BURSITIS AND TENDONITIS: Arthritis Foundation

There are a number of quite painful and localised conditions that are often confused with arthritis, of which two of the most common are bursitis and tendinitis.

Although these conditions involve a degree of painful inflammation, they are different from most forms of arthritis in several key respects.

Bursitis

Most people are aware of the importance of the synovial membrane that protects the joint and secretes a fluid which lubricates the joint. The bursa plays a similar lubricating role but is not located within the joint itself. The bursa is an entirely separate sac containing a fluid that lubricates the movement of the muscles, both muscle across muscle, and muscle across bone. The bursa can become inflamed and cause significant pain. The old fashioned complaint ":housemaid's knee" is, in fact, inflammation of the bursa in front of the kneecap. Other common sites are at the shoulder and over the point of the elbow, where a fluid-filled sack can often be clearly visible. The pain for bursitis tends to be localised, but may affect both body sides when, for example, both knees are affected. When the inflamed area is pressed, it can be quite painful and there is often associated heat and redness. Most bursae are located deep within the muscle tissue, but if they are close to the skin there may be visible swelling.

Bursitis develops relatively suddenly from within a few hours to several days. It is often associated with injury, repeated pressure or overuse. It tends to subside over days or several weeks.

Tendinitis

This is another localised condition involving inflammation of the tendons: fibrous chords that attach muscle t bone. "Tennis Elbow" is a common cause of pain involving the tendon, caused by forceful movement of the forearm and hand.

Diagnosis of Localised Conditions

There are no laboratory tests for these conditions. The diagnosis will be made on the basis of medical history and physical examination. The doctor will ask questions about recent activities which may have caused or had an impact on the problem. An X-ray is sometimes used to confirm that there is no other condition that could be causing the pain.

Management

In most cases, it will be a case of waiting for the body to heal itself. If the pain is severe, however, a more proactive treatment program may be required. Medications are generally used carefully - many of the anti-inflammatory drugs are system in nature, working on the whole body; whereas the inflammation caused by bursitis and tendinitis is generally localised to a specific part of the body. If the pain and inflammation is severe and persistent, the bursa may be injected with corticosteroids.

Useful relief can be obtained through the use of heat or cold packs, as appropriate. Gentle exercise of the affect part of parts is also necessary to maintain joint movement, once the affected area ahs been rested. It is particularly important to avoid further stress or injury to the area. In particular, repetitive movements should be avoided that may exacerbate the condition.