Knee swelling, also known as knee effusion, occurs when excess fluid accumulates in or around the knee joint. It is often a sign of an injury or underlying condition. While severe or persisting knee swelling requires medical attention, you can try several remedies at home to help reduce mild swelling, pain and inflammation.
Causes of Knee Swelling
Some common causes of knee swelling include:
- Injuries such as fractures, sprains, tears in ligaments or tendons [1]. Knee fractures can occur from high impact falls or trauma. The patella or kneecap, tibia, and femur bones can all be fractured, leading to pain, swelling, and inability to bear weight on the leg. Sprains or tears to the anterior and posterior cruciate ligaments and medial and lateral collateral ligaments are also common knee injuries that cause swelling.
- Arthritis such as osteoarthritis, rheumatoid arthritis, gout [2]. Osteoarthritis causes progressive loss of cartilage in the knee joint, resulting in swelling, pain, and stiffness. Rheumatoid arthritis leads to synovial inflammation in the knee while gout causes severe pain and swelling due to uric acid crystal deposition.
- Infections such as septic arthritis [3]. Septic arthritis is a bacterial or fungal infection within the knee joint space that causes severe pain, swelling, redness and immobility. It can rapidly damage joint cartilage and tissue.
- Fluid retention disorders like edema [4]. Edema is swelling caused by excess fluid trapped in body tissues. Knee edema may occur due to poor drainage of fluid from the joint or underlying conditions like congestive heart failure, kidney disease or cirrhosis.
- Autoimmune diseases like lupus [5]. Inflammation caused by autoimmune disorders can affect the joint linings, causing fluid accumulation and swelling. Joint pain and swelling are common symptoms of lupus.
- Imbalance between joint fluid production and drainage [6]. Synovial fluid normally lubricates the knee joint, but injuries or disease can affect joint fluid production and drainage, leading to swelling.
- Bone tumors like giant cell tumor [7]. Tumors affecting the knee bones are rare causes of swelling. Benign bone tumors like giant cell tumors near the knee joint can cause fluid buildup.
- Plica syndrome [8]. Plica is excess synovial tissue in the knee that can get irritated and inflamed, causing pain and swelling. Plica syndrome often affects athletes.
- Patellar tendonitis [9]. Overuse inflammation of the patellar tendon connecting the kneecap to the shinbone can cause swelling at the lower border of the kneecap.
- Popliteal cysts [10]. Cysts forming near the knee joint from underlying conditions like arthritis can compress nerves and vessels, leading to swelling.
- Hypermobility syndromes [11]. Connective tissue disorders like Ehlers-Danlos syndrome that cause very flexible joints are associated with recurring joint swelling and pain.
When to See a Doctor
Consult your doctor if you experience:
- Severe knee swelling that doesn’t improve with home treatment
- Inability to fully straighten or bend the knee
- Redness, warmth or tenderness in the knee
- Fever higher than 100.4°F (38°C)
- Sudden, severe knee pain
- Swelling lasting more than 3 days
- Locking, popping, crunching sounds in the knee
- Leg weakness or numbness [7]
Signs like significantly reduced knee function, joint instability, intense pain and swelling can indicate serious ligament/meniscus tears, fractures, sepsis or rapidly progressing osteoarthritis. Delaying medical care risks permanent joint damage and disability.
While waiting for your doctor’s appointment, try these 12 home remedies to reduce knee swelling, pain and inflammation:
1. Rest
Give your knee adequate rest by avoiding any strenuous activities that put pressure on it like running, squatting or stair climbing. Take a day or two off work if possible. Rest allows the injured structures to heal. Stop any exercise routines that could be causing knee strain.
You may need to use crutches to avoid placing weight on an injured knee. Elevate your leg when sitting or lying down. Sleep with a pillow under your calf, not your knee. While complete immobilization is not advisable, minimize knee movement and activity as far as possible.
Gently flex and extend your knee several times a day to maintain mobility in the joint. Support your leg on a stool or pillow when resting [8]. Don’t push through intense pain or go beyond a comfortable range of motion.
