Knee bursitis treatment starts with rest, ice, and reducing pressure on the affected knee. Most cases resolve within a few weeks with these simple measures. When inflammation persists or infection is involved, medical treatment ranges from fluid drainage and steroid injections to antibiotics or, rarely, surgery.
What Knee Bursitis Actually Is
Bursae are small, fluid-filled sacs that cushion the bones, tendons, and muscles around your joints. When one of these sacs becomes inflamed, the result is bursitis: swelling, warmth, pain, and restricted movement. The knee has several bursae, and the location of the inflamed one determines the type of bursitis you’re dealing with and, to some degree, how you treat it.
The three most common types at the knee are prepatellar bursitis, infrapatellar bursitis, and pes anserine bursitis. Prepatellar bursitis sits right in front of the kneecap and is the most frequently seen form, often called “housemaid’s knee” because it results from prolonged kneeling. Infrapatellar bursitis develops just below the kneecap, while pes anserine bursitis affects the inner side of the knee, a few inches below the joint line. Pes anserine bursitis is more common in runners and people with osteoarthritis, whereas the front-of-knee types are typical in people who kneel for work: roofers, plumbers, carpet installers, gardeners.
Home Treatment for Mild Cases
If your knee bursitis came on gradually and there’s no sign of infection (no fever, no spreading redness, no intense heat), you can manage it at home. The core approach is straightforward: stop doing whatever irritated the bursa, reduce swelling, and protect the knee while it heals.
Rest and activity modification. Avoid kneeling, squatting, or any repetitive motion that puts direct pressure on the swollen area. If your job requires kneeling, you’ll need to take a break from that specific task or use well-fitted knee pads (more on prevention below). Staying off the knee doesn’t mean total immobility. Gentle walking and light movement are fine and help maintain circulation.
Ice. Apply ice for 15 to 20 minutes at a time, never longer than 20 minutes per session. Wait 30 to 40 minutes between icing sessions. Repeat several times a day, especially in the first 48 to 72 hours when swelling peaks. Use a thin cloth between the ice pack and your skin to prevent frostbite.
Compression and elevation. A light elastic bandage or knee sleeve can help control swelling. Elevating the leg on a pillow when you’re sitting or lying down encourages fluid to drain away from the knee.
Over-the-counter anti-inflammatories. Ibuprofen or naproxen can reduce both pain and inflammation. These work best when taken consistently for a few days rather than only when the pain spikes. If you have stomach issues or kidney concerns, acetaminophen handles the pain but won’t address the underlying inflammation.
With consistent home care, most mild bursitis cases improve noticeably within two to three weeks.
When You Need Medical Treatment
If home treatment isn’t working after two or three weeks, or if the swelling is severe from the start, a doctor can offer more targeted options.
Aspiration (Fluid Drainage)
When a bursa is visibly swollen with fluid, a doctor may use a needle to drain it. This serves two purposes: it relieves pressure immediately and provides a fluid sample for testing. Because the prepatellar bursa is the second most common site of septic (infected) bursitis, doctors routinely send the fluid to a lab to check for bacteria and inflammatory crystals. An infected bursa can look deceptively similar to a non-infected one on initial examination, so lab analysis is important even when infection seems unlikely.
Corticosteroid Injections
For stubborn inflammation that isn’t caused by infection, a steroid injection directly into the bursa can provide rapid relief. The injection reduces swelling and pain, often within a day or two. These are typically limited to no more than every six weeks and usually no more than three or four times per year, since repeated steroid exposure can weaken surrounding tissues over time. Many people find that one or two injections, combined with activity changes, are enough to resolve the problem.
Steroid injections are not used when infection is suspected, because suppressing the immune response in an infected bursa can make things significantly worse.
Treating Infected (Septic) Bursitis
Septic bursitis is a different situation that requires prompt medical attention. It typically develops when bacteria enter through a cut, scrape, or insect bite over the knee. The hallmarks are intense redness, heat, rapidly increasing swelling, and sometimes fever or feeling generally unwell.
Treatment involves antibiotics and usually drainage of the infected fluid. A large study of hospitalized patients found the typical antibiotic course lasted about 13 days total, with intravenous antibiotics given for roughly the first 3 days before switching to oral medication. For patients without immune system problems, a shorter course of around 7 days may be sufficient. The most common culprit is Staphylococcus aureus, a skin bacterium, which guides the choice of antibiotic.
If you notice the skin over your knee becoming increasingly red and warm, especially if you have a nearby wound, don’t wait to see if home treatment helps. Untreated septic bursitis can spread to deeper tissues or the bloodstream.
Physical Therapy and Exercises
Once the acute inflammation settles, strengthening and stretching the muscles around the knee helps prevent recurrence. Weak or tight muscles alter how forces distribute across the joint, which can put extra stress on bursae.
For prepatellar and infrapatellar bursitis, quadriceps strengthening is the priority. Straight leg raises, wall sits, and gentle squats (only if pain-free) build the front-of-thigh muscles that support the kneecap. For pes anserine bursitis, the focus shifts to the hamstrings and inner thigh muscles. Hamstring stretches, held for 30 seconds at a time, reduce tension on the pes anserine tendons that run over the bursa.
A physical therapist can also assess your movement patterns. Sometimes bursitis recurs because of how you walk, run, or move at work rather than simple overuse. Correcting a gait issue or adjusting your workstation setup addresses the root cause rather than just the symptoms.
Surgery for Persistent Cases
Surgery is rare and reserved for cases that haven’t responded to months of conservative treatment, or for chronic septic bursitis that keeps coming back despite antibiotics. The procedure, called a bursectomy, involves removing the inflamed bursa entirely. It can often be done with small incisions using a camera (endoscopic approach), which reduces recovery time compared to open surgery.
After a bursectomy, most people return to daily activities and light exercise within a few weeks to a couple of months. Full recovery, meaning the point where the knee feels completely normal during demanding activity, can take longer and may extend up to a year in some cases. The body typically regenerates a new, healthy bursa over time.
Preventing Recurrence
Bursitis has a frustrating tendency to come back, particularly if the activity that caused it continues. Prevention strategies depend on what triggered it in the first place.
If your bursitis is occupation-related, knee pads are essential. Not all knee pads are equal. Look for pads with cushioned padding (polyurethane or gel), a hard outer shell to distribute impact, and adjustable straps that keep the pad in place without cutting off circulation. A pad that shifts around or fits poorly won’t protect you and may discourage you from wearing it at all. Research into knee protection for high-risk workers has emphasized that fit and comfort matter as much as padding thickness, since workers tend to stop using equipment that feels awkward.
Beyond equipment, simple habit changes make a difference. Take breaks from kneeling every 15 to 20 minutes. Use a kneeling bench or foam mat when gardening. If you’re a runner dealing with pes anserine bursitis, check your shoes for wear and consider a gait analysis to identify biomechanical issues. Maintaining a healthy weight reduces the load on all knee structures, bursae included.
Keeping the quadriceps and hamstrings strong through regular exercise is one of the most reliable ways to protect the knee long term. Even 10 to 15 minutes of targeted leg exercises three times a week can meaningfully reduce recurrence risk.