Bursitis vs Tendonitis: Symptoms, Causes, and Treatment

Bursitis vs Tendonitis: Understanding the Difference and the Best Treatment Options

Infographic illustrating the differences between tendonitis and bursitis

Pain around a joint can be frustrating, limiting, and confusing—especially when terms like bursitis and tendonitis are used interchangeably. While these conditions often feel similar and can occur in the same regions of the body, they affect different tissues and may require slightly different treatment strategies. Understanding the difference between bursitis vs tendonitis can help guide smarter care decisions and faster recovery.

At Lamb Chiropractic, we frequently see these conditions overlap with movement dysfunction, joint restriction, and chronic inflammatory patterns that extend beyond the painful area itself. Addressing the root cause—not just the irritated tissue—is key to long-term relief.

What Is Bursitis?

Bursitis of the knee infographic

Bursitis is inflammation of a bursa, a small fluid-filled sac that acts as a cushion between bones, tendons, muscles, and skin. Bursae reduce friction and allow tissues to glide smoothly during movement.

When a bursa becomes irritated, it can swell, thicken, and become painful—especially with pressure or repetitive motion.

Common Areas Where Bursitis Occurs

Bursitis can develop anywhere a bursa is present, but it is most commonly seen in:

Shoulder (subacromial bursitis)
Hip (trochanteric bursitis)
Knee (prepatellar or pes anserine bursitis)
Elbow (olecranon bursitis)
Heel (retrocalcaneal bursitis)

These areas are often subjected to repetitive stress, prolonged pressure, poor biomechanics, or joint stiffness.

What Is Tendonitis?

Tendonitis of the shoulder illustration

Tendonitis (more accurately referred to as tendinopathy in chronic cases) is irritation or degeneration of a tendon, the thick connective tissue that attaches muscle to bone.

Unlike bursitis, tendonitis pain is often provoked by active movement, loading, or resistance rather than direct pressure.

Common Areas Where Tendonitis Occurs

Tendonitis frequently affects:

Rotator cuff tendons (shoulder)
Biceps tendon
Lateral or medial elbow (tennis or golfer’s elbow)
Patellar tendon (jumper’s knee)
Achilles tendon
Wrist and thumb tendons (De Quervain’s)

These injuries are commonly associated with overuse, poor movement patterns, sudden increases in activity, or inadequate recovery.

Key Differences Between Bursitis and Tendonitis

Although they can coexist, bursitis and tendonitis differ in important ways:

Tissue involved: Bursa vs tendon
Pain pattern: Bursitis is often painful with pressure or compression, while tendonitis worsens with movement and loading
Swelling: More common and visible with bursitis
Chronicity: Tendonitis is frequently degenerative rather than inflammatory in long-standing cases

Because of this overlap, imaging alone does not always tell the full story. Functional assessment and movement analysis are essential.

Acute, Subacute, and Chronic Inflammatory Stages

A graphic showing the stages of inflammation in tissue.

Understanding the stage of inflammation helps determine the most appropriate treatment.

Acute Stage (0–72 hours)

This phase is dominated by inflammation, swelling, and pain following injury or irritation.

Ice is most appropriate during this stage
The goal is to reduce excessive inflammation and pain
Compression and relative rest may be helpful

Subacute Stage (3 days to several weeks)

This is the transition phase, where inflammation is still present but tissue repair is underway.

Alternating ice and heat can be very effective
This contrast helps “pump” edema and waste products out of the tissue
Gentle motion becomes critical to prevent stiffness

Chronic Stage (Weeks to Months)

Most cases of bursitis and tendonitis seen in clinical practice are chronic, not acute.

Inflammation is low-grade and persistent
Tissue quality has often deteriorated
Heat is typically more beneficial than ice
Moist heat or paraffin wax baths can significantly improve circulation and tissue extensibility

Why Bursitis and Tendonitis Become Chronic

These conditions rarely persist due to the tissue alone. Chronic cases often involve:

Joint restriction
Poor biomechanics
Reduced blood flow
Nervous system stress
Weak or inhibited stabilizing muscles

This is why isolated rest or medication often fails to resolve symptoms long-term.

