• Bone and Joint Health
• Health Topics
• Joint Pain/Pain Management
• Osteoarthritis

Making Sense Of Joint Pain: Arthritis, Tendinitis, Bursitis

If you feel pain or swelling in your joints, there’s a chance you may have osteoarthritis, tendinitis, or bursitis. Knowing which you have helps you and your doctor create the best treatment plan for your symptoms.

Osteoarthritis

The most common form of joint pain, osteoarthritis, is a condition that occurs with age, injury, overuse, or disease. The protective cartilage that provides cushioning between two bones breaks down. Bone rubs on bone, causing pain and swelling. Joints may become stiff and painful to move.

Osteoarthritis most commonly affects your knees, hips, hands, and spine. Pain and movement limitations may come and go and can range from mild to severely disabling.

Diagnosis And Treatment

To diagnose osteoarthritis (and differentiate it from other types of arthritis), your doctor starts with your medical history and a physical exam. X-rays can confirm arthritic changes and, if needed, ultrasound or magnetic resonance imaging (MRI) can produce even more detailed images. Blood tests can reveal inflammation, and your doctor may want to use a needle to get a small sample of fluid from the painful joint for testing.

Dr. Michael Raab discusses types of tests used to diagnose osteoarthritis.

Click play to watch the video or read video transcript.

Pain relievers such as acetaminophen and anti-inflammatory medications are the first line of treatment to relieve pain and inflammation. In severe cases, steroid injections and more potent pain relievers may be helpful. If joint damage significantly reduces your ability to move, your doctor may recommend arthroscopy or a joint replacement.

Exercise and movement also can help with arthritis pain and swelling. Walking, yoga, tai chi, and other activities that don’t put stress on your joints are beneficial. In addition, physical therapy, massage, acupuncture, and guided imagery can help lessen pain and swelling. Taking certain vitamins, minerals, and herbs may improve joint health.

Tendinitis

A tendon is a thick cord of flexible, fibrous tissue that connects muscle to bone. Inflammation of the tendon, caused by injury, overuse, aging, or disease, is called tendinitis.

The most common form of joint pain, osteoarthritis, is a condition that occurs with age, injury, overuse, or disease.

Tendinitis most frequently occurs in these spots:

• Elbow. Tennis elbow refers to pain in the tendon that runs along the back side of the elbow and forearm and allows the wrist to bend back. Pain also may occur on the tendon that runs from elbow to hand on the palm side. This tendon permits the wrist to flex toward the palm.
• Shoulder. Rotator cuff tendinitis occurs in the shoulder capsule and can make movement painful.
• Knee. Patellar tendinitis is an injury to the tendon connecting the kneecap (patella) to the shinbone.
• Heel and lower leg. Achilles tendinitis is an overuse injury of the Achilles tendon, the band of tissue that connects calf muscles at the back of the lower leg to the heel bone.

Diagnosis And Treatment

In addition to a history and physical exam, your doctor may take an X-ray or use a needle to remove a small amount of tendon fluid to test for infection or other disease.

Tendinitis generally gets better with conservative treatment. Rest and ice may reduce swelling and pain. Anti-inflammatory medications, steroid injections, or a splint to reduce movement all are options to further reduce pain and swelling. Antibiotics help with infection.

Bursitis

Bursitis is the inflammation of a bursa, a small, fluid-filled sac that provides a cushion to ease movement of muscles and tendons over bone or ligaments.

You have several bursae throughout your body. Common sites for bursitis include the bursae in the shoulder, knee, hip, and elbow. They may also flare up where the Achilles tendon attaches to the heel and between the skin of the heel and Achilles tendon.

The inflammation usually results from injury, overuse, arthritis, surgery, and infection.

Diagnosis And Treatment

Imaging tests such as X-rays, ultrasound, and MRI provide doctors with visual confirmation of inflamed bursae. Sometimes, blood tests or a sample of fluid in the bursa obtained with a needle may help identify infection or provide other useful information.

Bursitis is usually a temporary condition that goes away with rest. Treatments include icing and elevating the painful area. Your doctor may prescribe anti-inflammatory or pain medications, a steroid shot to reduce painful swelling, or a splint or brace to reduce movement while the bursa heals. Antibiotics help if the bursa is infected.

Sources: Michael Raab, MD, Premier Orthopedics; National Institutes of Health; Arthritis Foundation

Michael G. Raab, MD

Premier Orthopedics

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