Tendonitis and Bursitis

Tendonitis is the inflammation or irritation of a tendon which causes pain and tenderness just outside a joint. Tendonitis may occur in any of the bodys tendons and is typically common around the shoulders, elbows, wrists, and heels. The more severe cases of tendonitis may lead to the rupture of a tendon and may need surgical repair.

In less severe cases of tendonitis, rest and medications are used to reduce the pain and inflammation, along with preventive measures to reduce the chances of developing tendonitis.

Tendonitis may become chronic or long term and can lead to the rupture of a tendon. It may also cause permanent damage to the tissue which makes up the tendons. Many different ligaments are involved in stabilizing the shoulder joint, particularly in the front.

The major stabilizing factors at the back of the joint are the muscles of the rotator cuff. These muscles help to keep the head of the humerus in place against the shoulder blade.


Bursitis is an inflammation of a bursa, a small sac that acts as a cushion or pad between moving structures, including bones, muscles, tendons, or skin. If a muscle or tendon is pulling around a corner, or over a bone, than a bursa serves to protect it from fraying and stress. Inflammation or irritation of this small sac is called bursitis.

Tendonitis or bursitis may occur in individuals with diseases such as rheumatoid arthritis, gout, psoriatic arthritis, diabetes, and thyroid disease. Tendonitis can be caused by sudden intense injury, but is most often the result of a repetitive and minor injury of the affected area.

Most people do recover full function after a combination of medications, physical therapy, and steroid injections. For patients with tendonitis and a bone spur, arthroscopic surgery is usually successful in restoring them to their pre-injury level of activity.

Rotator Cuff Tendonitis

Rotator cuff tendonitis, also known as bursitis, or impingement syndrome, occurs when the rotator cuff gets irritated on the undersurface of the acromion. The reason this occurs is a source of some debate. Some people are born with a hooked acromion that will predispose them to this problem.

Others have rotator cuff weakness that causes the humerus to ride up and pinch the cuff. This means that the bursa becomes inflamed. Common signs of rotator cuff tendonitis include pain located primarily on top and in the front of the shoulder.


Mild to moderate weakness is very common, especially when overhead activity is performed. On occasion, bursitis that occurs with rotator cuff tendonitis can cause a mild popping or crackling sensation in the shoulder.

Often the diagnosis is suggested by the symptoms. The orthopedic surgeon or primary care physician will have the patient perform various maneuvers to detect rotator cuff tendonitis. The physical examination is designed to test motion, strength, and certain positions of pain.

In addition, plain x-rays can show a spur on the undersurface of the acromion. An MRI is often ordered if a rotator cuff tear is suspected. Treatment for tendonitis of the rotator cuff includes resting the injured shoulder from the activities that caused the problem and from the activities that cause pain. Ice packs applied to the shoulder and non-steroidal anti-inflammatory drugs will help reduce inflammation and pain.