I get so many patient’s that are diagnosed with bursitis and tendonitis and they have absolutely no idea what it is. All they know is that they went to their doctor, they looked at the area of complaint for a second or two. They saw that the patient can move the body part ok, but they had pain. The answer…BURSITIS or…..TENDONITIS. What the heck is bursitis and tendonitis. Lets begin by getting a definition, then we will break it down by location, the mechanism of injury and ultimately how to get rid of it (which is obviously the most important thing).
First, lets break the word down. Burs- stands for bursa. A bursa is a fluid-filled sac lined by a membrane. It provides a cushion between bones and tendons and/or muscles around a joint. This helps to reduce friction between the bones and allows free movement. Bursae are filled with synovial fluid and are found around most major joints of the body. -Itis stands for inflammation. Therefore, when we put it together bursitis stands for inflammation of a bursa. The most common locations for bursitis are in the shoulder, elbow and hip. But you can also have bursitis by your knee, heel and the base of your big toe. Bursitis often occurs near joints that perform frequent repetitive motion. If you have bursitis, the affected joint may feel achy or stiff, hurt more when you move or press on it and may look swollen or red. A lot of my patients get bursitis from throwing a baseball or lifting something over their heads repeatedly, leaning on their elbows for long periods of time, excessive kneeling like my carpet guys or scrubbing floors like my cleaning people and my patients that sit for long periods of time, especially on hard surfaces. Does this remind you of someone?
TENDONITIS or TENDINITIS
Again, lets break it down. Tendon-stands for a thick elastic band that attaches the muscle to a bone. -Itis again is inflammation. So putting it together means inflammation of a tendon. Sometimes the tendons become inflamed for a variety of reasons, and the action of pulling the muscle becomes irritating. If the normal smooth gliding motion of your tendon is impaired, the tendon will become inflamed and movement will become painful. There are too many causes for tendonitis to even list. Anything that you do can case tendonitis if the right mechanisms are there. Unlike bursae which are not located all over the body, every muscle has a tendon so tendonitis can occur anywhere. The most common sites are at the base of the thumb, elbow, shoulder, hip, knee and achilles tendon.
So I have Bursitis and/or Tendonitis, what do I do? Usually by the time my patients get to me they have tried a long period of “wait and see”. I usually tell people to avoid the “wait and see” mentality all together. I know its tough these days, when you look everything up on the internet and it says that most things will go away on its own. Although, this may be true sometimes, it is definitely not true all the time. My philosophy is that if your body can handle it, your body won’t even let you know you have something wrong. By the time your body gives you conscious awareness of a problem (a symptom) for example pain, swelling, redness, spasm, fever it should be looked at by a professional. Again, most things are not severe, but what if there is something severe going on and you don’t have it checked by a professional, now we have a problem. The worst thing that can happen with a non-serious condition is that your doctor sends you home and tells you that there is nothing wrong. However, when you don’t go to a professional and there is something serious going on, the worse case scenario can be very severe. (just my two cents!!!). Back to the treatment. The first thing anyone wants to do when they have bursitis/tendonitis is stop the activity that caused it from happening. Continued irritation will only make the condition worse. If you are throwing you need to stop throwing, if you are kneeling you need to stop kneeling. A lot of times just eliminating the mechanism of injury will heal the problem. Another modality to use is ice. If you look back into my heat vs. ice blog you can learn more about the benefits of ice. Anti-inlammatories are helpful for these conditions as well because as we said -itis is inflammation so taking an anti-inflammatory will help reduce the inflammation and help with the overall pain. I tell all my -itis patients that if you got it once you may be prone to getting it again so strengthening is usually very helpful to prevent further episodes. There are a few cases that do not respond to general therapies like a just listed so more aggressive or advance therapies are available. In my office we offer a class IV 15 watt laser therapy to heal tendonitis and bursitis. We perform techniques like Active Release Technique (A.R.T.) and Graston technique. We use Kinesio Tape and other supports to help. Our physicians perform cortisone injections and even P.R.P. injections for the very advanced cases. This is not the only way to treat it but a very effective combination is usually very successful with my patients. If treated properly a full recovery is expected and when done correctly therapy prevents the prevalence of further episodes as well.