Prepatellar bursitis is a common complaint of people who work on their knees or are at higher risk for knee injury. Home treatment, including ice, rest, and over-the-counter pain relievers can help in most cases.
Pain in the knee can come from various sources. When the pain is focused on the kneecap and accompanied by sudden swelling and warmth, it may be a condition called prepatellar bursitis.
This article explains more about the condition, why it happens, and treatments that can help return to your daily activities without pain.
The word “bursitis” means inflammation of a bursa, a fluid-filled sac. There are bursas around various joints in the body, including the knees, elbows, and shoulders. Prepatellar bursitis refers to inflammation of the bursa on the front of the kneecap.
- Acute prepatellar bursitis is caused by direct injury or an infection.
- Chronic prepatellar bursitis is caused by overuse or friction from activities where you remain on your knees for long periods of time.
Regardless of type, the experience is relatively the same.
When a bursa become inflamed, it causes pain and other symptoms like swelling. In the knees, this means you may see a fluid-filled lump on the top of your kneecap.
Other names this condition is known by
The location of pain and inflammation with prepatellar bursitis may result from frequently kneeling. For this reason, people use various informal names for the condition according to the various activities that may cause it.
- carpenter’s knee
- housemaid’s knee
- carpet layer’s knee
- coal miner’s knee
- plumber’s knee
- gardener’s knee
The causes of prepatellar bursitis can be divided into three main categories:
- pressure on the knee from jobs or activities that involve repeated kneeling
- blow to the knee through an injury or in sports (football, wrestling, etc.)
- bacterial infections from wounds that break the skin and allow bacteria to enter the bursa
Having health conditions like gout or rheumatoid arthritis may also increase a person’s risk of developing prepatellar bursitis.
Pain with prepatellar bursitis is typically dull and achy. It may come with activity and go away at rest.
You may notice pain during the day when you’re up walking around that goes away when you’re sitting down or sleeping.
Other symptoms include:
- sudden swelling on the kneecap
- discomfort when touching the kneecap
- warmth around the kneecap
- trouble moving the knee
While less common, infection-induced bursitis may cause additional symptoms. It can be helpful to watch for excess fluid and redness at the kneecap, as well as fever and chills.
Treatment for prepatellar bursitis depends on the cause and the severity of the condition. Your doctor will perform a physical exam to assess the severity before prescribing a treatment plan.
Diagnosis may also include imaging tests to rule out other causes. Those tests may include:
If your doctor suspects you have infection-induced bursitis, they may collect a joint fluid culture by aspirating the bursa with a needle.
If the bursa is inflamed but not infected, your doctor may suggest conservative treatment measures.
R.I.C.E. method: What to know
In particular, the R.I.C.E. method can be an effective first-line method to ease pain and lessen inflammation.
- Rest: Steer clear of any activities, like sports, or modify the kneeling position in any activities that make your pain worse.
- Ice: Use a cooling pack to ice the affected knee for 20 minutes, 3 to 4 times a day.
- Compression: Wrap the knee with an elastic bandage (as directed by your doctor) to help with fluid buildup or swelling.
- Elevation: Keep the affected leg elevated with pillows when you are not walking around.
Over-the-counter (OTC) pain relievers can help ease discomfort and reduce swelling.
Your doctor may suggest using nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen (Aleve) or ibuprofen (Advil). Another option is acetaminophen (Tylenol), if you cannot take NSAIDs.
If home measures do not work, your doctor may use a hollow needle to drain the bursa. After it’s drained, your doctor may also inject the area with a corticosteroid shot to help reduce any remaining inflammation and pain.
Infection in the bursa must first be addressed using oral antibiotics to kill bacteria.
If the treatment is not effective, your doctor may also drain the bursa.
Symptoms should get better with home treatment in 1 to 2 weeks. If they do not improve, you may want to consider scheduling an appointment with your doctor.
You may also consider consulting your healthcare team if:
- you have a fever, chills, or other signs of infection
- you cannot move the knee joint
- your pain becomes sharp, shooting, or severe
While rare, bursitis may become a chronic issue for some people. If you notice symptoms keep returning even after treatment, your doctor may suggest surgery to drain or remove the bursa.
Prepatellar bursitis is a common complaint of people who work on their knees or are at higher risk for knee injury. Home treatment, including ice, rest, and OTC pain relievers can help in most cases. Medical and surgical treatments can help in more serious cases or for infection-induced bursitis.