Prepatellar bursitis, often known as housemaids knee, is a common ailment caused by inflammation of the prepatellar bursa, a tiny fluid-filled sac positioned in front of the kneecap. This ailment is frequently brought on by repetitive kneeling or a direct impact on the knee. In this blog, we will explore the causes, symptoms, diagnosis, and various treatment options for housemaid’s knee.
What Is Housemaids Knee (Prepatellar Bursitis)?
Housemaids knee is a type of knee bursitis in which the prepatellar bursa becomes inflamed and irritated as a result of friction or pressure. The major purpose of the bursa is to cushion and preserve the knee joint from excessive wear and tear. When it becomes inflamed, however, it expands and produces pain and discomfort. When it does you can straight away take our online doctor consultation
Causes of Housemaids Knee
The primary causes of housemaids knee include:
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Frequent kneeling:
Frequent kneeling is a common cause of prepatellar bursitis, and it disproportionately affects individuals in certain professions, such as tradesmen and gardeners. These occupations often require prolonged periods of kneeling while performing various tasks like laying tiles, gardening, or tending to outdoor maintenance. Repetitive pressure on the front of the knee can lead to irritation and inflammation of the prepatellar bursa, resulting in housemaid’s knee.
Tradesmen, such as carpenters, plumbers, and construction workers, often find themselves on their knees to complete their daily tasks. Gardeners, too, spend extended periods kneeling while planting, weeding, or pruning. The repetitive nature of these activities places continuous stress on the bursa, causing it to become inflamed and swollen.
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Repetitive Kneeling:
Repetitive kneeling is one of the primary culprits behind housemaids knee. When individuals frequently kneel and place pressure on the front of their knee, the prepatellar bursa is subjected to constant friction and compression. Over time, this repetitive trauma leads to irritation and inflammation of the bursa.
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Constant Rubbing between Tissues and Bursa:
The constant rubbing between the bursa and the underlying tissues, including tendons and muscles, can cause the bursa to produce excess fluid as a protective mechanism. As the bursa swells, it exerts pressure on the surrounding structures, resulting in pain, tenderness, and limited knee mobility.
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Sudden Force:
In some cases, this disease can develop due to a sudden force or impact on the front of the knee. This could happen during sports activities, accidents, or falls. The direct blow to the knee can cause trauma to the prepatellar bursa, leading to inflammation and swelling.
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Contact Sports:
Individuals who engage in contact sports like football or rugby are at higher risk of experiencing a direct blow to the knee, which can result in this disease. Additionally, accidental falls, especially when landing on the knee, can also lead to bursa inflammation.
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Underlying Medical Conditions:
Certain underlying medical conditions can predispose individuals to develop housemaid’s knee. Rheumatoid arthritis, an autoimmune disorder that affects the joints, can cause chronic inflammation throughout the body, including the knee bursa. Persistent inflammation may lead to the development of this disease.
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Infection:
Although rare, housemaids knee can be caused by an infection introduced through an open wound near the knee. Bacteria can enter the prepatellar bursa through a cut, scrape, or puncture wound, leading to infection and subsequent inflammation.
Some Common Symptoms
Common symptoms of housemaids knee include:
- Swelling at the front of the knee around the patella, resembling a squashy orange or water balloon.
- Knee pain, particularly when moving the knee, makes it difficult to bend the leg, kneel down, or walk.
- Redness and warmth in the knee area, accompanied by tenderness upon touch.
If any of these symptoms you identify in your body, you should do an online GP registration for prevention of this disease.
Diagnosis of Housemaids Knee
It is typically diagnosed through a physical examination by a healthcare professional. Imaging tests like X-rays or MRIs are usually not required for diagnosis. In cases of suspected infection, fluid may be drained from the bursa and tested, followed by antibiotic treatment if necessary.
Treatment Options for Housemaids Knee
Housemaids knee is treated using a multifaceted strategy aiming at lowering discomfort, and inflammation, and facilitating recovery. A mix of home treatments, pharmaceuticals, and, in some circumstances, medical procedures can effectively control the illness. Each therapeutic measure is explained in full below.
Treatment for housemaids knee often involves the following measures:
PRICE (Protect, Rest, Ice, Compress, Elevate) Method:
The PRICE method is a widely used protocol for managing various soft tissue injuries, including prepatellar bursitis. It involves the following steps:
Protect:
Avoid activities that aggravate the knee, such as kneeling or squatting. Wearing knee pads or using cushioning while performing tasks that involve kneeling can help protect the affected area.
