Everything You Need To Know About Water On The Knee
What is it and how is it treated?
Your knee typically has an ounce of liquid inside of it. However, when you have an injury, arthritis, or another problem that irritates your knee, fluid accumulates to cushion and protect your joints.
Clinically, this is known as knee effusion, but most people call it water on the knee.
These Problems Are Getting Worse Despite Years Of Medications
When we see a patient in our clinic with knee swelling, we ask, what have you been taking for this?
Typically the first line of treatment will include the use of anti-inflammatory drugs. The list includes many familiar names, medications you may already be on as well.
- Most common : aspirin, ibuprofen , naproxen
- Prescriptions: celecoxib, diclofenac indomethacin, oxaprozin , piroxicam
When To See A Doctor
A swollen knee is a common occurrence. If mild, it can go away on its own after some good rest. However, if it persists for more than three days or gets severe, it could be a serious underlying condition. Medical attention, in this case, will be necessary. Also, see a doctor if your knee prevents you from doing things like bending, walking, or sitting.
Using heat worsens the condition? Therapeutic heat is not recommended in reducing inflammation or swelling.
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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.
How To Prevent Knee Effusions
You can keep healthy knee joints by doing 150-300 minutes of moderate-intensity aerobic activity and strength training twice a week.
Also, try to keep your BMI below 25. Some studies show that the higher the BMI, the more risk of having excess knee fluid.
If you have arthritis or any other medical condition, follow the indications of your doctors before starting any physical activity regime.
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How Can I Prevent Fluid On The Knee
One of the best ways to prevent this condition is to take care of your joints. Maintain a healthy weight, practice exercises to keep the surrounding muscles strong, flexible, and supportive.
Consider low-impact activities such as cycling, swimming, or moderately challenging walking avoid steep hills. Make sure you use the correct form with any exercises to protect your knees and other joints.
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.
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What Happens At Your Gp Appointment
They may take a sample of fluid from the affected joint using a needle . This will be sent off to test for an infection and conditions, such as gout.
The aspiration may also help your symptoms. It might be done in your GP surgery or you may be referred to the hospital.
If your symptoms do not get better, you may also be referred for other tests.
Treatment For Water On The Knee Or Knee Effusion
The treatment for Water on the Knee or Knee Effusion is two fold and is done by either using medications or a surgical procedure.
Medications: Some of the medications used for treatment of Water on the Knee or Knee Effusion are:
- Pain Medications: Pain medications like ibuprofen etc. can be used for control of pain and inflammation.
- Antibiotics: In case an infection is the cause of the fluid buildup then the physician will prescribes appropriate antibiotics to treat the infection.
- Corticosteroids: Medications like prednisone can be used short term for pain relief.
Surgical Procedures: Some of the surgical procedures used for treatment of Water on the Knee or Knee Effusion are:
- Arthrocentesis: In this procedure, the fluid present in the knee is removed and the pressure in the knee is relieved. After removal of the fluid, the physician may give a shot of steroid to calm the inflammation down.
- Arthroscopy: This procedure is done by making a small incision and inserts an arthroscope which has a minature camera to look at the internal structures of the knee and repairing the damaged structures
- Joint Replacement: This procedure is done if the knee joint gets damaged beyond repair and weightbearing becomes extremely painful and intolerable.
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Knee Effusion Home Remedies And Exercises
The following are some home remedies for water on the knee or knee effusions that can be done before getting professional medical attention.
Rest: Constantly putting stress on your knee joint will make it difficult for the healing process. Stress by simply standing for long periods of time can take a toll on weight bearing joints like the knees.
Cold therapy: This may be done by simply applying ice on the affected knee to help reduce pain and swelling. Using an ice pack is ideal, but ice cubes in a towel or a bag of frozen vegetables will also do the trick. It is recommended to ice the affected joint for about 15 to 20 minutes every two to four hours.
Elevate the joint: This can help relieve pressure on your knee joint and return blood to the upper part of the body. The general rule of thumb is to raise the knee higher than the level of the heart and support the leg with the use of pillows.
Use crutches or walking devices: This will help protect the knee and reduce the stress put on it through daily activity. Knee braces may also be utilized to a similar effect.
While the above recommendations are considered the initial conservative therapy for knee effusion, once the pain and swelling have gone down, performing strength and balance exercise can help ensure your knee has muscle support to reduce the chances of injury in the future. The following are some knee joint effusion exercises for injury prevention you can try today.
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.
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What Is Joint Aspiration
Joint aspiration is a procedure to remove fluid from the space around ajoint using a needle and syringe. This is usually done under a localanesthetic to relieve swelling and/or to obtain fluid for analysis todiagnose a joint disorder or problem.
Joint aspiration is most often done on the knee. However, fluid can also beremoved from other joints, such as the hip, ankle, shoulder, elbow, orwrist.
Other related procedures that may be used to help diagnose joint problemsinclude X-ray, bone scan, magnetic resonance imaging , computedtomography , arthroscopy, and arthrography. Please see theseprocedures for additional information.
