Bursitis and Tendinitis

What Is Bursitis And Tendinitis?

A bursa is a small sac of tissue lined with a membrane and filled with fluid. Bursae are found in areas where tendons or muscles or bones move over one another to allow smooth motion. When the bursa is working properly, tissues slide over each other effortlessly and painlessly. However, when the bursa is inflamed, movement causes pain and dysfunction. A tendon is a tough fibrous cord that forms at the end of a muscle and allows the muscle to attach to bone. Some tendons are surrounded by a thin layer of tissue called a sheath. When a tendon becomes inflamed, it also is associated with pain and significant loss of motion and function. This is known as tendinitis.

What Causes Bursitis and Tendinitis?

Bursitis and tendinitis are commonly caused by an injury to the tissue, such as might occur in a sporting event. Usually, however, inflammation in these tissues results from “overuse” or “repetitive use” such as can be seen in persons spending long hours on the computer, or clipping hedges, etc. The wear and tear on the tendon or bursa during repeated motion causes the inflammation. Bursitis and tendinitis might also develop at pressure points, such as elbow(olecranon) bursitis in truck drivers who constantly lean on their left elbow as they drive.

How Is Bursitis And Tendinitis Diagnosed?

Bursitis and tendinitis are diagnosed by a careful physical examination by a trained physician. These disorders do not reveal themselves in laboratory studies. Most times there are also no radiographic clues to the diagnosis. An exception is in “calcific bursitis” of the shoulder in which calcification may be seen on the shoulder xray and help point to the diagnosis. But more common cases of tendinitis such as “tennis elbow”, or “golfers’ elbow”, or hip bursitis will have no changes on xray. Occasionally, a bursa or tendon sheath can become infected and look like typical bursitis or tendinitis. In those cases, the physician must remove fluid from the bursa or sheath and culture the fluid to look for offending organisms.

How Is Bursitis And Tendinitis Treated?

Of course infected bursa and tendons are treated with antibiotics. In the more typical case, however, the first line of treatment is to decipher any aggravating activities and to formulate avoidance techniques. This might include re-arranging one’s computer work station, for example. Physical modalities, such as liniments, heat, or ice packs may help. Sometimes bracing or splinting an acutely inflamed tendon or bursa affords relief. Usually, anti-inflammatory medications are used to decrease inflammation, relieve pain, and improve mobility. Occasionally, injections of steroids into the inflamed sheath or bursa can provide prompt relief. Bursitis and tendinitis may recur, especially if the offending activity is not corrected. Rarely does a bursa have to be surgically removed because of continuing severe pain or immobility. And rarely does a tendon sheath or the “pulleys” overlying tendons have to be surgically corrected. Most cases of bursitis and tendinitis respond favorably to conservative measures.

Authored by: Carolyn Smith, M.D.

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