Dr. M.J. Bazos, Patient Handout
Tendinitis/Bursitis

WHAT IS TENDINITIS?
Tendinitis is inflammation or irritation of a tendon. Tendons are the thick fibrous cords that attach muscles to bone. They function to transmit the power generated by a muscle contraction to move a bone.

WHAT IS BURSITIS?
Bursitis is inflammation or irritation of a bursa. Bursae are small sacs located between bone and other moving structures such as muscles, skin or tendons. The bursa allows smooth gliding between these structures.

Since both tendons and bursae are located near joints, inflammation in these soft tissues will often be perceived by patients as joint pain and mistaken for arthritis. Symptoms of bursitis and tendinitis are similar: pain and stiffness aggravated by movement. Pain may be prominent at night. Almost any tendon or bursa in the body can be affected, but those located around a joint are affected most often. Tendinitis and bursitis are usually temporary conditions, but may become recurrent or chronic problems. Unlike arthritis, they do not cause deformity, but can restrain motion.

CAUSE
The most common cause of tendinitis and bursitis is injury or overuse during work or play, particularly if the patient is poorly conditioned, has bad posture, or uses the affected limb in an awkward position. Occasionally an infection within the bursa or tendon sheath will be responsible for the inflammation. Tendinitis or bursitis may be associated with diseases such as rheumatoid arthritis, gout, psoriatic arthritis, thyroid disease and diabetes.

HEALTH IMPACT

• Tendinitis and bursitis are common musculoskeletal problems in both the young and old populations.
• Overuse and sports injuries are common in physically active populations.
• These diseases often result in loss of work and income.

DIAGNOSIS
Diagnosis of tendinitis and bursitis requires a careful medical history and physical examination. X-rays may be helpful to exclude bony abnormalities or arthritis. Tendons and bursae are generally not visible on x-rays. Aspiration of a swollen bursa may be performed to exclude infection or gout. Blood tests may be ordered to confirm underlying conditions such as rheumatoid arthritis or diabetes, but are generally not necessary to diagnose tendinitis or bursitis.

TREATMENT
Treatment of these two conditions is based on the underlying cause. In overuse or injury, reduction or avoidance of a particular activity is useful. Proper positioning during offending activities is important to prevent recurrent injury. An adequate warm-up before and correct posture during exercise is useful. Splinting the affected area, applying moist heat, or sometimes ice, and using other form of physical therapy are helpful. Anti-inflammatory medications reduce inflammation and pain. Corticosteroid injections into the affected area are frequently helpful.

If an infection is present, an appropriate antibiotic is necessary and serial aspiration or surgical debridement of the tendon or bursa may be required. Surgical intervention for other forms of tendinitis or bursitis is uncommon.

Once the acute attack of tendinitis or bursitis subsides, preventing recurrences is crucial. Proper conditioning, ergonomically correct work stations and joint positioning, and appropriate splints or pads to protect
susceptible areas help to prevent recurrences.

THE PHYSICIAN’S ROLE IN TREATING TENDINITIS AND BURSITIS

Most cases of tendinitis and bursitis are self-limited and do not require a physician’s help. Persistent pain should be evaluated and treated by a physician. The physician is well suited to manage treatment of tendinitis and bursitis because of experience and knowledge about patient education, rehabilitation and drug therapy.