Introduction

Tendonitis and bursitis are common conditions affecting both the young and old, which are often related to motion. They are inflammatory conditions arising in the tendons or bursae of the arms and legs.  

Tendons are the fibrous cords attaching muscles to bone. They slide back and forth as the joints bend and straighten.

Bursae are fluid-filled sacs lying between tendons and joints. They are nature?s way of minimizing friction between the tendons and joints during motion. Sometimes the effect of the friction is excessive and the tendons and bursae become inflamed producing conditions known as tendonitis and bursitis.     
 

Cause

There are a number of possible causes for pain or inflammation in a tendon or bursa, but some are more common than others.

Excessive activity related to work or play, especially in people who are not accustomed to it, may result in these conditions. In rare cases, these problems may be due to infection, rheumatoid arthritis, gout, thyroid problems or diabetes.

Chronic inflammation of a tendon or bursa may result in calcium deposits, which may worsen and prolong the condition. When a doctor sees calcium deposits, in or near tendons or joints on an X-Ray, a diagnosis of calcific tendonitis and/or bursitis may be made.

Symptoms

Patients with tendonitis usually have soreness directly over the inflamed tendons and the discomfort is often made worse when using those muscles and tendons. In extreme cases there may be visible swelling.

In most cases the symptoms of tendonitis and bursitis are recognized in the early stages and can be easily managed. If the condition is ignored, it can become a chronic or long-term problem difficult to treat. As a result, tendonitis and bursitis are more easily resolved with early diagnosis and treatment.
     
Treatment

In the average case, treatment has two goals:

• Reduce the pain
• Eliminate the underlying cause 

The most reliable treatment for tendonitis and bursitis, particularly in the early stages, is to rest the involved muscles, tendons and joints, and eliminate the stresses producing the problem.

When the condition first arises, ice applied to the sore areas may be beneficial. After several days or weeks the application of moist heat may be more appropriate. Splints help reduce the strain on muscles and tendons and may ensure affected tendons and bursae are adequately rested.

Doctors may elect to treat conditions of tendonitis and bursitis with non-steroidal anti-inflammatory drugs (NSAIDS) and injections of steroidal anti-inflammatory medications. These medicines may be prescribed in combination with rest and individualized exercise therapy. When nothing else works, surgery may be an option.

In the few instances where surgery may benefit patients with tendonitis, the procedures are usually done to decompress tight passageways in which the tendons travel or to remove inflammatory tissue or calcium deposits from the tendon. Inflamed bursae can be drained or removed. Infected bursae must also be cut into and drained. If there are boney spurs irritating tendons or contributing to the formation of inflamed bursae, they can be removed surgically.

Surgery for tendonitis and bursitis is rare. The problem is usually short-lived and generally goes away on its own.