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Bursitis vs Tendonitis: Understanding the Difference

Understanding the key differences can help patients recognise the cause of joint pain and seek appropriate treatment. 

Home / Articles / Bursitis vs Tendonitis: Understanding the Difference

March 16, 2026 by Jon Handley-Collins

Musculoskeletal pain around joints is often caused by inflammation of the soft tissues that support movement. Two of the most common causes are bursitis and tendonitis. Although bursitis and tendonitis can cause similar symptoms, including pain, swelling, and reduced movement, they affect different structures within the body and may require different approaches to treatment.

Understanding bursitis vs tendonitis can help patients recognise the cause of joint pain and seek appropriate treatment. 

What Is Bursitis?

Bursae are small, fluid-filled sacs located throughout the body. Their role is toreduce friction between bones, muscles, tendons, and ligaments, allowing joints to move smoothly during activity.

Bursitis occurs when one of these sacs becomes inflamed. This inflammation can develop due to:

  • Repetitive movements
  • Prolonged pressure on a joint
  • Injury or trauma
  • Underlying joint conditions such as arthritis

Common areas affected by bursitis include:

  • Shoulder (subacromial bursitis)
  • Hip (greater trochanteric bursitis)
  • Elbow (olecranon bursitis)
  • Knee (prepatellar bursitis)

Symptoms of Bursitis

Typical bursitis symptoms include:

  • Localised pain around the joint
  • Swelling or tenderness
  • Pain when moving the joint
  • Warmth or redness in the affected area
  • Reduced range of motion

Pain from bursitis is often worse when the joint is compressed or when pressure is applied, such as lying on the affected side or leaning on the elbow.

What Is Tendonitis?

Tendons are strong fibrous tissues that connect muscles to bones. They allow muscles to move joints and play a key role in stability and movement.

Tendonitisoccurs when a tendon becomes irritated or inflamed, often due to repetitive strain, overuse, or sudden increases in activity.

Common areas affected include:

  • Shoulder (rotator cuff tendonitis)
  • Elbow (tennis or golfer’s elbow)
  • Knee (patellar tendonitis)
  • Achilles tendon at the ankle

Symptoms of Tendonitis

Typical tendonitis symptoms include:

  • Pain that worsens with movement or activity
  • Tenderness along the tendon
  • Mild swelling
  • Stiffness, particularly after rest
  • Weakness in the affected muscle

Unlike bursitis, tendonitis pain is usually most noticeable when the muscle attached to the tendon is actively used, such as lifting, gripping, or walking.

Key Differences Between Bursitis and Tendonitis

Although these conditions may feel similar, the main difference between bursitis vs tendonitis lies in which structure is inflamed.

FeatureBursitisTendonitis
Affected tissueBursa (fluid-filled sac)Tendon (connects muscle to bone)
Pain triggerPressure or compressionMovement or muscle use
SwellingOften visible or palpableUsually mild
CauseFriction or joint pressureRepetitive muscle use

Because bursae and tendons sit close together around many joints, particularly in the shoulder and hip, it is also possible for bursitis and tendonitis to occur at the same time.

How Do You Know If You Have Bursitis or Tendonitis?

Because the structures involved sit so close together, it can sometimes be difficult to tell whether pain is caused by bursitis or tendonitis.

Pain that worsens with direct pressure on the joint, such as lying on the hip or leaning on the elbow, may suggest bursitis. In contrast, pain that increases when moving the joint or contracting a musclemay indicate tendonitis.

However, symptoms can overlap, so an accurate diagnosis usually requires a clinical examination.  Ultrasound imaging is particularly helpful for identifyinginflamed bursae, tendon thickening, or small tears, helping guide the most appropriate treatment.

Treatment Options for Bursitis and Tendonitis

Most cases of bursitis and tendonitis respond well toconservative care, especially when diagnosed early. Conservative treatment focuses on reducing inflammation, supporting tissue healing, and addressing the mechanical stresses that contributed to the condition.

Initial management often includes activity modification or relative rest, allowing irritated tissues time to settle. Ice, anti-inflammatory strategies, and gradual return to movement may also help control symptoms.

