When pain and inflammation strike near a joint, people often confuse the source of their discomfort. Both conditions involve the soft tissues surrounding the body’s joints, leading to similar symptoms like localized pain, swelling, and stiffness. However, these two musculoskeletal issues affect entirely different structures. Understanding which tissue is involved—a cord-like structure or a fluid-filled cushion—is the primary step toward effective management.
Understanding Tendonitis
Tendonitis is an irritation or inflammation of a tendon, which is a fibrous cord of tissue connecting muscle to bone. These structures transmit the force generated by a muscle contraction to the bone, allowing for movement. This condition typically results from repetitive motions or overuse.
This condition commonly affects areas subjected to repeated strain, such as the Achilles tendon in the heel, the rotator cuff tendons in the shoulder, or the tendons around the elbow, leading to what is commonly called “tennis elbow”. When the attached muscle is worked against resistance, the pain along the tendon path is often triggered or worsened.
Understanding Bursitis
Bursitis, by contrast, is the inflammation of a bursa, a sac filled with synovial fluid. These sacs function as cushions and shock absorbers, reducing friction between bones and surrounding soft tissues. Bursae are generally located around bony prominences, such as the outside of the hip, the kneecap, or the top of the shoulder.
Inflammation in a bursa can be caused by prolonged pressure, direct impact, or excessive friction against the sac. Common sites for bursitis include the elbow, the hip, and the knee (sometimes called “housemaid’s knee”). When the bursa becomes irritated, it can fill with excess fluid, leading to localized swelling and discomfort.
How Symptoms Differ and Overlap
Both tendonitis and bursitis cause pain and localized inflammation, but the characteristics of the pain differ. Tendonitis pain is typically described as a dull ache that worsens substantially with specific movements or activities that engage the affected muscle and tendon. The discomfort is usually felt along the entire path of the tendon or at its insertion point on the bone.
Bursitis pain, however, is often more constant and localized directly over the inflamed sac. It can be sharp or aching and may be intense even when the joint is at rest. A distinguishing feature is the swelling directly over the bursa location. Applying pressure directly to the site of the bursa, such as lying on the affected hip or kneeling, typically intensifies the pain.
Initial Management Strategies
Initial management for both conditions involves rest, ice application, and over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs). Activity modification is a foundational part of recovery for both, ensuring the affected soft tissue has time to heal. Applying ice for short periods, typically 10 to 15 minutes a few times a day, can help reduce swelling and provide temporary pain relief.
However, the longer-term recovery strategies diverge based on the affected structure. For tendonitis, rest is followed by a gradual return to activity, incorporating specific, controlled stretching and eccentric exercises. Bursitis management focuses more on protection and pressure avoidance, such as using padding or modifying positions to prevent further friction on the fluid sac. Consulting a healthcare professional for an accurate diagnosis is the safest approach before starting any rehabilitation or exercise regimen.