How To Care For A Swollen Knee
This blog post was updated for content on October 20. 2020. Existing comments have not been modified or removed.
Knee swelling occurs when excess fluid accumulates on or around the knee joints. Doctors call this an effusion, and some people call it water on the knee. Sometimes, swelling will go away with home treatments. Other times, it may require visiting a doctor for medical treatment.
A Villain In All This The Synovial Macrophages Eating Away At Your Knee
First, lets identify what Synovial macrophages are. A paper in the journal Frontiers in immunology describes them this way: Synovial macrophages are one of the resident cell types in synovial tissue and while they remain relatively quiescent in the healthy joint, they become activated in the inflamed joint and, along with infiltrating monocytes/macrophages, regulate secretion of pro-inflammatory cytokines and enzymes involved in driving the inflammatory response and joint destruction. Probably what you got the most out of this paragraph is driving the inflammatory response and joint destruction.
How are the synovial macrophages doing it? By bloating chondrocytes and making them puke up corrosive substances in your knee
Here is a May 2021 study in the journal iScience that explains what is happening in your knee: Synovial macrophages that are activated by cartilage fragments initiate synovitis, a condition that promotes hypertrophic changes in chondrocytes leading to cartilage degeneration in osteoarthritis. . . Stimulated macrophages promoted hypertrophic changes in chondrocytes resulting in production of matrix-degrading enzymes of cartilage. So the chondrocytes becomes bloated with matrix-degrading enzymes of cartilage and pukes them out in the knee.
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What Causes Swelling Behind The Knee
There are a number of different causes of swelling behind the knee. In most cases, back of knee swelling is caused by a build-up of fluid or an abnormal growth in the popliteal space the soft area at the back of the knee.
Here we look at five common causes of swelling behind the knee, the causes and symptoms of each, how to tell whether its something serious and the best ways to treat causes of swelling behind the knee.
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Physical Therapy First Why
What Causes Prepatellar Bursitis
There are a few situations and conditions that can cause prepatellar bursitis, including:
- Frequent kneeling: Most cases of prepatellar bursitis are caused by pressure and irritation from frequent kneeling.
- A direct hit to the knee: Trauma to your knee from falling or getting hit with something can cause prepatellar bursitis.
- Bacterial infection: If you have a scratch, insect bite or cut on your knee that becomes infected, it can spread to your prepatellar bursa sac. This kind of prepatellar bursitis is called infectious bursitis. Its not as common, but its a serious condition that needs immediate medical treatment.
- Having rheumatoid arthritis and/or gout: Although its not as common, both rheumatoid arthritis and gout can cause prepatellar bursitis.
How Does A Meniscal Cyst Develop
Usually, a tear forms in the meniscal cartilage from degeneration or an acute meniscus injury. Fluid from the knee joint then leaks out of the tear, forming a cyst. So, a meniscal cyst is not a true cyst but an outpouching of displaced knee fluid. Also, the cartilage tear can form a one-way valve preventing the fluid from returning to the knee. The liquid then collects as a cyst below the knee cap.
Often, meniscal cysts form in people with a history of a knee injury, cartilage damage, or contact or twisting sports. Also, the presence of arthritis predisposes to the formation of a cyst on the side of the knee.
Medical History And Physical Examination
Your doctor will talk with you about your symptoms, such as the severity of your pain, how long you have had symptoms, and your risk factors for developing prepatellar bursitis.
Your doctor will likely ask questions regarding any signs or symptoms of infection, such as fever or chills. Prepatellar bursitis caused by an infection requires a different treatment plan.
During the physical examination, your doctor will inspect your affected knee and compare it to your healthy knee. They will examine your knee, checking for tenderness, and will also assess the range of motion in your knee and whether pain prevents you from bending it.
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When To Seek A Doctors Help
If you suspect you may have knee bursitis, its best to see a doctor as soon as possible. The knee is a complex joint with a variety of muscles, bones, tendons, and other tissue. It is prone to a variety of injuries and bursitis is just one of them. A lot of the times, you may experience overlapping symptoms with a lot of knee conditions.
Getting a doctor to check your knee condition will ensure you get the right diagnosis and treatment. While bursitis is not a dangerous condition and can be treated, delaying a diagnosis and treatment can cause you unnecessary pain and symptoms. For a fast and effective recovery, you should get a diagnosis and treatment soon after you experience symptoms.
What Is Knee Swelling
Swelling in the knees is a common problem with many possible causes. Knee joints are complicated structures with a number of parts that can cause pain, including:
- Tendons, which connect muscles and bones
- Ligaments, which connect bones to other bones
- Cartilage, which covers the ends of bones and cushions them from each other
Knees have a heavy workload in our lives and bear our weight much of the time. Many kinds of injuries, arthritis, and other problems caused by repetitive use can lead to swelling, an accumulation of fluid in a particular part of the body.
