Pes anserine bursitis and swelling

The pes anserine bursa sits between several tendon attachments and the upper inner shin. Irritation can make this small sac and nearby tissues feel puffy, although visible swelling may be subtle. The area may hurt when kneeling, climbing stairs, rising from a chair or lying on that side. Swelling across the whole knee, marked stiffness or pain deep inside the joint may suggest an additional or different cause. A clinician can compare both knees and assess the joint, tendons and skin.

For general information about swelling around a joint, read [Joint Swelling](/symptoms/joint-swelling/).

Avoid direct pressure and scale back the activity that triggered the flare, then return gradually as movement becomes easier. Rest the leg between activities and use a covered cold pack for short periods if that feels soothing. Ask a clinician or pharmacist whether [Anti-Inflammatory Medication](/treatments/non-surgical-orthopedics/anti-inflammatory-medication/) is appropriate for you. If symptoms persist, assessment may lead to physiotherapy or consideration of a [Cortisone Injection](/treatments/non-surgical-orthopedics/cortisone-injection/). [Joint Aspiration](/treatments/non-surgical-orthopedics/joint-aspiration/) is a procedure for selected fluid collections and is not a routine response to every inner-knee swelling.

Get prompt medical advice if swelling becomes hot, red, rapidly larger or very painful, especially with fever or feeling unwell. Seek urgent assessment after a major injury, if you cannot bear weight, or if the knee is stuck. A clinician should also review swelling that keeps returning, extends through the leg or does not improve with sensible activity changes.

Is the swelling superficial over the pes anserine bursa or inside the knee joint? Should I use cold treatment or medication, and for how long? Which exercises can maintain strength without aggravating the area? Do I need imaging or a procedure to clarify the cause?