2. Ice
Applying ice packs constricts blood vessels, reduces blood flow to the knee and helps lessen inflammation and swelling. Ice therapy works best within the first 48-72 hours following a knee injury.
Icing early after an acute knee injury also helps control pain. Cold reduces nerve conduction velocity and numb the area. But ice should not be used for pain relief beyond a week as it can damage tissue. Chronic knee pain warrants medical attention to diagnose and treat the underlying condition.
How to:
- Wrap ice cubes in a towel and place it over the swollen area for 10-15 minutes
- Repeat every 2-3 hours daily
- Never place ice directly on the skin
Caution: Avoid icing if you have poor circulation or numbness [9], [10].
Limit icing sessions to 10-15 minutes and allow skin temperature to return to normal before reapplication. Nerve damage can occur from prolonged exposure to ice. Observe for symptoms like worsening numbness, tingling, stinging or burning sensations.
3. Compression
Wrapping an elastic bandage around your knee provides mild to moderate compression, which prevents fluid accumulation and controls swelling. Don’t wrap too tightly as it can restrict blood flow.
Compression bandaging should begin at the farthest point – the toes in case of knee swelling. Wrap upwards towards the knee in overlapping turns creating an even pressure. Ensure toes remain visible and monitor for discoloration. Excessive compression can cause tissue damage.
How to:
- Wrap an elastic bandage starting from the foot up to the knee
- Keep the wrap snug, but not too tight
- Remove the wrap if your foot becomes numb, cold or changes color
- Re-wrap every few hours [11]
Elastic bandages lose compression strength when wet, so change wrappings if wetness or leakage occurs. Remove compression bandaging at night and reapply in the morning. Compression coupled with elevation gives optimal results.
4. Elevation
Keeping your leg elevated above heart level helps promote blood and fluid drainage from the knee joint, harnessing gravity to reduce swelling. Avoid pillows propped under the knee as this causes flexion that can increase swelling.
How to:
- Lie down and place your entire leg on a pillow above heart level
- You can also sit on a reclining chair and prop your leg up
- Maintain elevation for 30 minutes 2-3 times a day [12]
The optimal elevation is around 30 inches above heart level. Adjust pillow height accordingly. Marked reduction in swelling can be noted after 48 hours of rest, ice, compression and elevation therapy. See your doctor if swelling persists beyond 3 days.
5. Hot and Cold Therapy
Applying a cold pack constricts blood vessels and reduces blood flow and swelling. A hot pack encourages blood flow, which helps reduce stiffness and pain. Alternate hot and cold therapy for best results. Cold therapy aims to limit knee swelling in the initial injury phase while heat therapy later helps recovery by improving circulation.
Cold therapy:
- Wrap ice in cloth and apply to knee for 10-15 minutes
- Repeat every 2-3 hours daily in the first 48-72 hours
Heat therapy:
- After 48-72 hours, apply a hot water bottle, heating pad or warm towel to the knee for 10-15 minutes
- Repeat 2-3 times a day [13]
Avoid direct dry heat like heating pads as it can burn skin. Note that heat should not be used in acute swelling or if swelling worsens with heat. Stop if you experience increased pain or discomfort.
6. Compression Sleeve
Wearing a compression sleeve or bandage designed for the knee provides constant compression to limit fluid accumulation and swelling. This allows you to remain mobile while still benefiting from compression.
Compression sleeves are worn over the knee and fastened using Velcro straps. They provide controllable compression levels, unlike elastic bandages. Using a sleeve makes it easier to continue work and other activities with knee support.
How to:
- Buy a knee compression sleeve from a pharmacy or online
- Ensure proper fit and adequate compression without restricting blood flow [14]
There are different compression sleeves specific to certain knee conditions – post-surgery sleeves, sleeves with side stabilization for arthritis and sports sleeves for athletic injuries. Consult your physiotherapist or doctor on the right one.
Wear the sleeve during activity and remove at night for skin break. Discontinue use if you experience increased pain, numbness or irritation. Clean sleeves regularly as per instructions.
