Treating Bursitis of the Knee with Solomon’s Seal

Think of your knee as an expensive sports car — a finely tuned machine that is capable of great power, but also highly vulnerable to breakdown. Over time, many things can affect knee functioning: mishap/injury, misuse or overuse of the joint, excessive weight, illness/disease. As we age, knee problems can become more common.

Significant and persistent knee pain affects nearly 25% of women and 20% of men. Your knees and hips — your largest joints — support your body’s weight while allowing your legs to move freely. Even walking at a leisurely pace puts a force that is double your body weight on each leg. Running or descending stairs quadruples that force. Two most common overuse injuries of the knee are Bursitis and Tendonitis.

This brief article discusses bursitis of the knee, its causes, symptoms and methods of relief, including the use of the herb, Solomon’s Seal. The key to understanding bursitis is to know the role synovial fluid plays as a “lubricating oil”. Solomon’s Seal is especially effective in increasing, decreasing or reinstating proper amounts of synovial fluid in the knee joints and tissues.

The Role of Synovial Fluid

In many respects, your knee is like a door hinge that needs oil to swing smoothly, to reduce the friction between its moving parts, and to minimize wear and tear.knee bursae 2

Cartilage and tendons in the knees rely on a lubricating synovial fluid that helps the legs swing smoothly and reduces friction between the moving parts in the knees. Synovial fluid is a viscous egg-whitelike fluid that circulates throughout the knee and passes in and out of various tissue pouches (bursae) located throughout the knee. A valve-like system exists between the knee joint and the bursa on the back of the knee (popliteal bursa). This regulates the amount of synovial fluid going in and out of the bursa.

Remember, the small fluid-filled bursae sacs cushion the movement of bones against muscle, skin, or tendons. Inflammation of the knee joint occurs with various types of arthritis, a kneecap injury, and a cartilage, tendon or ligament tear. When such injuries occur, the knee produces too much synovial fluid in the bursae sacs. The resulting bursitis occurs because one or more of the bursae sacs become inflamed.

Prepatellar and Intrapatellar Bursitis of the Knee

prepatellar bursitis 2Irritation from prolonged kneeling can result in bursitis involving either the sac that lies between the front of your kneecap and your skin (called prepatellar bursitis or “housemaid’s knee”) or the bursa just underneath the kneecap (called infrapatellar bursitis). People who kneel on the job or during prolonged gardening and housecleaning are susceptible to these forms of bursitis.

You may also develop prepatellar bursitis if you hit the front of your knee in an accident or dive to the floor playing sports. To prevent prepatellar bursitis, wear protective kneepads (such as roofer’s pads or gardening pads) while kneeling or while playing sports likely to involve hitting the knees. Bursitis can recur if you don’t take preventive measures after it heals.prepatellar bursitis 1

Symptoms of prepatellar and intrapatellar bursitis include:

  • Swelling in front of the kneecap (prepatellar) or underneath the kneecap (infrapatellar)
  • Warmth and tenderness
  • Pain when you bend or straighten your knee
  • The pain is located right in the front of your knee, and it can even be painful to have the bedsheets touch your skin in this area.

Pes Anserine Bursitis of the Knee

Thipes bursitiss form of bursitis involves the lubricating sac between your shinbone and the hamstring tendons at the inside of your knee. In other words, Pes Bursitis is swelling located on the inside (medial) part of your knee along the upper part of your tibia. Walking alone may stress the pes anserine bursa if you are obese, have tight hamstring muscles, have knees with a natural turnout, or have changed how you walk in response to another type of joint damage (such as osteoarthritis).

Runners are susceptible, particularly if they neglect to stretch and warm up properly, if they quickly increase their mileage, or if they train on hills. Repeatedly kicking a ball also irritates this bursa.

Pes anserine bursitis may cause distinctive pain as follows:

  • Pain located a few inches below the kneecap, in the center of it, or behind it
  • Increase in pain when you climb stairs or exercise
  • Pain that radiates to the back and inside of your thigh
  • Pain when your knees touch as you lie on your side (as when sleeping)

Treatment of Bursitis of the Knee

Bursitis is treated
with rest, ice, and compression to reduce swelling. To relieve pain, doctors typically recommend an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Advil, Motrin, and others) or naproxen (Aleve, Anaprox, and others). Note: an effective alternative anti-inflammatory is Solomon’s Seal.

You’ll also need to avoid activity that aggravates the condition during the healing process, which usually lasts two to six weeks. If the fluid in the bursa shows signs of infection, you’ll need to take antibiotics, and the doctor may remove fluid daily. In extreme cases, the swollen bursa is removed surgically.

