By William R. Beach, MD
Limb and joint pain can occur at almost any age for a number of reasons. Two of the most common causes are bursitis and tendonitis. To understand which condition may be causing you pain, let’s examine the characteristics of both bursitis and tendonitis.
Bursitis and Tendonitis: What They Have in Common
Two types of inflammation of soft tissue are bursitis and tendonitis. The inflammation is often caused by trauma-often repetitive small trauma or occasionally significant severe trauma. The injured areas affected by both bursitis and tendonitis include knees, elbows, hips, ankles, or wrists.
Bursitis vs. Tendonitis: How They Differ
In areas of your body where structures come into contact – bone, muscle and tendon – fluid-filled sacs known as bursae are present to allow those parts to glide smoothly over one another. Bursitis is the inflammation of one of these bursae. This is typically the result of overuse of the structures in question.
Common types of bursitis include prepatellar bursitis (knee), olecranon bursitis (elbow), and trochanteric bursitis (hip).
Your body has many cord-like structures called tendons, which connect muscles to bones to create motion. Tendonitis is inflammation of one of these tendons. Tendonitis is generally caused by repetitive use of the associated muscle. We often see older patients complaining of tendonitis/pain.
Common types of tendonitis are tennis elbow tendonitis, Achilles tendonitis (heel, calf), and jumper’s knee tendonitis.
Bursitis or Tendonitis: Diagnosing the Cause of Your Pain
As with any injury, your doctor will begin with a medical history and physical exam. He may order X-rays to rule out problems that might stem from your bones, like a fracture. Your doctor needs to know where and when the pain occurs to identify the correct diagnosis and to create the treatment plan.
Diagnosing the problem as either bursitis or tendonitis has much to do with the anatomic location of the injury. Your doctor can determine which is more likely to be the issue based on your particular signs and symptoms.
Significant fluid in the bursa suggests bursitis. Conversely, tenderness of the tendons is an indicator of tendonitis. Differentiating between the two may be more challenging in the shoulder, as the inflammation of the bursa is often associated with tendonitis. Stretching of the muscle can aid your doctor by identifying at what point in the range of motion the onset of pain occurs. This helps isolate the likely cause of the injury. Tenderness to palpation, strength and resistance testing, and joint stability testing will aid us in identifying the correct diagnosis.
Treatment of Bursitis and Tendonitis
For both bursitis and tendonitis, treatment often begins with RICE. RICE (rest, ice, compression and elevation) assists in reducing inflammation, as well as, non-steroidal anti-inflammatory medication. Tendonitis may result from repetitive occupational or recreational activities. Identifying and eliminating those activities or movements is a key element in the treatment of tendonitis. In the case of bursitis, aspiration, or fluid draining, of the bursa may be prescribed, followed by a corticosteroid injection to prevent further swelling. In rare instances, the bursa may be removed, either through arthroscopic or open surgery.
To reduce the risk of injuries like bursitis and tendonitis, be sure to warm up and stretch before exercising and wear protective padding during any activities that you and your doctor have identified as the cause of your injury.
Learn more about your own bursitis or tendonitis symptoms by scheduling an appointment with an orthopedist at Tuckahoe Orthopaedics today.