Modern Treatment Options for Bursitis and Tendonitis

Shockwave Therapy

Radial shockwave therapy has become a powerful non-invasive option for chronic soft tissue injuries.

Stimulates blood flow
Promotes collagen remodeling
Helps break up fibrotic tissue
Particularly effective for Achilles, plantar fascia, shoulder, hip, and knee conditions

Cold Laser Therapy

Cold laser (low-level laser therapy) helps reduce inflammation while accelerating cellular repair.

Improves mitochondrial activity
Enhances tissue healing without heat
Often used for acute flare-ups or sensitive tissues
For more information, follow this link to cold laser therapy

Knee-On-Trac Decompression

For knee-related tendon and bursa issues, Knee-On-Trac can help by:

Reducing compressive forces
Improving joint nutrition
Allowing inflamed tissues to recover under less stress

This approach is especially helpful for patellar tendonitis and knee bursitis.

For more information on this, click here: Knee on Trac

IASTM / Muscle Scraping

Instrument-assisted soft tissue mobilization helps:

Break down scar tissue
Improve fascial glide
Restore normal tissue texture
Increase blood flow to chronic injury sites
Here’s more on muscle scraping

Kinesiotaping and Bracing

Doctor applying kinesiotape to a male athletes' shoulder

Taping and bracing can:

Reduce strain on irritated tissues
Improve proprioception
Allow movement while healing continues

These are often used as temporary supports during activity.

Regenerative Options: PRP and Stem Cells

In stubborn cases, regenerative medicine may be considered.

PRP (Platelet-Rich Plasma) uses concentrated growth factors to stimulate repair
Stem cell therapies aim to regenerate damaged tissue

These options are typically reserved for cases that do not respond to conservative care and should be considered within a broader movement-based strategy.

The Role of Chiropractic Adjustments

Extremity Adjustments

Adjusting the joints above and below the injured tissue helps:

Restore normal motion
Reduce abnormal stress on tendons and bursae
Improve biomechanics during movement

Full Spine Chiropractic Adjustments

Spinal alignment plays a critical role in healing.

Improves nervous system signaling
Enhances muscle coordination
Increases the body’s ability to regulate inflammation

This is especially important when pain has altered movement patterns over time.

You can learn more about how spinal health supports recovery on our
back pain treatment page and
nervous system health page.

Nutrition for Tissue Healing and Inflammation Control

Healing connective tissue requires the right nutritional building blocks.

Key Nutrients

Vitamin C: Essential for collagen synthesis
Collagen: Provides structural support to tendons and ligaments
High-protein diet: Supplies amino acids needed for repair

Natural Anti-Inflammatories

Turmeric (curcumin)
Ginger
Boswellia
Fish oil (omega-3s)
DMSO (under professional guidance)

Nutrition alone will not fix biomechanics, but it dramatically improves healing capacity when combined with proper care.

Heat, Ice, and Paraffin Wax Therapy

For chronic bursitis and tendonitis:

Moist heat improves circulation and tissue elasticity
Paraffin wax baths are excellent for hands, wrists, and feet
Heat prepares tissue for manual therapy and exercise

Ice still has a role during flare-ups but should not be the default for long-standing injuries.

Frequently Asked Questions

Can bursitis and tendonitis happen at the same time?

Yes. It is very common for both tissues to be involved, especially around the shoulder, hip, and knee.

Should I completely rest these injuries?

Complete rest often delays recovery. Controlled movement is usually necessary for healing.

How long do chronic cases take to heal?

Healing timelines vary, but chronic cases often require several weeks of consistent, structured care.

Are injections always necessary?

No. Many cases respond well to conservative, movement-based treatment before injections are considered.

A Smarter Approach to Joint Pain

Bursitis vs tendonitis is not an either-or diagnosis—it is often a spectrum of tissue overload influenced by movement, posture, and nervous system function. Treating only the inflamed tissue without addressing the mechanical cause frequently leads to recurrence.

At Lamb Chiropractic, our goal is to restore motion, improve healing speed, and reduce inflammation naturally—so your body can return to normal function without unnecessary procedures.