Knee bursitis is a common source of knee pain and swelling that occurs when the small, fluid-filled sacs (bursae) near the knee joint become inflamed. Bursae reduce friction between bones, tendons, and muscles. Managing the resulting swelling and discomfort is a primary concern. This article explores the role of compression in managing this condition and outlines other comprehensive treatment options.
What is Knee Bursitis?
The knee joint contains several bursae, which are thin, slippery pouches filled with lubricating fluid. Their purpose is to cushion and reduce mechanical friction where soft tissues move over bone, enabling smooth joint movement. Bursitis is the inflammation of one or more of these bursae, causing the sac to produce excess fluid and swell noticeably.
The prepatellar bursa, located directly in front of the kneecap, is the most frequently affected site, sometimes called “housemaid’s knee.” Bursitis commonly results from repetitive or prolonged pressure on the knee, such as extended periods of kneeling. Other causes include a direct blow or trauma to the knee, or an infection, which leads to septic bursitis.
Compression Therapy: Mechanism and Effectiveness
Compression is a standard component of conservative treatment for knee bursitis, primarily targeting the reduction of edema, or swelling. Applying external pressure helps minimize the accumulation of excess fluid within the inflamed bursa and surrounding tissues. This controlled pressure assists the body’s natural fluid dynamics, encouraging lymphatic drainage and venous return.
The mechanical support provided by compression materials, such as elastic bandages or specialized knee sleeves, helps stabilize the joint and surrounding soft tissue. This stabilization limits excessive movement, which can irritate the inflamed bursa, contributing to pain relief. Proper compression can reduce knee swelling in mild to moderate cases, promoting a more comfortable recovery.
Compression mimics the body’s muscle pump action, aiding in moving metabolic waste and deoxygenated blood back toward the heart. By improving local circulation, the therapy enhances the delivery of oxygen and nutrients to the affected area, supporting the natural healing process. The goal is symptom management—controlling the volume of swelling—rather than treating the root cause of the bursitis.
Risks and Limitations of Compression
While generally beneficial for swelling, compression is not without risks, especially if applied incorrectly. Applying a bandage or sleeve too tightly restricts blood flow, potentially leading to nerve damage or skin irritation. Signs that compression is too restrictive include numbness, tingling, a change in skin color (such as paleness or blue discoloration), or increased pain distal to the device.
Compression may require caution in specific medical situations. Individuals with certain vascular conditions, such as peripheral arterial disease, should consult a healthcare professional before using compression. If septic (infected) bursitis is suspected, compression should typically be avoided, as external pressure could potentially spread the localized infection.
A key limitation is that compression primarily manages the symptom of swelling and does not address underlying causes like infection or chronic irritation. A compression garment that directly presses on a highly swollen and tender prepatellar bursa can sometimes increase discomfort. Ensure the compression device is a proper fit, feeling snug but never painful.
Comprehensive Treatment Approaches
Management of knee bursitis extends beyond compression, often starting with conservative measures to reduce inflammation and protect the joint. Rest is paramount, requiring the temporary avoidance of activities that aggravate the bursa, particularly kneeling or prolonged pressure. Elevating the affected leg above the heart leverages gravity to reduce fluid accumulation and swelling.
Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, are commonly used to manage pain and decrease inflammation. Applying ice to the affected area for short intervals helps numb pain and constrict blood vessels, limiting the inflammatory response. These initial home measures resolve most cases of non-infectious bursitis.
Medical Interventions
When conservative treatment proves insufficient, medical interventions may become necessary. Aspiration, where a healthcare provider uses a sterile needle to drain excess fluid from the bursa, can relieve pressure and allow for fluid testing. If the bursitis is not septic, a corticosteroid injection may be administered into the bursa to provide powerful, localized anti-inflammatory effects.
If fluid analysis indicates a bacterial infection (septic bursitis), the patient requires a course of antibiotics to eliminate the infection. In rare, chronic, or severe cases where other treatments have failed, surgical removal of the bursa may be considered.