Your doctor may also recommend physical therapy. Physical therapy focuses on strengthening and stretching the quadriceps and inside hamstrings. A physical therapist can also show you how to protect your knee in sports and daily activities. If your normal stance puts pressure on the pes anserine bursa, using flexible, over-the-counter arch supports in your shoes may reduce it.

In summary, follow these three treatment approaches:

  • Follow the P.R.I.C.E. principles. — Protection, Rest, Ice, Compression and Elevation.
    Protect the leg by using crutches to take the weight off the knee joint and to allow pain-free walking. Rest the leg. Ice the inflamed area. Compress the knee with a wrap. Elevate the leg, especially at night.
  • Try nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen. NSAIDs such as aspirin, ibuprofen (Advil, Motrin, others), naproxen (Naprosyn, Aleve, others) and similar drugs can help relieve pain, as can acetaminophen (Tylenol, others). Prescription NSAIDs can provide higher dosages and greater potency than over-the-counter NSAIDs. Note: an effective alternative anti-inflammatory is Solomon’s Seal.
  • Scale back physical activity. Doing so will reduce irritation of the knee joint.


To help prevent bursitis or reduce the severity of flare-ups:

  • Warm up or stretch before physical activity. This is perhaps the most important preventive measure. Routine stretching the affected joint, as well as any tightened muscles above and below on a regular basis lengthens the tendon connections around the bursa. This will allow less friction to the tendon/bursa/bone connection.
  • Strengthen your muscles to help protect the joint. Wait until the pain and inflammation are gone before starting to exercise a joint that has bursitis.
  • Take frequent breaks from repetitive tasks. Alternate repetitive tasks with rest or other activities.
  • Cushion your joint. Use cushioned chairs, foam for kneeling or elbow pads. Avoid resting your elbows on hard surfaces. Avoid shoes that don’t fit properly or that have worn-down heels.
  • Don’t sit still for long periods. Get up and move about frequently.
  • If your bursitis is caused by a chronic underlying condition, such as arthritis, it may recur despite these preventive measures.


To take care of your bursitis at home:

  • For relief, take nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin, others) or naproxen sodium (Aleve, Anaprox). Use as directed or in consultation with your medical advisor. Prolonged use can cause gastrointestinal problems, ulcers, heartburn, etc.
  • Administer Solomon’s Seal tincture, as noted in this article, to restore tissue viability and moisture and to reduce inflammation. (Note: NSAIDs do not do this!)
  • Apply ice packs. Use for 20 minutes several times a day during the first 2 days, or for as long as the joint area is warm to the touch.
  • Apply heat. Use heat after the affected joint is no longer warm or red to help relieve muscle and joint pain and stiffness. But don’t overdo it. Heat shouldn’t be applied for more than 20 minutes at a time. Sometimes moist heat seems to penetrate deeper and give you more relief than dry heat.
  • Perform stretching exercises. Stretching can help restore full range of motion.
  • Elevate the affected joint. Raising a knee or an elbow can help reduce swelling.
  • Keep pressure off your joint. Use an elastic bandage, sling or soft foam pad to protect a joint until the swelling goes down.


The Use of a Liniment for Short-term Relief of Pain & Discomfort

An herbal liniment (such as our Cortesia Quick Relief Liniment) is a medicinal liquid of herbs in a base or “carrier” of rubbing alcohol, Witch Hazel, or oil that is firmly rubbed into the skin to provide temporary, fast-acting pain relief and increased blood circulation. A liniment can be used alone, however, its effectiveness is increased when part of a 3-Step Healing Strategy using an accompanying topical salve and tincture. Our Cortesia Quick Relief Liniment is formulated in a base of organic double-distilled Witch Hazel and Isopropyl Alcohol (rubbing alcohol) and contains Solomon’s Seal and 8 therapeutic herbs: Comfrey, Calendula, Arnica, St. John’s Wort, Rosemary, Cayenne, Horsetail, and Menthol. It is perfectly suited for providing relief to bursitis, arthritis and joint discomfort (among other uses). For detailed information read our article at, or the two detailed articles on this Blog.

The Use of a Topical Cream to Reduce Inflammation & Pain

Reducing bursa inflammation and soothing the pain of bursitis can be done topically if a pain reliever has the ability to penetrate the skin barrier and contains anti-inflammatory agents. A topical formula will not only relieve pain or inflammation, but also dilate the blood vessels (if it contains natural menthol). This allows for relief of the bursitis, without causing any stiffening of the tissue.

