Tendinitis & Bursitis

1 in 31

Approximately 1 in 31 people in the US have bursitis, that's 8.7 million people.

80%

of the patient population with bursitis is male.

What are tendinitis and bursitis?

Tendinitis (also called tendonitis) and bursitis are separate conditions that involve the pain, swelling, and inflammation in the soft tissue around a joint. Both conditions occur as a result of overusing muscles and tendons, especially through repetitive movements such as gardening, pounding a hammer, or throwing a ball. Bursitis and tendinitis are also linked to infections and conditions like rheumatoid arthritis or gout. 

Tendinitis involves inflammation of the tendon, or the tissue that connects the muscle to the bone. The tendons ordinarily help muscles move bones. Bursitis involves inflammation of the bursa, the fluid-filled sac that acts as a cushion between your bone, muscle, tendons, and skin. When your tendons or bursa are inflamed, the result is pain that gets worse during movement.

There are several types of each condition, and the type of bursitis or tendinitis that you have is determined by the areas of your body that are most affected by the condition. Bursitis and tendinitis are often co-occurring, which means people often have both conditions at the same time. 

Who is affected?

Anyone can be diagnosed with tendinitis and bursitis, though older people are more likely to develop the conditions due to tendons becoming less flexible with age. Women are more likely than men to develop bursitis of the hip. [1]

Participating in certain sports or jobs that require repetitive motion, awkward positions, or other irregular movements may make you more at risk of developing tendinitis and bursitis. Certain conditions can also put you at greater risk of developing bursitis, such as rheumatoid arthritis, gout, and diabetes.

What happens in your body?

Tendinitis often involves the following symptoms near the joint (icons): [2] [3]

  • Dull aching pain when moving the affected joint or limb
  • Swelling
  • Tenderness

Bursitis often involves the following symptoms near the joint (icons): [4] [5]

  • Aching, stiffness, and limited motion in the affected region
  • Pain when you apply pressure to the area
  • Tenderness
  • Swollen and red appearance

How do I know if I have tendinitis and bursitis?

It is important to get an accurate diagnosis as quickly as possible to make sure that the condition does not worsen. The best way to do this is by visiting your doctor and, if possible, getting a referral to a specialized care provider. Providers that specifically treat tendinitis and bursitis include rheumatologists, physical therapists, and orthopedic surgeons.

Some ways that your doctor can assess whether you have tendinitis is through conducting a physical examination and X-rays or other imaging tests. To assess whether you have bursitis, your doctor may review your medical history, and conduct a physical examination or medical tests (such as blood tests and imaging tests).

How is it treated?

Integrative interventions have shown to be promising in reducing pain and discomfort associated with tendinitis and bursitis. [6]

Integrative interventions offer a holistic approach to treatment. Instead of just conventional medicine, integrative treatments combine conventional medicine with nutritional tools, mind-body medicine, and manual medicine for a holistic approach to treating tendinitis and bursitis. 

For those new to integrative medicine, learn more here.

Conventional Medicine

Many people with tendinitis and bursitis find that certain medications work for them and others do not. So, in order to find an effective conventional treatment, people with tendinitis and bursitis often work with their doctors to determine which medication works best with their body and needs. 

With the right medication, it is possible to manage symptoms and prevent the rapid worsening of the condition. Before starting to take any medication, be sure to ask your doctor about possible side effects. And if you notice any of the side effects once you start your treatment, let your doctor know as soon as possible.

Examples of conventional treatments:

  • Non-steroidal anti-inflammatory drugs (common name: ibuprofen), or NSAIDs, are commonly used treatments for inflammation and pain resulting from tendinitis and bursitis.

  • Analgesics (common name: aspirin) are intended to relieve pain and are often recommended to patients to reduce discomfort associated with both conditions.

  • Cortisone injections (also called corticosteroids) are steroid drugs that can be taken by injection, and may help to reduce joint swelling and ease pain in targeted areas.

  • Antibiotics are drugs used to fight infections caused by bacteria, and are recommended for treating bursitis if the inflammation in your bursa is caused by an infection.

  • Platelet-rich plasma (PRP) treatment involves using injections of a patient’s own platelets, or tiny blood cells, to heal affected tendons, and can be useful in treating tendinitis.

