Knees are exceptionally prone to over-use injuries. A physical exam will be necessary to judge the extent of the damage and rule out an a stress fracture or infection, but the condition most common to your profession and symptoms would be: prepatellar bursitis.
Repetetive kneeling irritates a small sac called the bursa located just in front of the kneecap. Normally the bursa enables the kneecap to move smoothly under the skin. With long term regular irritation the bursa becomes inflamed, it fills with fluid and causes swelling at the top of the knee. Once fracture and infection are ruled out, conservative treatment, followed by preventative measures should restore your knee to health.
You can begin with:
Rest the knee, suspending any activity that causes pain to worsen. This will require more time off, which can be a burden. It is vital however to prevent long term complications and allow healing.
Apply ice at regular intervals three or four times a day for 20 minutes at a time. Each session should reduce swelling considerably if the knee is also being rested.
Elevate the affected leg except when necessary to walk.
Take an OTC anti-inflammatory medication such as ibuprofen, as tolerated, every four hours. During initial rest period take around the clock-not just in response to pain. This will target the inflammation as well as the pain. If stomach pain or bleeding occurs however consult your Doctor for an alternative anti-inflammatory.
Add a supplement with Glucosamine & Chondroitin. Glucosamine is believed to play a role in cartilage formation and repair. Chondroitin sulfate is part of a large protein molecule that gives cartilage elasticity. These target the cartilage and won't necessarily improve the inflammation, but are a good suggestion for overall knee health.
If the swelling is significant, your physician may refer you to an orthopaedic surgeon to decide whether to drain the bursa with a needle, to encourage healing. If the condition returns after treatment and causes chronic swelling that causes disability the orthopaedic surgeon may recommend surgical removal of the bursa. The operation is an outpatient procedure. It takes a few days for the knee to regain its flexibility and some weeks before normal activities can be resumed, but often provides long term relief and function.
After condition resolves initially you can help prevent future incidence of bursitis by following some simple recommendations:
Wear kneepads
Rest your knees regularly by stopping to stretch your legs. If possible rotate job duties through the day
Routinely apply ice and elevate your knees after work
The knee is a very complex region with multiple areas open to injury. These interventions should immediately reduce some swelling, but this improvement shouldn't discourage a proper medical exam.
Good luck to you, hope you feel better!
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