What is bursitis and how is it different from tendonitis? 

Bursitis and tendonitis are two common conditions that cause pain, tenderness, and swelling around the joints. While they often occur in the same areas of the body and share similar causes, they involve different types of soft tissue and require specific approaches to management. Understanding the distinction between the inflammation of a bursa and the irritation of a tendon is helpful for those seeking to understand their symptoms and the typical recovery path. 

What We’ll Discuss in This Article 

• The anatomical definitions of bursitis and tendonitis. 

• Specific differences in how each condition presents during movement. 

• Commonly affected joints and areas of the body. 

• Primary causes and lifestyle risk factors for soft tissue inflammation. 

• The standard diagnostic process used by healthcare professionals in the UK. 

• Typical management strategies and self-care techniques for recovery. 

What are bursitis and tendonitis? 

Bursitis is the painful inflammation of a bursa, which is a small, fluid filled sac that cushions the spaces between bones and surrounding soft tissues like muscles, tendons, or skin. There are over 150 bursae in the human body, and they act as buffers to reduce friction and prevent tissues from rubbing against one another during movement. In contrast, tendonitis is the inflammation or irritation of a tendon, which is the thick, fibrous cord that attaches muscle to bone. While both conditions involve inflammation of the soft tissues that support joint function, they affect different structures. 

How is bursitis different from tendonitis? 

The main difference between these two conditions is the specific tissue affected and the type of pain experienced during physical activity. Because tendons are responsible for transmitting the force from muscles to bones to create movement, pain from tendonitis is often most acute and sharp during specific movements or when the muscle is contracted. Bursitis pain, however, often feels like a constant, dull ache or stiffness that becomes more intense when direct pressure is applied to the area. For example, a person with bursitis in the knee may feel significant pain specifically when kneeling, whereas someone with tendonitis in the same area may feel the most pain when climbing stairs or running. 

Comparing symptoms and locations 

Symptoms of both conditions often overlap, but there are distinct clinical features that medical professionals look for during a physical assessment. Swelling is often more visible and localized in cases of bursitis, sometimes appearing as a distinct lump over a bony area. 

Feature	Bursitis	Tendonitis
Primary Location	Over bony prominences or between tendons and bones.	Where the muscle meets the bone.
Pain Description	Aching or stiffness that increases with pressure.	Sharp or dull pain triggered by movement.
Visible Swelling	Often present and may look like a localized lump.	Usually minimal or localized strictly to the tendon.
Common Sites	Shoulders, elbows, hips, and knees.	Wrists, heels (Achilles), and shoulders.

Common areas affected by inflammation 

Both conditions frequently affect the shoulder, which is a complex joint where many tendons and bursae reside in close proximity. In the elbow, bursitis often affects the tip of the bone (olecranon), while tendonitis typically occurs on the inner or outer sides, commonly known as golfer’s or tennis elbow. The hip is another common site for bursitis, often causing pain on the outer thigh when lying down. Tendonitis is frequently seen in the Achilles tendon at the back of the heel or in the patellar tendon just below the kneecap. Understanding these common sites helps in identifying which structure might be the source of discomfort. 

What causes these conditions to develop? 

Overuse or repetitive strain is the most frequent cause of both bursitis and tendonitis in the UK. Performing the same movement repeatedly over a long period, such as during gardening, painting, or specific sports, can irritate these delicate tissues. For example, NHS guidance on bursitis notes that the condition can also be caused by sudden injury or even infection. As people age, tendons become less flexible and more prone to injury, making older adults more susceptible to tendonitis. Certain underlying health conditions, such as rheumatoid arthritis, gout, or diabetes, can also increase the risk of developing inflammation in the bursae or tendons.  

How are these conditions diagnosed? 

A diagnosis is typically made through a physical examination and a review of a person’s symptoms and medical history. A healthcare professional will check for tenderness, localized swelling, and the range of motion in the affected joint. In many cases, the specific location of the pain helps the clinician distinguish between the two. If the diagnosis is unclear or if symptoms do not improve with initial management, further tests may be required. These might include an ultrasound scan to visualize the soft tissues or an MRI for a more detailed view. If an infection is suspected in a bursa, a procedure called aspiration may be performed to take a small sample of fluid for laboratory testing.  

Management and recovery options 

The primary goal of management for both conditions is to reduce inflammation and allow the affected tissue to heal. Most cases can be managed effectively at home using the ‘PRICE’ method, which stands for protection, rest, ice, compression, and elevation. Resting the joint and avoiding the activity that caused the irritation is essential to prevent further damage. According to NICE standards for musculoskeletal pain, over the counter painkillers like ibuprofen or paracetamol may be used to manage discomfort and reduce inflammation. Physical therapy is often recommended for recurring cases to strengthen the muscles around the joint, which helps to redistribute the load and reduce stress on the tendons and bursae.  

Conclusion 

Bursitis and tendonitis are distinct conditions that cause significant joint discomfort through the inflammation of different soft tissues. While bursitis involves the cushioning sacs and tendonitis involves the muscle to bone connectors, both generally respond well to rest and conservative management. Most people experience a full recovery within a few weeks of consistent care and activity modification. If you experience severe, sudden, or worsening symptoms, or if the area becomes red, hot, and you feel generally unwell, call 999 immediately. 

Authority Snapshot 

This article provides evidence based information regarding the differences between bursitis and tendonitis to help patients understand these common inflammatory conditions. It has been written by the MyPatientAdvice Medical Writing/Research Team and reviewed by Dr. Rebecca Fernandez to ensure clinical accuracy. All content is strictly aligned with current NHS and NICE guidance for the management of musculoskeletal health.