Our Cortesia Solomon’s Seal Acute & Chronic Injury Salve is a very effective topical salve, especially when used with our Solomon’s Seal Tincture, or any of our Solomon’s Seal formulas. The salve contains Arnica, Calendula, Comfrey, Horsetail, Mullein, St. John’s Wort and Solomon’s Seal root. Unlike most topicals, however, the herbal properties in our salve permeate deeply through the skin layers into the cellular level of affected tissues.

The Use of Solomon’s Seal Tincture

The body has what is called a plastic regeneration response to injuries, that is, the ability of the body to create a healing response that attempts to repair tissues or bursae following injury. The fascinating medical observation about Solomon’s Seal’s effectiveness is that the quality of repair to the injured tissue leaves little or no trace/evidence of scar tissue. Furthermore, Solomon’s Seal is also useful to fight and correct joint inflammation, tumors, as well as the acute and chronic swelling and edema that occur in the surrounding tissues following injury, or in the case of bursitis.

The allantoin in Solomon’s Seal acts as an anti-inflammatory on almost all of the connective tissues. This is achieved by restoring proper lubrication, i.e. synovial fluid that both supplements the deficiency and acts protectively to reduce friction on the tissues.

For the treatment of Bursitis, using Solomon’s Seal, we recommend the following four options in our line of tinctures, formulas and salve. Clients have repeatedly found relief and accelerated healing using:

Regular Solomon’s Seal Tincture

Solomon’s Seal Tincture, Formula #3 – Cartilage & Tissue Repair
This formula combines Solomon’s Seal with the powerful herb, Horsetail. Horsetail’s high silica content helps to rebuild damaged cartilage and structures. It strengthens connective tissue, bones, cartilage, mucous membranes, arteries, skin and other tissues.

Solomon’s Seal Tincture, Formula #6 – All-in-One Deep Healing
This powerful, high dosage formula combines numerous herbs used in our other formulas: Solomon’s Seal, Gravel Root, Boneset, Mullein, Pleurisy Root, Horsetail. Effective in deep healing of complex injuries related to several or all of the following: joints, tendons, ligaments, muscles, bones, cartilage, connective tissue, and bursae.

Solomon’s Seal Acute & Chronic Injury Salve
The salve contains Arnica, Calendula, Comfrey, Horsetail, Mullein, St. John’s Wort and Solomon’s Seal root. Unlike many topicals, the herbal properties in our salve permeate deeply through the skin layers into the cellular level of affected tissues.


When using herbal interventions or products such as a tincture, salve or liniment, we believe that a 3-Step Method is the best way to address many of the types of acute and chronic injuries mentioned above. (Note: This approach should never take the place of other practical strategies such as rest, support or elevation of injury, increasing water intake, adjustment of diet and nutrition, etc.)


Apply Cortesia Quick-Relief Liniment topically several times daily, as needed, in area(s) where pain or discomfort is occurring. Apply morning, afternoon, and evening OR before and after periods of activity and again before bed. This will provide short-term relief so that certain activities are less painful or so that you can get to sleep. It is important to firmly rub the liniment for several minutes to stimulate blood circulation in the effected tissue or joint area. This works very well for arthritic conditions or joint issues to increase flexibility. Of course, use lighter pressure for a sprain, bruise, very sore muscle, or painful area.


sssalveApply Cortesia Acute and Chronic Injury Salve externally to injured area twice daily, morning and evening (apply after the liniment). Wrap or bandage as needed to protect clothing. This is an important long-term method of healing for strains, sprains, aches, symptoms of arthritis, damaged muscles, tendons, ligaments, joints, etc. It perfectly compliments the liniment.

Note: After applying a liniment or salve, it is very useful to simply lay your hand(s) lightly over the affected area for a few minutes. This form of “touch healing therapy” is therapeutic (see our article Solomon’s Seal and the Healing Effects of Touch to understand more). You can feel the warm or cooling sensation of your injury; you can also mentally visualize healing currents.


ss tincture

Consider taking Cortesia Solomon’s Seal Tincture internally several times daily. Solomon’s Seal works to harmonize, feed, lubricate, and tighten or loosen (as needed) tendons, ligaments, muscles, attachments, and joints. It is a valuable connective tissue anti-inflammatory, and is known to help moderate the symptoms of osteoarthritis, repetitive use injuries, and connective tissue damage. Depending on your injury or condition, one of our Solomon’s Seal Formulas (described elsewhere on this site) may be appropriate — for example, the #1 Arthritis & Joint Repair, the #2 Bone-Building & Bone Repair, the #3 Cartilage & Tissue Repair, the #4 Pain & Tension Relief, or the #6 All-in-One Deep Healing Formula.

You can review these products and their ingredients, and order, at our website

Additional Reading


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