Risk Factors For A Swollen Knee
- Being overweight or obese your knees are weight-bearing so any excess weight puts more strain on them, which can damage your knee joint over time obesity also increases the risk of osteoarthritis, which is a common cause of a swollen knees
- Playing certain sports if you take part in sports that involve pivoting, rotating or twisting your knees, youre at greater risk of knee injuries, which cause swelling
- Your age your risk increases as you get older
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Swelling in the knee most commonly develops after an injury but there are a number of different possible causes to consider. The diagnosis will depend on the cause so, to get an idea, its important to consider events leading up to the swelling as well as how quickly it came on.
Broadly speaking, there are two types of swelling within the knee.
The knee lining, or synovium, produces fluid containing nutrients and lubricants to keep knee cartilage nice and healthy.
The first type of knee swelling, sometimes called an effusion, is where the synovium manufactures excess fluid, which makes the knee appear to be swollen.
The second type is caused by bleeding in the knee that can follow some kind of trauma to the ligaments, the tough bands of tissue that connect the femur to the tibia .
Bleeding in the knee can also follow a bone fracture or a trauma to one of the two meniscus cartilages that lie between the major bones of the knee.
Here are the five main instances of swelling to the knee:
How Do I Reduce Swelling Naturally
Follow these six tips for reducing inflammation in your body:
Simple changes to reduce or prevent swelling
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Facts You Should Know About Knee Bursitis
- A bursa is a fluid-filled sac that functions as a gliding surface to reduce friction between moving tissues of the body.
- There are three major bursae of the knee.
- Localized swelling, warmth, and tenderness, as well as knee pain, often accompany bursitis of the knee.
- Bursitis is usually not infectious, but the bursa can become infected.
- Treatment of noninfectious bursitis includes rest, ice, and medications for inflammation and pain. Infectious bursitis is treated with antibiotics, aspiration, and surgery.
First Of All You Need To Understand The Basic Anatomy Of Your Knee
Its a synovial joint which means it allows a lot of movement. This degree of movement is made possible largely because of fluid within and around the bones and other soft tissue that make up your knee.
The synovial fluid in the knee basically reduces friction between the joints moving parts, similar to how gear oil helps your car to run smoother. Its also what most people consider water on the knee.
So, if youve ever wondered, is it bad if you have fluid in your knee?
No, its not. Having fluid in the knee joint is actually normal. But, also like gear oil, the problem begins when you have too little or too much.
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Can Fluid On The Knee Get Worse
Yes. Its important to get a correct diagnosis of why your knee is swollen and follow proper treatment. A bacterial infection could spread and lead to permanent cartilage damage. If the problem is an internal tear, youre likely to have long-term, progressively more debilitating pain and loss of mobility if its not treated.
Why Rice And Ice Is Not The Answer
You may be recommended to use ice to reduce the swelling. For many athletes, a doctors recommendation of the RICE protocol for healing their sports-related soft tissue issue injury was seen as the gold standard of care. However, this treatment is now under criticism from a surprising source, the doctor who created the RICE treatment guidelines, Gabe Mirkin, MD.
In a recent article on his own website, Dr. Mirkin admits that both ice and rest may delay healing. This insight comes nearly 40 years after Dr. Mirkin authored The Sportsmedicine Book , where he coined the acronym RICE for the 4 elements which became the standard of care in treating soft tissue injuries- Rest, Ice, Compression, and Elevation. Coaches, physicians, physical therapists, and the lay public have recommended and followed the RICE guidelines for decades, but as Mirkin states:
- it now appears that both ice and complete rest may delay healing, instead of helping.
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Can Synovial Fluid Leak
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Causes of the swelling include arthritis or an injury to the ligaments of the knee. Knee effusion could also be caused by an underlying disease or condition. The type of fluid that accumulates around the knee depends on the underlying disease, condition, or type of traumatic injury that caused the excess fluid.
Likewise, is joint effusion serious? Joint effusion associated with severe arthritis may lead to progressive muscle loss, a condition referred to as arthrogenic muscle inhibition. A common complication of a joint effusion is the formation of the fluid-filled nodule, known as a Baker’s cyst, in the joint space.
Beside this, can synovial fluid be replaced?
Synovial Fluid Replacement, also known as viscosupplementation, is a treatment to restore the viscosity of synovial fluid. Hylauronic Acid , is injected directly into the knee joint which not only supplements the body’s own dwindling supplies but also stimulates the joint linings to begin producing it by themselves.
What does bloody synovial fluid mean?
Less stringiness in the fluid could signal inflammation. Excess fluid in the joint could be a predictor of osteoarthritis. Reddish-colored fluid could mean blood is present. Blood in the fluid could point to a bleeding injury in the joint or a more serious bleeding problem throughout the body, such as hemophilia.