How Do I Get Ready For A Joint Aspiration
Your healthcare provider will explain the procedure to you and offer you the chance to ask any questions that you might have about the procedure.
You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.
Tell your healthcare provider if you are sensitive to or are allergic to any medicines, latex, tape, and anesthetic agents .
Tell your healthcare provider of all medicines and herbal supplements that you are taking.
Tell your healthcare provider if you have a history of bleeding disorders or if you are taking any anticoagulant medicines, aspirin, or other medicines that affect blood clotting. It may be necessary for you to stop these medicines before the procedure.
If you are pregnant or suspect that you are pregnant, you should notify your healthcare provider.
Generally, no prior preparation, such as fasting or sedation is needed.
Based on your medical condition, your healthcare provider may request other specific preparation.
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Treatment For Fluid In Knees
As with any injury, it’s 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:
Aspiration – 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 Method – 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.
Medications – 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 – Pain medications such as ibuprofen or aspirin may be used to help reduce inflammation
- Steroids – 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 – If your knee fluid is caused by infection, then antibiotics may be necessary to fight the bacteria
What Are The Risks Of A Joint Aspiration
As with any surgical procedure, complications can happen. Some possiblecomplications may include:
Discomfort at the aspiration site
Bruising at the aspiration site
Swelling at the aspiration site
Infection at the aspiration site
There may be other risks depending on your specific medical condition. Besure to discuss any concerns with your healthcare provider before theprocedure.
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Why Do We Have Water On The Knee
Naturally, you do have some amount of liquid or water present in the knees. It serves the purpose of cushioning the blow during an impact that fluid is named synovial fluid.In arthritis patients, the body goes through excess inflammation because of certain triggers and starts producing additional fluid in response to it.
Accumulation of water on the knee might not seem much big of a deal, but it hinders the quality of life and presents the following symptoms:
- Pain in the knee
These symptoms limit the movement of an individual walking, climbing the stairs, or even bending becomes problematic.
Does Joint Effusion Go Away
Check with your healthcare provider. They can determine if you need treatment for your swollen joint or not. Typically you’ll need treatment, even if it’s just resting the joint at home.
A note from Cleveland Clinic
Joint effusion is where the fluids in the tissues around your joint increase causing your knee, shoulder, ankle or other joint swells up. Treatments help heal the swelling by addressing the cause. There are several actions you can take at home to help heal your joint effusion.
Your swollen joint might be a sign of an injury, infection, arthritis or other condition. It can be unnerving to look at the puffy skin, especially if you dont know what caused it. Take charge of your health by trying the at-home treatments and also contacting your healthcare provider for help if you have symptoms in addition to joint effusion.
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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.
How To Get Rid Of Fluid On The Knee Treatments Symptoms
Otherwise known as knee effusion, water or fluid on your knees is a clear sign that something isnt right. Moreover, there are several things that can cause this, such as arthritis and injuries, and how to get rid of fluid on the knee may depend on the underlying cause.
So, today, allow me to show you a few treatments and options, along with why you might want to go a certain route.
But, just so Im sure were on the same page, lets get our definitions straight.
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What Are We Seeing In This Illustration
This illustration demonstrates the progression of knee osteoarthritis from a small tear or injury to degenerative joint disease. In this example a simple ligament injury, such as the medial collateral ligament depicted here) is not resolved, the resulting joint instability that this small injury can cause is the complete breakdown of the knee joint. As we are demonstrating in this article, a small unrepaired injury can spontaneously lead to osteoarthritis through swelling and inflammation.
What Is Water On The Knee
Water on the knee is a result of your bodys natural efforts to protect itself. When you injure your knee joint causing irritation and inflammation, your body produces extra joint fluid to cushion and lubricate your joints.
The extra fluid causes:
You wont be able to put pressure on your knee. Fluid on the knee can also limit your mobility and make it painful to go up and downstairs, kneel, or squat.
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Comprehensive Prolotherapy For Problems Of Knee Instability And Wear And Tear And Bone On Bonerepetitive Inflammation As An Anti
Comprehensive Prolotherapy is an injection technique that uses a simple sugar, dextrose, and in some cases, it is combined with Platelet Rich Plasma Therapy to address damage and micro-tearing of the ligaments or soft tissue in the knee. A series of injections are placed at the tender and weakened areas of the affected structures of the knee. These injections contain a proliferant to stimulate the body to repair and heal by inducing a mild inflammatory reaction.
The localized inflammation causes healing cells to arrive at the injured area and lay down new tissue, creating stronger ligaments and rebuilding soft tissue. As the ligaments tighten and the soft tissues heal, the knee structures function normally rather than subluxing and moving out of place. When the knee functions normally, the pain and swelling go away.
In published research in the Journal of Prolotherapy, we investigated the outcomes of patients receiving Prolotherapy treatment for unresolved, difficult-to-treat knee pain at a charity clinic in Illinois. Here are the bullet points of our research: