Which is worse tendonitis or bursitis

If more detail is needed to confirm a diagnosis, doctors may recommend imaging tests, such as MRI scans and X-rays. Doctors examine the affected area to look for swelling, redness, or warmth. They also feel for bumps beneath the skin, which may indicate swollen bursae. Doctors use their hands to gently move the affected part of the body to see if bursitis or tendinitis are limiting range of motion or causing pain. You may be asked to stand and walk a few steps or perform other motions as your doctor assesses whether symptoms affect your ability to move.

Your doctor can usually differentiate between bursitis and tendinitis based on the location of the pain and swelling in relation to the anatomy of the affected area, but he or she may recommend imaging tests to confirm the diagnosis. During the examination, doctors ask about your current and past health as well as the nature of your injury. They may want to know when you first noticed discomfort, whether symptoms resulted from a specific incident, or whether they worsen during activity—especially if repeated motions are involved.

They also ask if you have had surgery on the affected part of the body. MRI is an advanced imaging technique that uses a magnetic field and radio waves to create detailed two- and three-dimensional pictures of soft tissue inside the body.

MRI scans provide clear images of inflammation in the affected bursae and tendons and may be used to confirm the extent of an injury. Eccentric strength training is effective in treating tendinopathies and helps promote the formation of new collagen. Patients should begin strengthening and stretching exercises after the pain has abated. One eccentric exercise for Achilles tendinopathy is the toe raise, which is performed while standing on a step.

The patient balances on the toes, then lifts the uninvolved foot and slowly lowers the other foot into dorsiflexion. Orthotics and braces. Tennis elbow bands and shoe inserts are used to support, unload, and protect tendons during activity and can provide additional benefit when used with other therapies.

Although few studies have evaluated their efficacy, orthotics and braces are safe, widely used, and often helpful in correcting associated biomechanical problems, such as excessive foot pronation and pes planus. Conservative treatment of aseptic bursitis is similar to that of acute tendinopathy and includes relative rest, cold and heat treatments, elevation of the affected extremity, NSAIDs, and joint protection. Ibuprofen, mg tid for 2 weeks, may be used, if there are no contraindications to high-dose NSAIDs.

Educate patients with bursitis on how to avoid aggravating their injury by not placing direct pressure on the affected area eg, for elbow pain, avoid pushing up with the elbows; for knee pain, avoid kneeling; and for hip pain, avoid lying on the affected side.

Provide patients with the appropriate method of joint protection for the affected area. For instance, patients at risk for prepatellar bursitis can use kneeling pads, and patients with Achilles bursitis can insert a thick heel pad in their shoe to raise the heel. In the patient with olecranon bursitis, the region was immobilized for 7 days and activities that aggravated the symptoms were discontinued for 1 to 2 weeks.

The patient was instructed on how to use ice compresses to help reduce the swelling. Ibuprofen mg tid with food for 2 weeks was prescribed for the pain.

He was symptom-free after 3 weeks. Local corticosteroid injections of the tendon is a topic of debate; currently, no evidence-based guidelines support their use in tendinopathy. The effects of peritendinous corticosteroid injections are unknown; however, they can be used with caution.

Avoid repetitive corticosteroid injections in any site, because corticosteroids may inhibit healing and reduce the tensile strength of the tissue, which could lead to tendon rupture. Corticosteroid injections should not be given if septic bursitis is suspected.

Other contraindications to injection include local cellulitis, bacteremia, Achilles tendinopathies, and minimal response after 2 treatments.

A wide range of corticosteroids have been used. No single agent is demonstrably superior. The recommended volume and doses for corticosteroid injection are listed in Table 2.

Complications include a "steroid flare" worsening of symptoms for a few days after injection , tenderness and erythema at the injection site, soft tissue atrophy, local infection, and tendon rupture.

Common overuse tendon problems: a review and recommendations for treatment. Am Fam Physician. Compression etiology in tendinopathy. Clin Sports Med. Rettig A. Tests and treatments of hand, wrist, and elbow overuse syndromes: 20 clinical pearls.

Tendonitis is generally caused by repetitive use of the associated muscle. As with any injury, your doctor will begin with a medical history and physical exam. He may order X-rays to rule out problems that might stem from your bones, like a fracture. Your doctor needs to know where and when the pain occurs to identify the correct diagnosis and to create the treatment plan. Diagnosing the problem as either bursitis or tendonitis has much to do with the anatomic location of the injury.

Your doctor can determine which is more likely to be the issue based on your particular signs and symptoms. Significant fluid in the bursa suggests bursitis. Conversely, tenderness of the tendons is an indicator of tendonitis.

Differentiating between the two may be more challenging in the shoulder, as the inflammation of the bursa is often associated with tendonitis. Stretching of the muscle can aid your doctor by identifying at what point in the range of motion the onset of pain occurs. This helps isolate the likely cause of the injury. Tenderness to palpation, strength and resistance testing, and joint stability testing will aid us in identifying the correct diagnosis. Select personalised content.

Create a personalised content profile. Measure ad performance. Select basic ads. Create a personalised ads profile. Select personalised ads. Apply market research to generate audience insights. Measure content performance. Develop and improve products. List of Partners vendors. Tendinitis and bursitis are two relatively common conditions that involve inflammation of the soft tissue around muscles and bones, most often in the shoulder, elbow, wrist, hip, knee, or ankle.

So closely are these conditions related that people will often use the terms interchangeably.