Tendonitis and Bursitis

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Tendonitis and bursitis refer to inflammation or degeneration of tissue around muscles and bones.

Generally, tendonitis and bursitis affect soft tissue around the shoulder, elbow, wrist, hip, knee, or ankle. Tendonitis is usually a short-term condition and can be the result of repetitive use. In some people, however, the problem can recur or become chronic.

Bursitis refers to inflammation of the bursa, the small sac that functions as a cushion between the moving structures of our body such as bones, muscles, tendons, or skin. A healthy bursa ensures that the bones do not fray or stress but when it becomes inflamed, it can cause significant pain even if there is no movement.

What are the Causes of Tendonitis and Bursitis?

In most cases, tendonitis is the result of a repeated, minor injury of the tendon (what doctors often refer to as repetitive stress or overuse). Typical examples include typing for long hours, sitting with an improper posture for long periods of time, painting for hours, cutting, sewing or chopping continuously, driving for a long duration, using backhand swing in tennis (tennis elbow), and wearing improper running shoes.

Tendonitis can be caused by a sudden, intense injury or it may occur gradually over time.

People who suffer from gout, pseudogout, or blood or kidney diseases can also develop bursitis because of their disease. Tendonitis and bursitis occur more in older people as their bones and muscles weaken with age.

What are the Symptoms and Diagnosis?

Pain along the tendon, or at specific points in the tendon, may be a sign of tendonitis. If there is swelling, warmth, or redness, then the bursa may be infected, signaling bursitis. Your orthopaedic specialist will determine if you have tendonitis or bursitis by conducting a thorough physical examination. If chronic pain continues, doctors may also do imaging tests such as X-rays, MRIs, ultrasound scans, and blood tests.

What are the Treatments of Tendonitis and Bursitis?

Specific treatment varies depending on the cause and severity of the injury. In patients where tendonitis is job-related, the healthcare provider may suggest worksite intervention. However, common treatment modalities include:

  • Rest – for the injured limb or joint to lessen symptoms and inflammation.
  • Ice – on the affected area for 10-15 minutes once or twice a day because it also helps reduce both pain and inflammation.
  • Medication – for persistent pain NSAIDs such as aspirin, ibuprofen or naproxen may be recommended to reduce pain and inflammation.

In some cases, corticosteroid injections may also be used if the pain does not subside with NSAIDs. Patients with severe pain may also use supports such as a cane and/or custom-made braces.

Physical therapy is quite useful for ankle tendonitis as regular exercises help maintain the strength and function of the muscle. In severe cases, or when the tendon is ruptured, surgery may have to be considered.

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