Musculoskeletal pain impacts daily life, often arising from conditions affecting joints and soft tissues. Common culprits include tendonitis and bursitis, both causing discomfort and limiting movement. While sharing similar symptoms, their underlying causes and affected structures differ, leading to distinct treatment considerations.
Understanding Tendonitis
Tendonitis is inflammation or irritation of a tendon, a cord-like structure connecting muscle to bone. Commonly affected joints include the shoulder (rotator cuff), elbow (tennis or golfer’s elbow), wrist, knee (patellar), and heel (Achilles). Pain intensifies with movement engaging the affected tendon, and direct pressure can cause tenderness.
Tendonitis pain is often a dull ache, noticeable during and after activity. Sometimes, a grating or crackling sensation (crepitus) occurs with joint movement. It frequently stems from repetitive motions, overuse, or sudden injuries. Age-related wear can contribute, as tendons may lose elasticity and become more susceptible.
Understanding Bursitis
Bursitis is inflammation of a bursa, a fluid-filled sac cushioning bones, tendons, and muscles near joints. These sacs reduce friction, facilitating smooth tissue gliding. Common locations include the shoulder (subacromial), elbow (olecranon), hip (trochanteric), and knee (prepatellar or infrapatellar).
Bursitis pain is localized, accompanied by swelling, tenderness, and sometimes redness or warmth directly over the inflamed bursa. Discomfort can be sharp or aching, often worsening with direct pressure or movements compressing the bursa. It commonly results from repetitive pressure, prolonged kneeling or leaning, direct trauma, or joint overuse. Infection can also lead to bursitis.
Key Differentiating Factors
Distinguishing tendonitis from bursitis relies on pain location, character, and symptoms. Tendonitis pain usually focuses along the tendon’s length, feeling like a deeper ache radiating along the muscle path. Bursitis pain, in contrast, tends to be diffuse around a joint and exquisitely tender to direct pressure over the bursa.
Pain type offers clues. Tendonitis pain worsens with movements stretching or contracting the affected tendon’s muscle. Bursitis pain, however, may be more pronounced with direct pressure on the bursa or with joint movements compressing it (e.g., lying on the hip or kneeling). Swelling and redness can occur with both, but bursitis, especially in superficial bursae (e.g., elbow or knee), is commonly associated with visible swelling and warmth.
Movement limitations vary; tendonitis restricts specific movements straining the injured tendon. Bursitis causes generalized pain with any joint movement irritating the bursa. Underlying causes differ: tendonitis arises from repetitive strain or microtrauma to a tendon from overuse. Bursitis, conversely, frequently results from direct friction, pressure, or trauma to the bursa, or from conditions increasing joint friction.
Diagnosis and Treatment Approaches
Diagnosis involves physical examination, including palpation and range of motion assessment. Specific maneuvers help identify involved structures, differentiating tendon from bursa inflammation. While clinical examination is often sufficient, imaging (e.g., ultrasound or MRI) may confirm diagnosis or rule out tears.
Initial treatment involves conservative measures for both conditions. Rest from aggravating activities is crucial for healing, complemented by ice to reduce swelling and pain. Over-the-counter pain relievers (e.g., NSAIDs) manage discomfort and inflammation. Physical therapy aids recovery, incorporating stretching for flexibility and strengthening to support the joint and prevent recurrence.
Activity modification prevents re-injury by adjusting movements or techniques contributing to the condition. If conservative treatments are insufficient, corticosteroid injections may be considered. For tendonitis, injections are administered around the tendon sheath to reduce inflammation; for bursitis, medication is injected directly into the bursa. Addressing the root cause (e.g., poor ergonomics, improper athletic technique, or repetitive strain) is paramount for long-term relief and prevention.