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Soothing the Pain of Bursitis and Tendinopathy

IMAGE Whether you work out on a regular basis, are a weekend warrior, or have just gone a little too far with activities, you know that overdoing it can lead to unhappiness. Activities that are repetitive or too intense can cause minor tears, strains, and inflammation which cause pain that can slow you down. Sometimes this can lead to tendinitis or bursitis. If it does, then how do you get rid of it?

Birth of Bursitis and Tendinitis

Tendons and bursae help support movement at your joints. Bursa are fluid filled sacs that help your tendons glide over bony areas of your joints. Tendons are connective tissues that bind muscles to bones. When these structures become injured, they can make joint movement painful. Overuse or stress injuries can easily cause the following injuries:
  • Bursitis—swelling and irritation of the bursa
  • Tendinopathy—problems in the tendon including
    • Tendinitis—swelling and irritation of the tendon
    • Tendinosis—a wearing down of the tendon in response to overuse
These injuries may be caused by something as simple as housecleaning or your everyday job, to something more complex like sports. It may also be caused by an imbalance in the muscles around your joint. It may be difficult to tell if the problem is with the tendon or bursa.
The pain may not always be due to an obvious injury. It may slowly develop or get worse over time. It is important to know your body to help distinguish between normal soreness from some workouts and soreness that indicates a problem.

Listen to Your Body, Avoid the Problem

Pain is a communication tool. It is the way your brain tells you that you need to pay attention because something is wrong. If you are feeling pain, you need to assess why, especially if the pain is always in the same location and continues or recurs often. Ignoring the pain may simply force you to be unnecessarily uncomfortable. It can also lead to long term problems.
Note what activities may be causing the pain. Find ways to change the activity to reduce stress on your joints. Some adaptations that may help include:
  • Check your technique. A small correction in how you do an activity can make a big difference.
  • Lower the intensity. You may have gone too hard, too fast. Lower your intensity level and gradually increase your intensity as you get stronger.
  • Vary your actities to distribute the stress.
  • Be aware of activities that have repetitive actions.
    • For tasks like shoveling or sweeping, take small breaks to give your joints a break.
    • For sport activites like tennis, do other types of exercise (cross-training) to give your body a break from the repetitive motions of one sport.
Not all injuries can be prevented. Fortunately, most tendon and bursa problems can be relieved with some basic at home care.

You Have Pain, Now What?

The Basics

Bursitis and tendinopathy need time and attention to heal. Most of the time, the pain will go away with home care. Here are some tips on what you can do at home:
  • Rest—avoid the activity that is causing the pain
  • Ice—can help reduce swelling, so pack it on for a short time, a few times a day.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)—pain relievers like ibuprofen or naproxen. If you have any medical problems, or take other medications, check with your doctor before starting this medicine.
  • Investigate what action may have caused the pain. Look for ways to prevent it from happening again.
These steps will help relieve discomfort but may not solve the underlying problem. Talk to your doctor if the pain does not go away. Your doctor may recommend other treatment options such as joint injections and physical therapy.

Injections

In some cases, cortisone may be injected into the bursa or occasionally around tendons. This medicine may help to reduce swelling and irritation.. These injections may make the pain may go away temporarily. The cause of the bursitis or tendinitis will still need to be addressed.

Physical Therapy

Physical therapy may help relieve the cause of the tendinitis or bursitis. A physical therapist may help to:
  • Improve balance of muscles around a joint—imbalances can increase your risk of injury
  • Strengthen muscles around the joint—to relieve pressure on the tendons and bursa
  • Identify improper techniques that may be causing problem
Other treatments like ice or heat therapy, braces, or wraps may help to manage the pain while you heal.
You may never know for sure if your ache is from tendinopathy or bursitis. Rest is the most important step for either injury. Give your body the chance it needs to heal before jumping back in to action. A few days of frustration are much easier to deal with than long term pain.
You may never know for sure if your ache is from tendinopathy or bursitis. Rest is the most important step for either injury. Give your body the chance it needs to heal before jumping back in to action. A few days of frustration are much easier to deal with than long term pain.

RESOURCES

American Orthopaedic Society for Sports Medicine http://www.sportsmed.org

American Society of Exercise Physiologists http://www.asep.org

CANADIAN RESOURCES

Canadian Society for Exercise Physiology http://www.csep.ca

Public Health Agency of Canada http://www.phac-aspc.gc.ca

References

Achilles tendinopathy. EBSCO DynaMed website. Available at http://www.ebscohost.com/dynamed. Updated April 29, 2014. Accessed October 24, 2014.

Andres BM, Murrell GA: Treatment of tendinopathy: what works, what does not, and what is on the horizon. Clin Orthop Relat rEs. 2008;466:1539-54.

Anterior tibialis and extensor teninopathy. EBSCO DynaMed website. Available at http://www.ebscohost.com/dynamed . Updated April 29, 2014. Accessed October 24, 2014.

Bass E. Tendinopathy: why the difference between tendinitis and tendinosis matters. Int J ther Massage Bodywork. 2012;5(1):14-17. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312643/. Accessed October 24, 2014.

Mayor, RB. Treatment of athletic tendinopathy. Conn Med. 2012 Sep;76(8):471-475.

Patellar teninopathy. EBSCO DynaMed website. Available at http://www.ebscohost.com/dynamed. Updated July 18, 2014. Accessed October 24, 2014.

Pes anserine bursitis. EBSCO DynaMed website. Available at http://www.ebscohost.com/dynamed. Updated September 20, 2012. Accessed October 24, 2014.

Posterior tibialis teninopathy. EBSCO DynaMed website. Available at http://www.ebscohost.com/dynamed. Updated April 29, 2014. Accessed October 24, 2014.

Questions about bursitis and tendinitis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health%5FInfo/Bursitis/. Published June 2013. Accessed October 24, 2014.

Wasielewski NJ, Kotsko KM: Does eccentric exercise reduce pain and improve strength in physically active adults with symptomatic lower extremity tendinosis? A systematic review. J Athl Train. 2007;42:409-21.

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