Therapy

Bursitis of the knee is easily treatable and usually heals by itself within four to six weeks. The affected knee should be spared and immobilized for the first one to two weeks to prevent further irritation of the bursa. The application of splints or bandages is recommended as a supporting measure to immobilize the knee joint.

The sparing itself should not be carried out for too long in order to prevent muscle loss and permanent restrictions of movement in the knee. In this case it is advisable to move the knee gently and lightly several times a day. For pain relief, the use of decongestant measures such as the application of cooling gels or ointments is recommended.

When using cooling gels, care should be taken to ensure that the cooling agent is not applied directly to the skin for more than five minutes at a time. Otherwise dangerous frostbite of the skin can occur. The use of heat should be avoided at all costs.

In an inflamed area this leads to an increase in pain and worsening of the inflammation. Anti-inflammatory painkillers, such as Ibuprofen® or Diclofenac®, can be used to treat bursitis of the knee. If the bursitis of the knee continues to be present in the knee joint after completion of therapy, the fluid caused by the inflammation can be removed by a doctor with minimal medical intervention.The affected knee is punctured with a syringe and the fluid is drained.

In addition, anti-inflammatory or anaesthetic agents can be injected into the knee by the treating physician. A pressure bandage is then applied. If there is no improvement under the above mentioned measures, if the affected person suffers an inflammation of the bursa of the knee several times a year or if the acute inflammation has turned into a permanent inflammation, this may be a reason for surgical removal of the bursa.

The knee is opened with a skin incision under anesthesia and the bursa is removed in its entirety. The skin incision is then closed with a suture. After the operation, the knee should then be immobilized for four to six weeks.

During this regeneration phase, the body forms new tissue at the site where the inflamed bursa once was. This new tissue fulfills a bursa-like function. However, a new inflammation cannot be ruled out.

If a bacterial infection is the cause of the bursitis of the knee, it may be necessary to take antibiotics. If the cause of the bursitis in the knee is another underlying disease, the therapy is based on the disease causing it. Nowadays, the use of ointments on normal skin is viewed rather critically, as new studies have shown that the active ingredients contained in the ointments are almost never absorbed by the skin, but remain in the uppermost layers of the skin.

The benefit of locally applied ointments on the knee is therefore questionable. If affected persons nevertheless wish to apply ointments locally, they are recommended to use Diclofenac Gel (= Voltaren ointment) for external application. This is because it contains a painkiller as the active ingredient, which also has an anti-inflammatory effect.

Assuming that the active ingredient is sufficiently absorbed through the skin, it is effective against both the pain and the signs of inflammation. Octenisept gel or Octenisept solution can be an alternative. If it is placed either as a gel directly on the swollen joint or, when the solution is applied to the affected area using soaked compresses, it has a very good anti-inflammatory effect and can lead to a significant reduction in swelling.

The effect is mainly based on the externally disinfecting and cooling effect. The use of antibiotics only makes sense in case of a bacterial infection of the knee. The pathogens are primarily secured by puncturing the knee joint.

If there is no puncture result, antibiotics are used mainly in cases of elevated inflammatory parameters in the blood and accompanying infection symptoms in the patient, such as fever. The more severe the clinical picture, the more likely it is that the antibiotics will be administered intravenously by means of an infusion. It is mainly behavioral and local measures that can contribute to a faster healing of a bursitis of the knee.

The simplest measure here is physical protection of the joint combined with elevation of the affected region. This can significantly reduce the swelling. If the affected joint is also cooled at intervals, the pain is relieved and the swelling is reduced.

A proven household remedy is the application of curd wraps over the affected joint. The effectiveness is based on various mechanisms. Since the curd is spread directly from the refrigerator in a thin, moist dry cloth and then wrapped around the joint in the cloth, it cools directly locally.

In addition, the wetness of the curd creates an evaporative cooling effect. The lactic acid contained in the quark is believed to absorb inflammatory substances from the knee joint, although there is no medical evidence of this. Other household remedies such as the application of apple vinegar or grated ginger on the joint are not recommended, as they often cause massive external irritation.

From a medical point of view, a homeopathic therapy for bursitis can be tried out by patients with very mild courses of the disease. However, it should only be used as a supplement to local measures such as cooling, elevation and protection, as there is no evidence for the exclusive use of homeopathic remedies. In the case of severe and bacterially caused bursitis, however, homeopathy is not advisable, since in most cases only a rinsing of the joint up to surgical removal of the bursa is effective.In addition, there may be interactions with antibiotics and painkillers, which would then delay the healing process.

Taping the knee in the case of bursitis is only useful if the cause of the inflammation and the resulting effusion is overstraining the joint. Only if there is a serous fluid in the joint does it make sense to drain it through the lymphatic system, as is the basic idea behind taping. Metaphorically speaking, the tape provides a “drainage channel” for the effusion and causes it to drain away as quickly as possible.

If there are pathogens in the knee, a tape bandage is not recommended to prevent the pathogens from spreading. Well-applied bandages help to minimize or reduce the effusion in the case of bursitis, as they exert circular pressure on the tissue and thus prevent fluid from spreading in the tissue. They are therefore highly recommended for the treatment of bursitis. However, patients should take care not to apply the bandages too tightly, so that sufficient blood circulation in the affected region is still guaranteed.