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When To See A Doctor
If the swelling doesnt go down in one to three days of using the RICE method, its time to call a doctor.Also, call a doctor immediately if there are any of these symptoms:
- The knee is severely swollen or has a pronounced abnormality
- The knee cannot fully straighten or flex
- The knee is severely painful
- The knee feels like it will give out or cannot support any weight at all
- The skin near the knee is hot or red
- Swelling has not gone down after three or more days
If youre experiencing knee swelling that will not go away or have pain, connecting with a specialist is always a good idea. Theres no need to rush into surgery. At Flexogenix, we specialize in cutting-edge, non-surgical treatment options, and can help you move past achy knees and into your best lifewithout invasive surgery. Contact us today to schedule your free consultation.
Knee Swelling Inside The Joint
The knee joint has a normal amount of fluid in it. This is called synovial fluid, It assists with lubrication and nourishment of cartilage. A normal amount of synovial fluid does not cause swelling of the knee and will not be detected as swelling during a routine examination.
Synovial fluid is produced by the inner lining of the knee joint . The synovium may produce excessive fluid as a result of irritation or inflammation. It is thought that this fluid is produced as a protective measure. The accumulation of fluid in the joint will result in swelling, called an effusion. This may be a small enough to be detected only by the most experienced examiner, or it may be big enough to be seen by everyone in the room.
The synovium itself may cause swelling if it is inflamed and thickened . There will usually be some fluid associated with this type of swelling.
Besides normal synovial fluid, blood which accumulates in the joint can also result in swelling. This is seen in conditions such as haemophilia and obviously in acute knee injuries. It is also seen after surgery. I will not discuss these conditions here.
There are many potential causes for a swelling inside the knee joint. Instead of giving you an exhaustive list I would prefer to tell you about some of the common conditions I see daily.
Swelling is usually associated with more severe cases where there is significant crepitus and fissuring.
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Are There Different Kinds Of Prepatellar Bursitis
There are two types of the condition: Acute prepatellar bursitis and chronic prepatellar bursitis. Acute prepatellar bursitis happens when theres sudden damage to your bursa in front of your kneecap. This usually happens from trauma or an infection. Chronic bursitis usually happens from repeated overuse or pressure to your knee, such as frequent kneeling.
Symptoms Of A Swollen Knee
- The skin around the kneecap is puffy
- The knee is stiff and its difficult to bend or straighten it
- Its painful and bearing weight is difficult or impossible
- Redness or warmth
Swelling that does not go away, also known as chronic swelling, can lead to joint damage, cartilage degradation, or bone softening.
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What Is Prepatellar Bursitis
Prepatellar bursitis is inflammation of the bursa that is in front of your kneecap . Prepatellar bursitis happens when your bursa is frequently irritated, damaged or infected and makes too much fluid. The extra fluid causes your bursa to swell and puts pressure on other parts of your knee. You can usually see prepatellar bursitis because the front of your knee will look swollen.
When Should I See A Doctor For Knee Bursitis
Are you experiencing an uncomfortable swelling in your knee or has the skin on your knee turned red and tender? You might have knee bursitis or inflammation of the knees bursa.
Knee bursitis can occur in any part of the kneeabove, below, or in the kneecap. Bursas are small fluid-filled sacs found in the knee joint. They prevent the various knee tissues from rubbing against each other, which can cause immobility and excruciating pain. When knee bursitis develops, a bursa becomes inflamed. Knee bursitis is typically a temporary condition, and you can recover completely after treatment.
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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.
Who Does Prepatellar Bursitis Affect
Anyone can get prepatellar bursitis, but it more commonly affects men between the ages of 40 and 60. Chronic prepatellar bursitis most commonly affects people who have jobs or hobbies that involve frequent kneeling, such as carpentry, house cleaning, plumbing and gardening. Children are more likely to develop septic prepatellar bursitis .
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Mildly Swollen But Painless Knee: Possible Cause
The most common cause of non-traumatic knee swelling is a misalignment of the large tibia bone that comprises the lower part of the knee joint, says Eugene Charles, DC, Diplomate of applied kinesiology and author of Journey to Healing: The Art and Science of Applied Kinesiology.
This frequently happens insidiously through daily activities where you turn your leg and foot out repetitively.
These subtle movements include getting out of a chair or car seat and going up stairs.
Over time the tibia bone rotates slightly out of alignment and needs to be realigned through a precise chiropractic or osteopathic adjustment.
