Some aspects of “Housemaid’s knee” with homoepathic mode of treatment-

Also known as roofer’s knee, it is a benign swelling over the knee on account of an enlargement of the bursa named prepatellar bursa in front of the patella, which in turn is due to an inflammation of the said bursa. Housemaid’s knee is so named because of the fact that this health problem was once found to be a major occupational hazard of Housemaid’s knee & was believed to be caused by leaning too much on the knee by them.

Pathology- Prepatellar bursa is a superficial bursa with a thin synovial lining in front of the patella in between the skin & the patella. It is seen in the lower half of patella & upper half of ligamentum patella. The bursa develops after birth within a few years of life as a result of mechanical pressure & friction. It helps in reducing friction on the underlying structures & thus allows maximal range of motion in the knee. The inflammation of the bursa usually due to repeated trauma to the knee with excess fluid causes restricted movement of the joint with pain, swelling & heat.

Age- Any age group can be affected.

Sex- It is more common in males.

Predisposing factors-
(1) Repeated rubbing or pressure on the knees from kneeling on hard surfaces in an occupation.
(2) A direct blow or a fall on the knee causing rupture of blood vessels & subsequent swelling of the prepatellar bursa.
(3) Spread of an infection from a surface injury, such as a skin wound over the kneecap. Infection is usually the main cause of Housemaid’s knee in children. Infection is also the main cause in people in whom the immunity is deranged such as those on steroid therapy or chemotherapy for cancer.

Clinical features-
(1) Swelling over the kneecap.
(2) Warmth over the kneecap.
(3) Limited motion of the knee.
(4) Painful movement of the knee.
Kneeling usually aggravates the symptoms, while sitting still relieves them.

Treatment-
[A] General measures to be taken are-
(1) Avoidance of the aggravating activity.
(2) Wearing of knee pads while kneeling.
(3) Exercise to strength the quadriceps muscle.
(4) Physiotherapy.

[B] Homeopathic medicines to be used are- Specific remedies include Arnica, Bryonia or Ruta graveolens (Ruta)। The potency & frequency of dosage varies with the severity of the condition & the individual। Usually a lower potency is to be used first for thrice daily & to be continued till the persistence of the symptoms। If improvement is seen, the same medicine is to be continued. But if there is no significant improvement or improvement has come to a standstill, the frequency of dosage should be increased. And in cases where there is no response within a reasonable amount of time, the medicine should be stopped & a different medicine is to be started. It is to be kept in mind that Housemaid’s knee caused by infection needs to be recognized quickly & treated promptly.


Prevention- Use of knee pads by those whose work necessitates kneeling for extended periods of time. This is especially true for those who had already an episode of Housemaid’s knee to prevent recurrence.

Prognosis- Housemaid’s knee may interfere with physical activity, but otherwise it is relatively harmless. But if left untreated, there may be associated loss of quadriceps muscle strength which in turn may cause the leg to give out.

In short, Housemaid’s knee manifests itself as a swelling over the kneecap & can be treated by Arnica, Bryonia or Ruta.

But in every case, a doctor should be consulted.

Some aspects of “Bursitis” with homoepathic mode of treatment

Bursitis is inflammation of a bursa. A bursae is a cushion like sac lined with membrane similar to synovium which is located between a tendon & a bone thus reducing friction between them & allowing the tendon to glide easily over the bone. When subjected to repeated pressure due to over & abnormal use it gives rise to bursitis.

Site of lesion-
Bursitis most often occurs in –
(1) Shoulder .
(2) Elbow.
(3) Knee.
(4) Hip.

Causative factors-
(1) Overexertion of a joint. The repeated motion of a joint causes friction in the bursa. Subsequently, with continuation of activity, the bursa becomes inflammed & filled with fluid. The bursa thickens & does not function well. Both the bursa & the tendon become irritated.
(2) Occasionally a bursa will become infected by haematogenous spread or due to open trauma to the overlying skin or blow to an area containing a bursa.

Clinical features-
Presentation -The patient presents with complain of pain, stiffness of a joint along with malaise & possibly fever.
Signs-
(1)Pain, tenderness & redness of the area of the affected bursa .
(2) Swelling & warmth around the area of the bursa.
(3)Restricted movement of the nearby joint with the subsequent result of restricted function of the affected limb.

Differential Diagnosis- Bursitis has to be differentiated from acute exacerbations of rheumatism & flare-ups of gout both of which clinically manifest with significant erythema & swelling.

Treatment-
[A] General measures to be taken are-
(1)Rest to the affected area & protecting the area from any kind of trauma.
(2)Exercise & application of heat.
(3) Stopping of the activity causing pain if the bursitis is a chronic one.
[B] Homeopathic medicines to be used are-
Benzoicum acidum (Benz.ac)- It acts well when the pain is tearing with stitches & the adjacent joint cracks on movement.
Bryonia- It may be used when the adjacent joint is stiff & painful & the pain is of stitching or tearing type & becomes worse from even the slightest motion.
Belladonna (Bell)-It acts well when there is shooting pain along limbs.
Rhus tox -This remedy is particularly helpful where there is pain on initial movement which gradually improves with movement. The pain may also be worse during sleep & in the morning on waking.
Silicea (Sil)- It acts well when the pain seems to be tightly bound & the sensation seems to be suppurating. Ruta graveolens(Ruta) – This remedy is particularly useful for bursitis after any injury. It is also helpful in acute bursitis with great stiffness & aching pain.

Some points to be kept in mind-
(1) The potency & frequency of dosage varies with the severity of the condition & the individual. Usually a lower potency like 30C is to be used first for thrice daily & to be continued till the persistence of the symptoms. If improvement is seen, the same medicine is to be continued. But if there is no significant improvement or improvement has come to a standstill, the frequency of dosage should be increased. And in cases where there is no response within a reasonable amount of time, the medicine should be stopped & a different medicine is to be started.
(2) If bursitis is caused by an infection, the infection should be combated first in addition to treatment of bursitis.
(3) If bursitis is related to any inflammatory condition such as arthritis, or gout, the disease is to be treated also for control bursitis.

Prevention-
(1)Wearing of protective pads if participating in contact sports.
(2)No overdoing of any kind of sports & activities & that too to be done correctly.

Prognosis- In general, bursitis has a favourable result if treated early but if the underlying cause is not removed properly it may develop into a chronic condition.

In short, bursitis manifests itself as a tender, warm, swelling adjacent to a joint & can be treated by Benz।ac, Bryonia, Rhus tox, Ruta or Silicea.

But in every case, a doctor should be consulted.