What Kind of Health Care Professional Treats These Conditions?

A primary care physician or a physical therapist can treat the common causes of tendinitis and bursitis. Complicated cases or those resistant to conservative therapies may require referral to a specialist, such as an orthopaedist or rheumatologist.

How Are Bursitis and Tendinitis Treated?

Treatment focuses on healing the injured bursa or tendon. The first step in treating both of these conditions is to reduce pain and inflammation with rest, compression, elevation, and anti-inflammatory medicines such as aspirin, naproxen (Naprosyn¹, Aleve), or ibuprofen (Advil, Motrin, or Nuprin). Ice may also be used in acute injuries, but most cases of bursitis or tendinitis are considered chronic, and ice is not helpful. When ice is needed, an ice pack can be applied to the affected area for 15-20 minutes every 4-6 hours for 3-5 days. Longer use of ice and a stretching program may be recommended by a health care provider.

Activity involving the affected joint is also restricted to encourage healing and prevent further injury.

In some cases (e.g., in tennis elbow), elbow bands may be used to compress the forearm muscle to provide some pain relief, limiting the pull of the tendon on the bone. Other protective devices, such as foot orthoses for the ankle and foot or splints for the knee or hand, may temporarily reduce stress to the affected tendon or bursa and facilitate quicker healing times, while allowing general activity levels to continue as usual.

The doctor or therapist may use ultrasound (gentle sound-wave vibrations) to warm deep tissues and improve blood flow. Iontophoresis may also be used. This involves using an electrical current to push a corticosteroid medication through the skin directly over the inflamed bursa or tendon. Gentle stretching and strengthening exercises are added gradually. Massage of the soft tissue may be helpful. These may be preceded or followed by use of an ice pack. The type of exercises recommended may vary depending on the location of the affected bursa or tendon.

If there is no improvement, the doctor may inject a corticosteroid medicine into the area surrounding the inflamed bursa or tendon. While corticosteroid injections are a common treatment, they must be used with caution because they may lead to weakening or rupture of the tendon (especially weight-bearing tendons such as the Achilles ankle?, posterior tibial arch of the foot?, and patellar knee? tendons). If there is still no improvement after 6-12 months, the doctor may perform either arthroscopic or open surgery to repair damage and relieve pressure on the tendons and bursae.

If the bursitis is caused by an infection, the doctor will prescribe antibiotics.

If a tendon is completely torn, surgery may be needed to repair the damage. After surgery on a quadriceps or patellar tendon, for example, the patient will wear a cast for 3-6 weeks and use crutches. For a partial tear, the doctor might apply a cast without performing surgery.

Rehabilitating a partial or complete tear of a tendon requires an exercise program to restore the ability to bend and straighten the knee and to strengthen the leg to prevent repeat injury. A rehabilitation program may last 6 months, although the patient can return to many activities before then.

¹ Brand names included in this booklet are provided as examples only, and their inclusion does not mean that these products are endorsed by the National Institutes of Health or any other Government agency. Also, if a particular brand name is not mentioned, this does not mean or imply that the product is unsatisfactory.

Can Bursitis and Tendinitis Be Prevented?

To help prevent inflammation or reduce the severity of its recurrence:

• Warm up or stretch before physical activity.
• Strengthen muscles around the joint.
• Take breaks from repetitive tasks often.
• Cushion the affected joint. Use foam for kneeling or elbow pads. Increase the gripping surface of tools with gloves or padding. Apply grip tape or an oversized grip to golf clubs.
• Use two hands to hold heavy tools; use a two-handed backhand in tennis.
• Don’t sit still for long periods.
• Practice good posture and position the body properly when going about daily activities.
• Begin new activities or exercise regimens slowly. Gradually increase physical demands following several well-tolerated exercise sessions.
• If a history of tendonitis is present, consider seeking guidance from your doctor or therapist before engaging in new exercises and activities.

Here is list of the methods for treating Patellar tendinitis: 

• Apply ice or a cold pack to the knee for 15-20 minutes, every 4 hours, for 2-3 days. Wrap the ice or cold pack in a towel. 

• Naproxen (Aleve, Naprosyn). 

• Heat therapy prior to activity followed by increased stretching. 

• Rest & Immobilization. 

• Non-steroidal anti-inflammatory drugs (NSAIDs) for pain and swelling. 

• Special stretching exercises to loosen up the muscle. 

• Another helpful tool is to apply a strap above the knee with pressure placed just above the site of irritation (above the lateral epicondyle). This band helps dissipate the tension on the tendon.