutrients to reach your painful joints. Heat helps loosen tight muscles and joints and relieves pain and muscle spasms. If you have swelling, it’s best to use ice for 24 hours, then switch to heat. If swelling isn’t a problem, it’s fine to use heat when you first notice knee pain.
Although a heating pad can help you feel better, it can cause burns if you use it too long or the setting is too high. Don’t use the heating pad for more than 10 to 20 minutes at a time. Stop using the heating pad sooner if it worsens your pain or your skin begins to look very red.
If you don’t have a heating pad or hot water bottle, wet a washcloth, wring it out, then microwave it for 30 seconds. You can microwave the washcloth for a few seconds longer if it isn’t quite warm enough.
A hot shower or bath is also a good choice if you have aching muscles or joints due to an injury, chronic low back pain or arthritis. The Arthritis Foundation® suggests keeping the water temperature between 92 and 100 degrees when you take a shower.