Mind-Body Medicine

Research shows that gentle, low-intensity mind-body treatments can help tendinitis and bursitis patients with mobility, mood, decreased pain, and more. There are a wide variety of mind-body treatments for tendinitis and bursitis, ranging from deep breathing to aqua-therapy.

When living with chronic pain, engaging in regular movement and exercise may feel difficult and unnecessary. But doing so can actually improve your symptoms. 

Before starting a physical exercise regimen, consult with your doctor about what might be the best activities for you and your body.

Examples of mind-body medicine:

  • Tai chi is a Chinese practice of slow, low-intensity movements that researchers have found can improve mobility, functionality, and psychological health in patients with chronic conditions.

  • Yoga comes in many different styles, often engaging both the body and the mind through controlled breathing and stretching. Researchers have concluded that yoga therapy may help sedentary individuals with arthritis safely increase physical activity, and improve physical and psychological health.

  • Gentle exercise programs guided by instructors who understand your condition can help you both lose weight and manage your symptoms. Research has shown the link between obesity and tendinitis and tendinopathies.

  • Relaxation therapies like deep breathing techniques, meditation, and biofeedback can help patients ease anxiety and better manage chronic pain. Researchers at the University of Calgary suggest that mind-body treatments like these can help with physical conditions. 

Manual Medicine

Manual treatments are administered by certified therapists, using physical pressure and stimulation on the body to reduce tendinitis and bursitis symptoms. Treatments can vary in intensity and incorporate other elements such as heat and aromatherapy to enhance relief. 

Examples of manual medicine:

  • A widely-adopted Chinese treatment administered by certified acupuncturists who insert very thin needles at strategic points on the body to support overall wellness. A randomized trial has demonstrated that acupuncture is an effective treatment for shoulder pain. 

      • Licensed massage therapists use different techniques, like shiatsu, hot stone, and Swedish massage, to provide temporary pain relief. Studies suggest that massage therapy is particularly helpful for muscle pain, and that it can also help reduce anxiety.              
  • Physical therapy can help with physical strengthening, mobility, and overall functionality. Licensed therapists provide one-on-one treatment and teach patients self-management techniques so that they can improve their condition on their own too. Recent research shows that physical therapy counseling is a promising treatment in improving functionality for people with inflammatory arthritis; this may also help patients with tendinitis or bursitis.  

  • Osteopathic manipulative treatment, or OMT, is a form of manual therapy used by osteopathic physicians (DOs) which has been shown to relieve muscle pain and increase range of motion in the joints. Osteopathic physicians perform this treatment by moving muscles and joints through techniques like stretching, gentle pressure and resistance.

Nutritional Tools

Nutrition plays a crucial role in your overall health, and is a tool you can use to combat joint damage, reduce inflammation, and manage other tendinitis and bursitis symptoms. 

Just like with conventional, mind-body, and manual medicines, there is not one ideal treatment for every tendinitis and bursitis patient. When selecting nutritional tools to treat your condition, it is best to consult with your doctor or work with a dietitian, naturopath, or nutritionist to find out the best diet for you. 

Examples of nutritional tools:

  • Anti-inflammatory diets

    • Anti-inflammatory diets include nutrient-dense foods that contain antioxidants and intend to reduce inflammation in the body. A popular anti-inflammatory diet is the Mediterranean diet which has been shown to reduce signs of inflammation.

  • Plant-based diets

    • Vegetarian and vegan diets have shown to promote gut health, which may have an anti-inflammatory impact.

  • Elimination diet

    • While some foods can help reduce symptoms, other foods may trigger them. An elimination diet, which is an eating plan that eliminates certain foods or food groups believed to be causing negative bodily reactions, can help you figure out which foods are triggering those symptoms and bring you closer to your ideal diet.

  • Fish

    • Research suggests that eating fish reduces overall inflammation in adults. 

    • Recommendation: Eat three to four ounces of fish (salmon, tuna, sardines, anchovies, or other cold-water fish) twice a week.

  • Fruits and vegetables

    • Fruits and vegetables have antioxidants, which support your immune system and may fight inflammation.

    • Recommendation: Eat one and a half to two cups of fruit (like blueberries, blackberries, cherries, and strawberries) and two to three cups of vegetables (like spinach, kale, and broccoli) per meal.

  • Nuts

    • Nuts are rich in healthy fat, protein, and fiber, and help fight inflammation.