Rehabilitation exercises are frequently introduced to restore strength, flexibility, and joint stability, which helps improve movement patterns and reduce the risk of the problem returning.

Chiropractic and MSK management

Chiropractic care can play an important role in managing both bursitis and tendonitis. Treatment focuses on restoring normal joint mechanics and reducing excessive stress on surrounding tissues.

Management may include:

  • Joint mobilisation or manipulation
  • Soft tissue therapy
  • Postural correction
  • Targeted strengthening and rehabilitation exercises

Addressing underlying biomechanical issues can be essential for preventing recurring inflammation or chronic pain.

Injection therapies

For persistent inflammation that does not respond to conservative care alone, musculoskeletal injection therapies can be considered.

At Private Injection Clinics, treatment options may include:

  • Corticosteroid injections to reduce inflammation in bursitis
  • Hyaluronic acid injections to support joint lubrication in certain conditions
  • Regenerative therapies, such as Prolozone Therapy, to support tissue healing

Many procedures are performed under ultrasound guidance, allowing precise placement of the injection and improving treatment accuracy.

When Should You Seek Treatment?

You should consider professional assessment if joint pain:

  • Persists for more than a few weeks
  • Interferes with daily activities or sleep
  • Does not improve with rest or simple treatments
  • Is associated with swelling or restricted movement

If you are experiencing persistent joint pain, a specialist assessment can help determine whether bursitis or tendonitis is responsible and identify the most appropriate treatment options.

Summary

Both bursitis and tendonitis are common causes of joint pain, but they affect different structures within the musculoskeletal system. Bursitis involves inflammation of the bursa, while tendonitis affects the tendon connecting muscle to bone.

The Private Injection Clinics provide comprehensive assessment, rehabilitation guidance and advanced ultrasound-guided injection treatments, whilst The Optimum Spine Centre offers specialist chiropractic care – both ensuring care is tailored to your specific diagnosis and goals. 

The Optimum Spine Centre is based on the coast in Leigh on Sea, and the Private Injection Clinics are in Leigh on Sea, as well as in Colchester, Essex  – perfect for patients in Essex, Kent, London, and surrounding areas.

Resources

  1. https://www.privateinjectionclinics.co.uk/
  2. https://www.optimumspinecentre.co.uk
  3. https://www.nhs.uk/conditions/tendonitis
  4. https://www.nhs.uk/conditions/bursitis
  5. https://www.news-medical.net/health/Tendonitis-versus-Bursitis.aspx

Frequently Asked Questions

1. Is bursitis the same as tendonitis?

No. Bursitis inflames the bursa, a fluid-filled sac around the joint, while tendonitis affects a tendon connecting muscle to bone. At Private Injection Clinics, we use chiropractic assessment and ultrasound to diagnose and guide treatment.

2. How can you tell if pain is bursitis or tendonitis?

Bursitis pain worsens with pressure on the joint, while tendonitis pain appears during movement or muscle use. Our clinicians use ultrasound and chiropractic evaluation to pinpoint the cause.

3. Can bursitis and tendonitis happen at the same time?

Yes. Both can occur together, often in the shoulder, hip, or knee. Early assessment allows for tailored care, including rehabilitation, chiropractic adjustments, and MSK injections.

4. What causes bursitis and tendonitis?

Both are often caused by repetitive stress, overuse, or joint strain, sometimes combined with poor posture or underlying joint conditions. Corrective exercises and injection therapies can help at Private Injection Clinics.

5. What is the best treatment for bursitis or tendonitis?

Conservative care usually works first: rest, rehab exercises, and chiropractic adjustments. If symptoms persist, ultrasound-guided MSK injections (like corticosteroids, hyaluronic acid, or prolotherapy) may be recommended.

6. Which is more serious: bursitis or tendonitis?

Neither is inherently worse, but untreated inflammation can become chronic, limiting mobility. Early treatment with chiropractic care and MSK injections helps recovery and prevents recurrence.

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St Albans Injection Clinic is a trading name of Optimum Spine Centre Ltd. Registered in England & Wales No: 07529588 Registered Office: 1212 London Rd, Leigh on Sea, Essex, SS9 2UA