What Other Treatment Options Are Available
Your healthcare provider may recommend advanced treatment options such as:
- Antibiotics if you have an infection.
- Physical therapy to increase range of motion.
- Occupational therapy to learn how to move in ways that dont stress the area.
- Injection of a corticosteroid medication to quickly decrease inflammation and pain.
- Surgery to repair the bursa, if other treatments dont work after six months to a year.
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Water On The Knee: Joint Effusion
Our body has a joint lubrication system that cuts down on friction and helps to promote smooth joint rotation. Sometimes, too much fluid gets accumulated around the joint causing joint effusion, also known as swollen knee or water on the knee. This condition can result from an injury, infection, or medical condition.
About 27% of people in the United States might experience fluid on the knee at some time in life. Together with swelling, the excess fluid in the joints can also result in pain and stiffness. The effusion tends to affect the larger joints including the knee, shoulder, elbow, or ankle. It is different from edema, which is a different type of swelling caused by inflammation, allergy, heart failure, and other conditions.
What Do 18 Months Of Continued Inflammation Do To Your Knee When You Have A Meniscus Tear
Early in January 2019, the same research team published in the journal Arthritis & Rheumatology a study of 221 patients with knee osteoarthritis and meniscal tear. They examined these patients over a time period of 18 months.
- effusion-synovitis was persistently minimal in 45.3% and persistently extensive in 21.3% of the patients.
- The remaining 33.5% of the patients had minimal synovitis on one occasion and extensive synovitis on the other.
- Patients with extensive effusion-synovitis at baseline persistently extensive effusion-synovitis had a significantly increased risk of progression of cartilage damage depth. .
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How Is Knee Swelling Treated
Depending on the type and severity of your problem, treatments range from surgery to home remedies. Non-surgical remedies include:
- RICE: an abbreviation for Rest, Ice, Compression and Elevation, is best to do shortly after suffering an injury. RICE can be helpful for managing minor pain.
- Compression: wrapping the knee not too tightly in an elastic bandage
- Physical therapy: doing exercises to strengthen the knee and improve its stability
- Wearing a brace on the knee
- Taking over-the-counter pain-relief medication
- If you are overweight, losing weight to reduce pressure on the knee
In some cases pain medication or a lubricating substance might be injected into the knee. Or a needle may be used to reduce swelling by removing excess fluid.
Why Nothing Is Helping You
There may be two reasons that you are reading this article. You did a casual search to see what you can do for your recent knee swelling event, perhaps you worked the long shift in the warehouse, decided to play 27 holes instead of 18, or did something to aggravate your knee beyond normal everyday function. Then you may have landed here because your knee swelling has been going on for years and you have tried everything.
Lets see some stories from the emails we get from people who have tried everything.
I want to return to activities without pain and swelling and tightness and sleep without pain.
Here is a story, probably sounds like many of yours: I want to return to activities without pain and swelling and tightness and sleep without pain. My right knee has been causing me pain for the last five years. It all started with some minor sprains and tears. First was to MCL, then the meniscus had a small tear. I had an MRI and X-rays and the surgeon recommended I get a cortisone shot before considering arthroscopic surgery. The surgery is to clean up some debris.
The cortisone injection did not help. I was prescribed physical therapy which made my knee worse. I was not sleeping so I scheduled the surgery. I am waiting for the surgery now.
The Bakers cyst
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What Are We Seeing In This Image Fluid On The Knee Or In The Knee Drowns Cartilage And Meniscus Cells And Leads To Bone On Bone Knees
In this image, we see cells that are drowning. How does this happen? Arent our knees protected by synovial fluid? Dont our knees live in fluid? Isnt 90% of our body made of water? So how do cells drown?
At the start of your chronic knee problems, you were at the development phase of knee instability caused by weakened or damaged knee ligaments. As your knee became more unstable and somewhat painful your body started to send extra fluids into the knee to act as a sort of brace and extra shock absorber. Your body needs a functioning knee so your body is trying to protect your knee. As you continue on with your job and activities and your knee becomes more of a problem, your body sends more fluid to the knee. Your body is trying to tell you something. Your knee is a problem.
As knee degeneration continues cracks start developing in the articular cartilage of the knee. That is the cartilage that wraps at the bottom of the thigh bone, the back of the patella, and the top of the shinbones. Cracks and tears also develop in the meniscus. Here you are on the way to bone on bone. But it can get worse.
Otc Pain Relievers Nsaids And Topical Salicylates
Over-the-counter medications are also options. You can buy them virtually anywhere without needing a doctors prescription and come in various brands and types.
Per MedlinePlus, there are 2 main types of oral OTC pain relievers you can buy:
- Acetaminophen , and
Acetaminophen has no anti-inflammatory properties but it does help you manage the pain. Popular examples include Tylenol and Panadol.