7. Pain Medication
Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen sodium help relieve knee pain and reduce inflammation that causes swelling. Follow dosage instructions carefully. They should be accompanied by rest and icing for best effects.
NSAIDs work by blocking cyclooxygenase enzymes responsible for prostaglandin synthesis involved in pain and swelling. Ibuprofen has a relatively faster onset of action compared to other NSAIDs.
How to:
- Take 200-400 mg ibuprofen every 4-6 hours with food
- Take 220-440 mg naproxen sodium every 8-12 hours [15]
NSAIDs must be avoided in kidney dysfunction, gastric ulcers, bleeding disorders, heart disease, hypertension and asthma. Do not exceed dosage limits or use for over 7 days without medical advice. Consider topical NSAID creams as an alternative.
For severe knee swelling, doctors may inject corticosteroids into the knee joint to rapidly reduce inflammation and pain. Oral steroids like prednisone may also be prescribed in some cases.
8. Massage
Gentle massage improves blood circulation, eases stiffness and facilitates fluid drainage to reduce knee swelling. Self-massage your knee or get it done professionally. Avoid massage if you have an acute injury, fracture, wounds/skin breakdown or blood clots.
Use light pressure in a kneading motion. As swelling subsides, you can use firmer strokes. Warm coconut or olive oil allows smooth glide over the skin. Essential oils like rosemary, lavender and eucalyptus also help relieve pain.
How to:
- Use gentle circular strokes working from the thigh down the knee
- Apply warm coconut or olive oil to improve blood flow
- Massage 2-3 times a day for 10-15 minutes [16]
There is limited research on massage for knee swelling. But small-scale studies found massage reduces knee pain, stiffness and improves function in osteoarthritis [17], [18]. More studies are needed on its benefits.
9. Exercise
While rest is important initially, gentle exercises help strengthen your knee, improve flexibility and circulation, promoting healing. Avoid high impact exercises that stress the joint. Consult a physiotherapist to design a specific exercise program for your condition.
Start basic knee flexion and extension exercises within pain tolerance. Progress to standing exercises like mini squats and finally low impact cardio like cycling. Swimming and water exercises are excellent options as well. Always finish with icing and elevation.
Helpful exercises:
- Knee flexion and extension
- Mini squats
- Leg raises
- Calf and thigh stretches
- Stationary biking
- Swimming [17]
Exercising an already swollen knee can worsen swelling, so allow swelling to subside before starting exercises. Build up intensity gradually. Exercise also helps manage many conditions associated with chronic knee swelling like osteoarthritis.
10. Lose Excess Weight
Being overweight or obese puts extra pressure on the knees during weight-bearing activities, increasing wear and tear that can cause swelling. Losing excess weight reduces stress on knee joints and lowers swelling risk.
Every pound you lose reduces knee joint stress during movement. Obesity is a major preventable risk factor for developing osteoarthritis, the top cause of chronic knee swelling. Aim for gradual, steady weight loss through dietary changes and exercise.
How to:
- Do 30-60 minutes of moderate exercise most days
- Follow a balanced, calorie-controlled diet
- Aim to lose 1-2 pounds per week [18]
As obesity worsens osteoarthritis and slows post-surgery recovery, doctors recommend weight loss before knee replacement procedures. Maintaining optimal body weight protects your knees.
11. Apply Hot and Cold Compresses
Simple hot and cold compresses can be easily made at home using towels and rice. Follow up knee exercises with compresses to reduce swelling and stiffness. Use either hot or cold compress based on whether you want to encourage circulation or limit inflammation.
Cold compress:
- Fill a plastic bag with crushed ice, frozen vegetables or cold water
- Wrap it in a thin towel and apply to knee for 10-15 minutes
Heat compress:
- Fill a sock with dry rice and knot the open end
- Microwave for 1-2 minutes
- Apply to knee for 10-15 minutes [19]
Ensure compresses aren’t too hot or cold. Do not fall asleep with hot compresses to avoid burns. Discontinue use if skin becomes irritated or numb. Compresses are a simple way to get hot/cold therapy at home.
