Tendonitis and Bursitis (What’s the Difference?)

What is Tendonitis?

Tendons are cord-like structures located where a muscle narrows down to attach to a bone. The tendon is more fibrous and dense than the elastic, fleshy muscle. A tendon transmits the pull of the muscle to the bone to cause movement. Tendinitis is often very tender to the touch. The pain it causes may be quite severe and often occurs suddenly. As in arthritis, the pain is worse during movement.
Tendinitis often results from repetitive use (overuse). Though the problem can recur or be chronic (long term) in some people, it is most often short term, mainly if treated early.

What is Bursitis?

Bursitis is inflammation of a bursa. This small sac acts as a cushion between moving structures (bones, muscles, tendons or skin). If a muscle or tendon is pulling around a corner of a bone, or over a bone, a healthy bursa protects it from fraying and stress. When a bursa is inflamed, it becomes very painful, even during rest.

Who Gets Tendonitis and Bursitis?

Tendinitis can occur from a sudden intense injury. Most often, though, it results from a repeated, minor injury of that tendon. Doctors call this repetitive stress or overuse. For example:

• Painting a ceiling for four hours or more, typing long hours, improper body position while using a keyboard, chopping, cutting or sawing may result in tendinitis or bursitis hours or days later.
• Tight clenching while using hand tools or while driving a long time.
• Using a backhand, mainly single handed, in an early-season game of tennis (“tendon elbow”).
• Wearing improper running shoes or not getting the proper training before sports.

To prevent these overuse injuries, follow the tips in the Joint Protection Table.
Persons with gout, or blood or kidney diseases often develop bursitis as part of that disease. Older persons are more prone to tendinitis and bursitis.
Rarely, some drugs can cause tendinitis and tendon rupture (spontaneous tear). These include fluoroquinolone antibiotics and statins (drugs that lower cholesterol).

How Are Tendonitis and Bursitis Diagnosed?

To determine the cause of these problems, a health care provider asks about your medical history and does a careful physical exam. Tenderness along the tendon or its sheath (outer covering), or at one specific point in the tendon, suggests tendinitis. Pain occurs when the muscle to which the tendon is attached is worked against resistance as part of the exam.

How Are Tendonitis and Bursitis Treated?

Treatment depends on the cause. In overuse or injury, you must reduce the causing force or stress. If tendinitis is job related, the doctor or physical therapist should review proper ergonomics, so you can work safely. Some patients may need joint protection advice and support of the involved region.

Treatment can consist of any of the following:

• Rest. You should rest the injured limb or joint, at least for a short time. Failure to rest it will most likely continue your symptoms. If the problem is in a hip, leg or foot, you may need to stop stressful weight bearing activities for a short time. This lets the inflammation lessen.
• Ice. Ice may help reduce inflammation and pain. Ice the area for 10–15 minutes once or twice a day.
• Supports. Use of a cane in the opposite hand can help a painful hip. Splints or braces for the affected part help rest and reduce stress on the part, above all, in the hand and wrist. Off-the-shelf supports may be enough.
• Physical therapy. Some tendon problems do not go away despite standard treatment. If tendinitis lasts beyond a few weeks, you may need to seek the help from a physical therapist. The therapist can give you exercises to do that will maintain strength and function. If the tendinitis or bursitis has begun to limit joint movement, or already restricts movement, seeing a physical therapist is wise.

Injuries