Bursitis And Tendinitis

By editor | September 18, 2007

Your body has about 150 bursae, small liquid-filled sacs that cushion muscles and tendons as they move within the body. Think of them as tiny balloons filled with something like mineral oil. When they’re injured, from a blow, a fall, or just too much constant pressure, they fill with even more fluid and swell painfully. This is called bursitis, which just means swollen bursae.

Kneeling too long can bring on bursitis, whether you’re scrubbing the floor or roofing a house. You can get it in your elbow, from a bump or from leaning it too long on a desk or table. Badly fitting or poorly designed shoes can cause bursitis in the hips or even bunions, bursitis in your toes. And, unfortunately, if you have painful arthritis, trying to compensate for sore joints by favoring one limb or moving awkwardly can irritate your bursae. Occasionally, bursitis is caused by an infection or by tendinitis.

Tendons are bands of tissue that connect your muscles to your bones. Tendinitis, or swollen tendon, is caused by stress on a tendon, or even a tear. You can get it in the heel, upper arm, elbow, wrist, hand, or hip. Because tendons and bursae are so close together, when tendons swell they can put pressure on the bursae, so you may often have both conditions at the same time, particularly in the shoulder. Doctors frequently diagnose the uncomfortable combo as “bursitis-tendinitis.”

Symptoms. You may have dull pain around a joint that gets worse with movement and awakens you at night. The area may be swollen and warm when you touch it, and it will be red if the bursa is infected.

Diagnosis. This is based partly on your symptoms and on an examination of your joints and the tissues around them. Your doctor will ask questions: When did the pain start? What makes it worse? Have you had an injury? Your doctor will also examine you, which will usually allow her to know whether you have bursitis-tendinitis or arthritis. Occasionally, X-rays are also needed. Although bursitis isn’t visible on X-rays, your doctor may have them taken to rule out other problems such as inflamed joints. And because infection is sometimes the cause, your doctor may remove some fluid from the bursa to check for a telltale high white blood cell count.

Prevention. The best way to prevent bursitis (and tendinitis as well) is to stay in shape, because then you’re less likely to be injured from overuse. Also, stop activities when you feel pain. Avoid reaching overhead for long periods or moving your shoulder repeatedly such as in nonstop vacuuming. Take breaks, and stretch a bit. Use knee pads when roofing, gardening, or scrubbing floors; toss out shoes that are too tight or have well-worn heels; use shoe lifts or specially made shoes if one leg is longer than the other. Don’t grip items too tightly. Tools or kitchen utensils with large handles, such as the ones designed for use with rheumatoid arthritis, will help keep you from squeezing too hard. Use your entire arm instead of your wrist whenever possible, whether you’re hitting a tennis stroke or pushing open a door.

Treatment. The best news is that you can usually treat bursitis at home. Your primary treatments are rest and ice. Of course, first stop the activity that hurts, and then apply ice packs for 20 minutes every hour or two that you’re awake. Mter 48 hours, switch to heat, such as a warm bath or a hot compress, for pain relief. You may want to take aspirin or an NSAID such as ibuprofen. After the pain lets up a bit, it’s time to do some gentle stretching. Someone may sympathetically offer to massage the painful area for you, but just say no this would make your bursitis worse. If you’re in severe pain or still feel no relief in four days, see your doctor. Your doctor may inject cortisone into the bursa or remove fluid with a needle to check for infection. Very rarely, in extreme cases, the bursa may be surgically removed.


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