12. Monitor Diet
Eating anti-inflammatory foods rich in omega-3 fatty acids like fatty fish, nuts, seeds, leafy greens and avoiding foods that may worsen knee swelling can aid recovery. Lose weight if obese or overweight.
The Mediterranean diet abundant in plant foods and fish is associated with lower incidence of osteoarthritis and knee swelling. Limiting sugar, refined carbs, processed and fried foods helps manage inflammatory conditions. Stay well-hydrated to allow nutrients to reach joint tissues.
Helpful diets:
- Mediterranean diet rich in plant foods and omega-3s
- Avoid sugar, refined carbs, processed and fried foods [20]
Focus on increasing intake of vegetables, fruits and anti-inflammatory spices like turmeric. Some supplements like glucosamine, chondroitin, collagen and green-lipped mussel extracts may also aid chronic knee swelling and arthritis, but more research is needed.
When to Seek Medical Care
See your doctor if home treatments don’t reduce your knee swelling within 2-3 days or if swelling is severe. Prompt medical care prevents complications like loss of joint function. Your doctor will determine the cause and prescribe appropriate medication, physiotherapy, joint aspiration, injections or surgery based on your condition.
- X-rays help evaluate bone injuries, fractures, arthritis
- MRI detects ligament tears, cartilage damage, tumors, infections [21]
- Joint fluid analysis diagnoses infections, gout, bleeding disorders
- Blood tests aid diagnosis of inflammatory arthritis, systemic diseases
- Arthrocentesis drains excess joint fluid while injecting corticosteroids
- Antibiotics treat knee infections
- Immobilization, crutches aid fractures and severe sprains
- Physiotherapy improves function in injuries, arthritis
- Surgery repairs damaged ligaments and cartilage, removes loose fragments
Certain medications can help manage specific causes of chronic knee swelling:
- Corticosteroids and NSAIDs for rheumatoid arthritis [22]
- Colchicine, steroids for gout [23]
- DMARDs like methotrexate for lupus [24]
- Diuretics, compression stockings for edema [25]
- Joint injections for osteoarthritis [26]
See an orthopedic doctor in case of recurring swelling or injuries. Rheumatologists manage inflammatory types of arthritis. Prompt and appropriate treatment can effectively control chronic knee swelling.
Lifestyle Measures
- Do knee strengthening and flexibility exercises regularly [27]
- Use assistive devices such as knee braces, walking sticks, shoe inserts [28]
- Apply topical pain relief creams containing capsaicin, menthol or NSAIDs [29]
- Consider supplements like glucosamine, chondroitin, turmeric for arthritis [30]
- Practice yoga, tai chi, cycling and swimming; avoid high-impact exercises [31]
- Use knee pads and braces during sports or occupational activities [32]
- Maintain a healthy weight; lose weight if overweight [33]
- Eat a balanced anti-inflammatory diet with omega-3s [34]
- Avoid smoking and minimize alcohol intake [35]
- Use proper posture and body mechanics to prevent knee strain [36]
When to Seek Medical Care
See your doctor if:
- Swelling persists over 3 days despite home treatment
- You develop sudden, severe knee swelling without injury
- Injuries cause deformity, instability or inability to bear weight
- Swelling recurs frequently
- Swelling is accompanied by significant knee pain and stiffness
- You have fever, warmth and redness in the knee
- Existing medical conditions like arthritis or injuries worsen [37]
Don’t take recurring swelling lightly as it indicates an underlying problem. Diagnosing the cause is key to get appropriate treatment and prevent long-term joint damage that can impair knee function.
Bottom Line
Applying RICE (rest, ice, compression and elevation), NSAIDs, massage, exercise and heating pads can help reduce mild knee swelling, pain and stiffness. Seek medical attention if swelling persists or you experience severe knee pain, instability or deformity. Lifestyle changes like weight loss and an anti-inflammatory diet also aid recovery.
References
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