Introduction
Bursitis refers to the inflammation and swelling of a bursa. A bursa is a small fluid-filled sac found between soft tissues and bones that lubricates and acts as a cushion to decrease friction between bones when they move.
Pes anserine bursitis is the inflammation of the pes anserine bursa present between the tendons of the hamstring muscle and the tibia or shinbone on the inner side of the knee. The condition occurs when the pes anserine bursa becomes inflamed and produces excess fluid causing the bursa to swell which places pressure on the adjacent sections of the knee. Pain and tenderness on the inner aspect of the knee are the most common symptoms of pes anserine bursitis, also known as goosefoot bursitis.
Causes
Pes anserine bursitis mainly results from overuse or constant stress and friction on the bursa. The condition is commonly noted in athletes, especially runners. Some of the other factors that can contribute to the occurrence of pes anserine bursitis include:
- Tight hamstring muscles
- Improper training techniques
- Osteoarthritis of the knee
- Medial meniscus rupture
- Obesity
- Sports requiring repetitive side-to-side motions, such as soccer and tennis
Symptoms
Some of the common symptoms of pes anserine bursitis include:
- Swelling
- Pain
- Tenderness
- Warmth
- Redness
- Restricted range of knee motion
Diagnosis
Pes anserine bursitis is diagnosed by reviewing your medical history and performing a thorough physical examination. Fluid from your bursa may be removed for lab analysis. Your doctor may order imaging studies, such as X-rays, MRI, and CT scan to rule out other problems.
Treatment
Some of the methods employed in the treatment of pes anserine bursitis include:
- Activity Modification: Avoiding activities that trigger symptoms and changing one’s habits
- Ice: Application of ice packs on the inflamed bursa to decrease swelling and pain
- Physical Therapy: A regular exercise regimen to improve range of motion and strengthen muscles around the knee
- Rest: Providing ample rest to the irritated bursa to facilitate self-healing
- Compression: Wrapping the knee with an elastic bandage or compression stocking can help minimize the swelling and pain and support your knee.
- Cushioning: Use of pillows between the legs while sleeping can help minimize pressure on the bursa.
- Weight-loss program: A customized weight loss regimen to relieve pressure on the knee joint in obese individuals.
- Anti-inflammatory Medication: Use of NSAIDs or nonsteroidal anti-inflammatory drugs such as naproxen and ibuprofen to relieve inflammation, swelling, and pain.
- Cortisone Injection: In this method, a corticosteroid is injected into the inflamed bursa in the knee. Cortisone is a very effective anti-inflammatory medicine for bursitis and a long-term pain reliever for tears and structural damage.
- Surgery: Surgical removal of the inflamed bursa may be required to treat severe cases of pes anserine bursitis that are nonresponsive to the above-mentioned conservative treatment methods.
Summary
Pes anserine bursitis is a debilitating condition that particularly affects athletes. It causes severe pain, inflammation, limited mobility, and can significantly affect your activities of daily living. Treatment often involves a combination of self-care practices and physician-administered treatments to mitigate pain and inflammation. Most cases of pes anserine bursitis can be resolved with conservative treatment within 6 to 8 weeks.