Rest:
Allow the knee to rest and avoid putting weight on it. Resting the knee helps reduce further irritation and gives the bursa time to heal.
Ice:
Applying ice to the affected area for 15-20 minutes every 2-3 hours during the initial 48 hours helps reduce swelling and alleviate pain. It is essential to use a cloth or towel as a barrier between the ice pack and the skin to prevent ice burns.
Compress:
Wrapping the knee with an elastic bandage provides support and helps control swelling. Be cautious not to wrap it too tightly to avoid impairing blood circulation.
Elevate:
Elevating the leg above heart level when sitting or lying down reduces swelling by allowing fluids to drain away from the knee.
Some Other Important Options
There are some other important to look for when treating this disease:
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Stretching Exercises:
Tight leg muscles can contribute to increased pressure on the bursa, exacerbating prepatellar bursitis symptoms. Stretching exercises that focus on the quadriceps, hamstrings, and calf muscles can help alleviate this pressure. Regular stretching improves flexibility and reduces tension on the bursa, promoting healing and preventing recurrence.
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Activity Modification:
Avoiding activities that put pressure on the kneecap and bursa is crucial during the recovery phase. Individuals with this disease should refrain from kneeling, squatting, or any movements that worsen the symptoms. Seeking alternatives to kneeling, using knee pads, or employing proper body mechanics can help reduce stress on the affected area.
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Gel Knee Pads:
For situations where kneeling is unavoidable, using gel knee pads provides extra cushioning and minimizes pressure on the prepatellar bursa. These pads distribute weight evenly, reducing discomfort and preventing further irritation. Gel knee pads are particularly beneficial for individuals in professions that require frequent kneeling, such as tradesmen and gardeners.
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Ice Therapy:
Ice therapy, also known as cryotherapy, is an effective natural method to reduce swelling and pain in the early stages of a housemaid’s knee. Applying ice to the affected area constricts blood vessels, reducing blood flow and inflammation. Correct usage of ice therapy can enhance the healing process and alleviate discomfort.
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Aspiration:
In cases of severe swelling, a doctor may perform an aspiration to drain excess fluid from the prepatellar bursa using a needle. This procedure helps relieve pressure and reduce pain. The extracted fluid may be sent for analysis to determine if an infection is present, guiding further treatment.
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Steroid Injections:
Injections of corticosteroids directly into the bursa can provide great relief from inflammation and pain. These potent anti-inflammatory medicines reduce swelling and decrease the immunological response in the affected area. Steroid injections are usually reserved for cases where other therapies have failed to offer adequate relief.
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Antibiotics:
Antibiotics are administered to treat the underlying bacterial or fungal infection that causes housemaid’s knee. To ensure total eradication of the infection, it is critical to complete the entire course of antibiotics as advised by the healthcare professional.
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Surgical Removal of the Bursa:
In rare and severe cases of housemaids knee, where conservative treatments have failed, surgical removal of the prepatellar bursa may be considered. This procedure, known as bursectomy, aims to alleviate persistent symptoms and prevent recurrent inflammation.
Recovery Time:
With proper treatment, housemaids knee typically improves within a few weeks. Addressing any contributing factors, such as muscle imbalances, can help prevent recurrence. Avoiding kneeling on hard surfaces and using cushioning like gel pads can reduce the risk of developing it again. If symptoms persist for more than six months with treatment, surgery might be considered to remove the bursa.
Differential Diagnosis
Although it is a common cause of front knee pain and swelling, there are other possibilities, such as patellofemoral pain syndrome, tendonitis, plica syndrome, meniscus tears, Osgood-Schlatters, and Bakers Cyst. Proper diagnosis by an immunologist online consultation is essential to determine the exact cause of the knee pain.
Conclusion:
Housemaids knee is a prevalent condition characterized by inflammation of the knee bursa. It often results from repetitive kneeling or a sudden impact to the knee. Fortunately, it can be effectively treated with home remedies and rarely requires surgical intervention. If you experience symptoms of this disease, it is crucial to seek medical advice or use an online doctor consultation platform like us for accurate diagnosis and appropriate treatment.