Resting it only helps because you are not using it, but rest alone does not fix the underlying cause of the knee problem specifically the misalignment of the knee joint itself.
Bakers Cyst Swelling Behind My Knee
I fight the urge to sing the notorious hit I Want It That Way by the Backstreet Boys as I start to write nearly EVERY articleTell me why?!? Swelling behind the knee is a common finding, often labeled as a Bakers Cyst . Sometimes it is accompanied by pain and sometimes it isnt. You might have painful swelling behind the knee right at this moment. You may also feel the same swelling on the other side without any complaints of pain. So I know what you are thinking, or singing, tell me why?! We have fluid filled sacs called bursae in various regions throughout the knee that serve a purpose. Your Bakers Cyst is actually one of these bursae. A Bakers Cyst specifically refers to a bursae located at the inner portion of the knee between the head of the calf tendon and hamstring tendon .
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What Is The Difference Between A Meniscal Cyst And A Bakers Cyst
A Bakers cyst is a swelling behind the knee caused by an outpouching of the capsule. Like a meniscal cyst, a Bakers cyst can form from a meniscal tear. However, they also form from any knee condition that increases knee joint fluid, such as arthritis or ligament damage. Generally, we can tell the difference between a meniscal cyst and a Bakers cyst based on the lumps location and size.
How Long Does It Take For Fluid On The Knee To Go Away
It usually goes down after 1 to 3 days with the formula. If you are experiencing swelling or pain after starting R.I.C.E., or if it persists after a few days, see a doctor. Over-the-counter medications may be effective in relieving knee swelling and associated pain, despite the fact that they are not always required.
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How Is Prepatellar Bursitis Treated
The treatment for prepatellar bursitis depends on if your bursa is inflamed or infected. Most cases of prepatellar bursitis that just involve inflammation can be treated from home without medical intervention. If an infection is the cause of the prepatellar bursitis, antibiotics are needed to treat it.
Treatment for prepatellar bursitis that involves just an inflamed bursa can include:
- Resting and minimizing certain activities: Be sure to avoid or minimize activities and motions that make your symptoms worse until your prepatellar bursitis gets better.
- Applying ice: Applying ice to your knee at regular intervals can help reduce swelling and pain.
- Elevating your leg: Try to elevate your leg with the affected knee when youre resting.
- Taking anti-inflammatory drugs: Anti-inflammatory drugs such as ibuprofen and naproxen can help reduce pain and inflammation.
- Corticosteroid injection: In some cases, your healthcare provider may give you a corticosteroid injection to help with the inflammation if rest and other anti-inflammatory drugs arent working.
Treatment for prepatellar bursitis that involves an infection can include the following:
- Antibiotics: Antibiotics are needed to treat bacterial infections. Your healthcare provider may have you take them by mouth as pills or by an IV.
- Surgical drainage: If antibiotics arent working to treat the infection, you may need to have your prepatellar bursa surgically drained.
How Can Bakers Cysts Be Prevented
Knee joints are susceptible to injury during sporting activities. Preventing knee injuries from occurring can reduce the risk of a Bakerâs cyst developing in the first place or coming back.
Things you can do to prevent knee injuries include:
- warming up and cooling down before and after exercising or playing sports
- wearing supportive footwear
- trying to turn on the balls of your feet, rather than through your knees.
If you injure your knee, stop your activity immediately, apply ice packs to treat the swelling and seek medical advice.
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Complications Of A Swollen Knee
You may develop a Baker’s cyst. This is when joint fluid leaks out into the back of the knee and causes pain and swelling. Treatment usually involves compression and applying ice packs. However, if your swelling is severe, you may need to have the fluid removed using a fine needle.
You may lose muscle mass, especially in your thigh muscles. This is because fluid in your swollen knee can prevent your thigh muscles from working properly over time this causes them to weaken and deteriorate.
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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Bursitis Could Be To Blame
Often confused with arthritis, bursitis is another condition that can cause swollen knees. Bursitis is a reaction in which sacks of fluids, blood vessels, and nerve endings that cushion your jointscalled bursaebecome inflamed, explains Dr. Gladstone. Typically, bursitis occurs across the front of the knees as a result of excess pressure and friction on the joint over time.
Those little blood vessels bleed and the bursa produces excess fluid, which creates this giant, swollen pouchlike a bubble of fluid just below the skin, Dr. Gladstone says. These inflamed pouches, which can take on all sorts of shapes and sizes, can be incredibly painful to put pressure on.
Bursitis is most common in people who work a lot on their knees, like carpenters, plumbers, and tile-setters, says Dr. Gladstone. However, a good fall can cause bursitis, too.