    • Recommendation: Eat one and a half ounces–about a handful–of nuts (like walnuts, pine nuts, pistachios, and almonds) per day. 

  • Beans

    • Beans (like red, pinto, navy, and black beans) are rich in fiber and protein, and are full of both antioxidants and anti-inflammatory properties.

    • Recommendation: Eat at least one cup of beans per week.

  • Olive oil

    • This heart-healthy ingredient contains healthy fat, antioxidants, and oleocanthal, an anti-inflammatory compound.

    • Recommendation: Consume two to three tablespoons of extra virgin olive oil per day by using it in your cooking or salad dressings. 

  • Onions

    • These simple, flavor-rich vegetables are packed with antioxidants and may help reduce inflammation, improve heart health, and help control cholesterol levels.

  • Fiber

    • Fiber is found in foods like beans, whole grain breads, and fresh vegetables. It makes you feel fuller for longer and boosts digestive health. It also may help reduce inflammation.

    • Recommendation: Incorporate a good mix of insoluble fiber (from vegetables, wheat, and seeds) and soluble fiber (from fruits and oats) in your diet or try fiber supplements. 

  • Fish oils 

    • Fish oils may reduce inflammation. Research has shown that fish oils dramatically reduce the symptoms of rheumatoid arthritis when combined with conventional therapies like methotrexate.

  • Glucosamine sulfate 

    • Glucosamine is found in cartilage. Some research suggests it may help treat the pain of osteoarthritis. It may also help reduce inflammation in tendinitis and bursitis.

  • Vitamin C

    • Research has demonstrated that Vitamin C may help repair connective tissue especially collagen synthesis. This may be helpful for patients diagnosed with tendinitis or bursitis.

  • Bromelain

    • Bromelain is found in pineapples and is a proteolytic enzyme that helps regulate the inflammation pathway. Research suggests it is safe to be used and may help reduce inflammation. 

  • Turmeric

    • Research shows that a key chemical compound (curcumin) in turmeric can relieve rheumatoid arthritis and its symptoms. This may suggest its efficacy in reducing inflammation in tendinitis and bursitis. 

  • Vitamin D

    • Vitamin D supplements are good for bone health, and they can also help keep the immune system functioning properly. 

  • Antioxidants

    • Selenium supplements can help keep your immune system functioning properly and prevent cell damage (also known as oxidative stress).

    • Studies show other antioxidants that can help prevent cell damage and keep the body in a balanced state. The antioxidant quality of pomegranates may ease symptoms such as tender joints.

  • Probiotics

    • Chronic conditions and medications can have a negative impact on gut health. Research on the effects of probiotic supplements have shown that they may help improve gut health and even lead to lower levels of inflammation.

  • Green tea extract 

    • Research on green tea extract (GTE) may help reduce overall inflammation and joint damage in patients with rheumatoid arthritis. This suggests that it may reduce inflammation in tendinitis and bursitis.

  • [1] Trochanteric Bursitis: Symptoms, Causes, Treatments. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/4964-trochanteric-bursitis. Accessed July 24, 2020. 
  • [2] Publishing HH. Tendonitis. Harvard Health. https://www.health.harvard.edu/diseases-and-conditions/tendonitis. Accessed July 24, 2020. 
  • [3] Tendinitis. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/tendinitis/symptoms-causes/syc-20378243. Published December 14, 2017. Accessed July 24, 2020. 
  • [4] Bursitis. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/bursitis/symptoms-causes/syc-20353242. Published August 12, 2017. Accessed July 24, 2020. 
  • [5] Bursitis. Bursitis | Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/bursitis. Accessed July 24, 2020. 
  • [6] Gebremariam L, Hay EM, van der Sande R, Rinkel WD, Koes BW, Huisstede BM. Subacromial impingement syndrome--effectiveness of physiotherapy and manual therapy. Br J Sports Med. 2014;48(16):1202-1208. doi:10.1136/bjsports-2012-091802 
  • [7] Bursitis: 5-Minute Clinical Consult. (n.d.). Retrieved July 12, 2020, from https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116099/all/Bursitis 
  • [8] Wolff, D. (2017). Bursitis. Retrieved October 12, 2020, from https://doi.org/10.1016/B978-0-12-801238-3.64175-2 
The information on this page is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek medical advice from your physician or health provider for your specific needs.