Tendinitis and Bursitis

Use a piece of machinery one too many times, and it just may eventually wear out. While humans are certainly not made of metal, plastic or rubber, our bones, muscles and tendons act somewhat like a machine's moving parts. Problems that can develop from overuse include tendinitis and bursitis.

Tendinitis and bursitis are inflammations of the soft tissue around the muscles and bones, most commonly in the shoulder, elbow, wrist, hip, knee and ankle. They are considered rheumatic diseases. (Read about "Arthritis and Rheumatic Diseases") According to the American College of Rheumatology (ACR), the pain associated with tendinitis or bursitis is most often located over a joint, and is most frequently caused by overuse. ACR says the two problems are common in both the young and the old, but especially in people who are physically active.

Tendinitis - ACR defines tendinitis as the inflammation (redness, soreness and swelling) of a tendon. A tendon attaches muscle to bone.

Bursitis - Bursitis is the inflammation of the bursa. The bursa is the small sac filled with fluid that cushions muscles and tendons, or muscles and bones.

The symptoms of both bursitis and tendinitis are similar according to ACR. They can include:

• pain and stiffness that is aggravated with movement
• pain that could be prevalent at night

The Arthritis Foundation (AF) lists the following as some of the causes of tendinitis and bursitis:

• overuse, which is the most common cause (Read about "Repetitive Stress")
• injury
• other diseases such as arthritis or diabetes (Read about "Arthritis & Rheumatic Diseases" "Diabetes")
• infection (Read about "Microorganisms")
• abnormal position of the joint

According to the American Physical Therapy Association (APTA), tendinitis and bursitis can occur in a number of areas of the body from head to toe.

• Shoulder - The shoulder is a complex structure of muscles, bones, tendons and ligaments. (Read about "The Shoulder") Tendinitis and bursitis are perhaps, according to APTA, the most common of all shoulder problems.
  • Impingement syndrome - This is a term used to describe inflammation of the shoulder tendons and the bursa that surrounds these tendons. There can be a lot of pain, especially when you reach for something over your head and while you sleep.
• Elbow - APTA says twisting your elbow repeatedly can put strain on the cartilage, ligaments and tendons surrounding the elbow joint. This can lead to swelling and inflammation.
  • Tennis elbow - So-called "tennis elbow" is an injury that can happen to anyone who stresses their elbow, not just tennis players. The pain can last for months, or even years.
• Wrist - The wrist, according to APTA, has eight bones known as carpals, which support the carpal tunnel. This tunnel contains tendons and a median nerve. Tendinitis is an inflammation of a tendon, and should not be confused with carpal tunnel syndrome, which has to do with pressure on the median nerve. (Read about "Carpal Tunnel Syndrome")
• Finger - Tendinitis can also occur in the fingers.
  • Trigger finger - "Trigger finger" is a common form of tendinitis that can be brought on by repeatedly grasping an object. It can occur in any of the fingers. In someone with this condition, the finger can feel locked into an open or closed position, and then pop when you try to move it. The stiffness can be worse in the morning, and there can also be pain.
  • DeQuervain's disease - DeQuervain's disease involves the tendon of the thumb and the distal radius (the end of the forearm bone that meets the thumb). This painful condition occurs when the tendon swells. It is sometimes referred to as DeQuervain's synovitis (Read about "Synovitis")
• Knee - The knee is another complex join that works like a hinge helping to bend and straighten the lower leg. (Read about "The Knee")
  • Jumper's knee - Tendinitis of the patellar tendon is sometimes called "jumper's knee." That's because, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), in sports that involve jumping, like basketball, the contraction of the muscle, combined with hitting the ground after a jump, strains the tendon.
• Ankle - The ankle is another area often subject to injury. Tendinitis of the ankle can involve the Achilles tendon, the posterior tibial tendon, or the peroneal tendon. Ankle tendinitis leaves the ankle feeling stiff and sore, and can often result from injury or sports activity.
  • Achilles tendinitis - What is sometimes called "Achilles heel" is a common overuse injury and inflammation of the Achilles tendon. The Achilles tendon is located at the back of the ankle. (Read about "Feet, Ankles and Legs") It is a large and strong tendon, but it is also vulnerable to injury and overuse. The resulting inflammation can cause redness, soreness and swelling. The ankle may also feel tender or stiff. Achilles tendinitis, according to APTA often results from sports that require a great deal of jumping. It can also result from overtraining or running up hills. Improper warm-ups can be a contributing factor. Sometimes underlying conditions such as arthritis can increase your risk. (Read about "Arthritis") People with flattened arches in the feet may also be more at risk.
• Hip - Though not as common as in other areas of the body, the tendons of the hip can experience wear and tear over time. Runners, according to APTA, are especially at risk for tendinitis of the hip. Inadequate warm-up and stretching before exercise can be to blame. (Read about "The Hip")

Diagnosis and treatment options

Diagnosing tendinitis and bursitis, according to ACR, requires a careful medical history taken by your physician as well as a physical examination of the painful areas. X-rays, ACR says, may help exclude bony abnormalities, but tendons and bursa usually do not appear on x-rays. (Read about "X-rays")

The good news is that bursitis and tendinitis, according to AF, often go away on their own. The goal is to minimize pain and inflammation. Depending on the type of injury, AF says relief can come in the following forms:

• rest - Your doctor will recommend the amount of time that you should refrain from your normal exercise program. You may also need to switch to another exercise that does not involve the affected area. Resting the affected area is essential for it to heal.
• splints or supports to restrict movement of the affected area
• corticosteroid injections into the affected area
• anti-inflammatory medications
• moist heat
• ice
• physical therapy (Read about "Rehabilitation")
• surgery - Surgery is often an option of last resort, but may be necessary in severe cases, for example if the tendon has ruptured or completely torn. (Read about "Arthroscopy")

Keeping tendinitis and bursitis from recurring is crucial, according to ACR. The agency recommends warming up before exercise and using correct posture during exercise (Read about "Stretching and Health"), as well as using an ergonomically correct work area. The objective is to keep your moving parts moving freely and painlessly, for years to come.

Related Information:

    Skeletal System

    Repetitive Stress

    Avoid Sports Injuries

    Strains

    Orthopedics