TendinitisTendinitisAny injury that produces an inflammatory response within the tendon substance. (tendonitistendonitisInflammation of a tendon.) and bursitis are closely related shoulder problems that commonly affect the shoulder's tendonstendonsFibrous bands, one at each end of a muscle, that connect the muscle to bones.. They may occur separately or in combination.

how do tendons work?

Tendons are fibrous cords that connect muscles to bones. As a muscle contracts, it pulls on the attached tendon and causes the boneboneThe hard tissue that provides structural support to the body. It is primarily composed of hydroxyapatite cryst... to move. The tendon is located between the humerushumerusThe bone of the arm, articulating with the scapula above and the radius and ulna below. (upper arm) bone and the acromion. A layer of tissuetissueA collection of similar cells and the intercellular substances surrounding them. sacs called bursae serves as a cushion between the tendon and the acromion.

Since both the tendon and bursae are so close to one another, it may be difficult to determine which one is the source of the painpainAn unpleasant sensation associated with actual or potential tissue damage, and mediated by specific nerve fibe.... Most often, both are involved.

tendinitis

Tendinitis is perhaps the most common shoulder problem. It is inflammationinflammationA local response to injury due to a physical reaction (such as abrasion), or to chemical or biological agents,... of a tendon. When it happens in the shoulder, the rotator cuffrotator cuffThe rotator cuff is made up of four muscles and their tendons. These combine to form a "cuff" over the head of... tendons or biceps tendons are inflamed, usually as the result of being pinched.

bursitis

Bursitis often accompanies tendinitis, although it can occur independently. Bursitis is inflammationinflammationA localized tissue response initiated by the injury or destruction of vascularized tissues. Inflammation Heat,... of the bursae, the sacs that help cushion the rotator cuff from the boney front edge of the shoulder blade (acromion).

what causes tendinitis and bursitis? who is at risk?

Anyone can experience tendinitis and bursitis, but it's more common as in older adults. As tendons age, they are less elastic and become more susceptible to injury.

The problem is most likely to happen after recurring repetitive movement that causes minor injury to the shoulder:

• Spending the weekend painting the living room or playing the first tennis match of the season can bring on the pain of tendinitis
• Simple daily activities like lifting a bag of groceries into the car can inflame the bursa and cause bursitis. A bursa also can become inflamed from injury or an underlying disease such as rheumatoid arthritis
• Frequently lifting heavy items above your head can cause tendinitis and bursitis
• Participating in sports that require repetitive overhead movement such as swimming, playing baseball, or racquetball can cause tendinitis and bursitis

how are tendinitis and bursitis diagnosed and treated?

Patients tendinitis and/or bursitis experience pain at rest that worsens with certain shoulder movements.

To diagnose the condition, doctors will examine the shoulder and ask about recent activities that may have caused the symptoms. An x-rayx-rayAn X-ray is a painless process that uses radioactive materials to take pictures of bone. If your doctor suspec... may be useful to show if a bone spur is compressing the tendon. The doctor also may suggest an MRIMRIShort for magnetic resonance imaging. This is a special radiologic test that allows for excellent imaging of t... to see if the rotator cuff is torn. If bursitis is suspected, an MRI may show if there is fluid or inflammation in the bursae.

To treat tendinitis and/or bursitis, physicians may suggest NSAIDsNSAIDsA nonsteroidal anti-inflammatory drug such as ibuprofen. to treat the pain and inflammation. It also may be advisable to modify some of the activities that caused your symptoms in the first place. Physical therapyPhysical therapyThe treatment consisting of exercising specific parts of the body such as the legs, arms, hands or neck, in an... may be helpful. Physicians also may suggest a corticosteroid injection into the space above the rotator cuff to decrease painful symptoms and make physical therapy easier. For patients with bursitis, sometimes doctors may recommend removing the bursa fluid by a needle and syringe (aspirationaspirationThe withdrawal of fluid from the body.).

Most tendinitis and bursitis can be managed without surgerysurgeryThe branch of medicine concerned with the treatment of disease, injury, and deformity by operation or manipula.... If symptoms are not well controlled with rest, medication, or injections, then surgery may be recommended to remove the inflamed bursa and bone spursspursA sharp, bony outgrowth located at the end of a bone..

what can patients with tendinitis and bursitis expect long-term?

Over time, tendinitis and bursitis often go away by themselves. If the problem persists, patients should check with a doctor for additional options, including surgery.

If the patient and surgeon decide on surgery, the surgeon can advise whether an arthroscopy can be performed. This form of minimally invasive surgeryminimally invasive surgerySurgery requiring small incision(s), usually performed with endoscopic visualization. allows the orthopaedic surgeon to see inside the shoulder and to carry out procedures through tiny incisions in the shoulder. Recovery time generally is faster.

learn more about arthroscopy surgery