NSAIDs, on the other hand, have anti-inflammatory properties as well as pain-relieving properties. Examples include Advil, Aleve, Celebrex, and several others.
Apart from oral medication, you could also get topical salicylates.
Topical salicylates are technically still considered NSAIDs, so they can also help reduce pain and swelling.
For those of you whose stomachs dont react well to oral NSAIDs, these topical alternatives may be the better option.
However, Harvard says that topical NSAIDs arent as effective as their oral counterparts because your body absorbs less of the medicine. So, you might not feel the same exact relief. Also, dont apply these on wounds or rashes.
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Which Type Of Knee Bursitis Do I Have
One easy way to identify knee bursitis is by understanding the location along with circumstances. This means where the potential bursitis is along with how quickly you began feeling the pain.
Prepatellar bursitis, infrapatellar bursitis, and superficial infrapatellar bursitis all come on fairly quickly. Its common to see the knee bursitis form after waking up in the morning. Usually, this bursitis attacks after physical activity has ceased for a number of hours.
All forms of patellar bursitis are located in the front of the knee. Prepatellar bursitis is typically felt right below the kneecap at the very top of the shin .
These forms will often start as a small bruised feeling, then about 6-8 hours later, the knee will begin to swell and stiffen. This is usually accompanied by moderate pain.
Other forms of bursitis usually take a little longer before they reach peak swelling and painfulness.
Often patients will notice that the area feels slightly bruised or stiff for a day or two before the more serious symptoms begin .
The exact type is best identified by using the image above.
What Happens After A Joint Aspiration
Once you are home, it is important for you to keep the joint aspirationsite clean and dry. Leave the bandage in place for as long asinstructed by your healthcare provider.
The aspiration site may be tender or sore for a few days after thejoint aspiration procedure. Take a pain reliever for soreness asrecommended by your healthcare provider. Aspirin or certain other painmedicines may increase the chance of bleeding. Be sure to take onlyrecommended medicines.
Notify your healthcare provider to report any of the following:
Fever of 100.4Â°F or higher, or as directed by your healthcare provider
Redness, swelling, bleeding, or other drainage from the aspiration site
Increased pain around the aspiration site
Your healthcare provider may give you additional or alternateinstructions after the procedure, depending on your particularsituation.
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Chronic Knee Swelling Is Developing And Worsening Knee Osteoarthritis
In this video Danielle R. Steilen-Matias, MMS, PA-C offers a brief summary of the constant degenerative process going on in your knee that shows itself every day to you as swelling.
Summary and learning points:
- Many patients tell us that their other health care providers and doctors dismiss or ignore their complaints of knee swelling. However, as research suggests, such as the research examined in this article, is that chronic knee swelling signifies the early development of osteoarthritis.
- The reason the knee is swelling relates to the strength or integrity or lack thereof of the soft tissue around the knee. So the knee swelling can be coming from knee ligament injury or instability. Your body, in an attempt to provide stability for the unstable knee, will swell the knee as a protective mechanism to provide stability to the need temporarily. It should be temporary. Your body is swelling the knee until healing of an injury can take place. The fluid fills the knee to also prevent excessive movement to accelerate healing. When the injury is healed the swelling goes away.
- If you do a job that is very physically demanding, you are on your feet all day, you climb ladders or steps, etc, that is a lot of strain to be putting on your knees and your body does the best it can to provide the swelling necessary to keep your knee together. The problem is chronic swelling is causing a rapid degeneration in the knee.
What Is The Best Way To Get Rid Of Fluid On The Knee
This is purely situational. Whats best for you may be different for someone else.
- The RICE method is essentially first-aid for fresh injuries.
- Oral over-the-counter medications like pain relievers and NSAIDs are solid options but topical salicylates may be better if the former give you gastric distress.
- Corticosteroids may also be prescribed if OTC options dont work or if the knee swelling is caused by autoimmune disorders
- Your doctor may also order antibiotics if bacterial infections are what caused the swelling and knee pain.
- Knee joint aspiration can also be an option to quickly evacuate the water inside your knees.
- Minimally invasive and extensive knee surgeries may be required if structures in and around your joint need repair.
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What If I Need Surgery On My Swollen Knee
Depending on your situation, surgery can range from arthroscopic surgery to replacing the knee joint with an artificial one.
Arthroscopic surgery uses a tiny camera that is part of an instrument called an arthroscope. It can be used as a tool for diagnosis as well as for treatment, and is usually an outpatient procedure . Depending on the type of surgery, physician therapy is often recommended afterward to restore mobility and strength in your knee.
Last reviewed by a Cleveland Clinic medical professional on 01/03/2018.