The usual treatment bursitis and tendonitis is so similar that even doctors often use the terms interchangeably.
Inflammation – good or bad?
Bursitis and tendonitis are both associated with inflammation of a soft tissue – be it the bursae or tendons.
Without inflammation, wounds and infections would never heal as it is the body protecting your health by trying to remove the harmful invaders in your system in order to initiate the healing process.
So in the short-term, inflammation is not a bad thing. But when your tissues are subject to irritation and inflammation for a longer period of time, they become more vulnerable to damage and negative effect of free radicals.
So the essential aspect of treatment is to remove the cause of the inflammation, starting with some simple steps (sometimes known under acronym PRICEM – Protection, Rest, Ice, Compression, Elevation, Medication) and adding in more advanced practices (as needed, depending on the specifics of your condition) if PRICEM does not do the job.
Stage 1 Treatments (PRICEM)
Protection
Protect the affected area by padding the affected area in order to protect it from any further damage.
Rest
Take it easy and do not try to push through the pain. Limit the usage of the joint closest to the inflamed area as it would only make your pain longer and stronger.
Rest is absolutely crucial to healing of bursitis and tendonitis. Yet, it does not mean you are bed ridden. In fact, inactivity can cause stiffness in your joints. After a few days of complete rest, gently move your joint through its full range of motion to maintain its flexibility. And of course, you can do all activities that do not stress the affected joint. Water exercise works wonders for me, for example.
Ice
Ice therap can help reduce the swelling, inflammation (cooling down) and pain (numbing agent) and increase healing (opening of blood vessels to increate blood flow).
Use a pack or towel so the ice is not directly on the skin and apply the ice pack on the affected area for about 20 minutes every 5 hours.
While ice is brilliant for acute bursitis and tendonitis, in will not be of much help with the chronic conditions, in which case heat can assist in increasing blood flow to the affected areas.
Compression
Elastic compression bandages and wraps or immobilizing brace around the joint until the inflammation subsides to limit negative effects on the joint.
Elevation
Lift the affected area above the level of your heart to limit the blood flow and reduce swelling and inflammation.
Medication
Over-the-counter nonsteroidal anti-inflammatory medications (NSAIDs) /e.g. naproxen or ibuprofen/, pain killers and/or topical anti-inflammatory or pain releaving creams, may relieve your discomfort.
Stage 2 Treatments
Antibiotics
If the inflammation in your bursa/tendon is caused by an infection, your doctor will probably prescribe an antibiotic.
Stronger NSAIDs
Stronger NSAIDs /e.g. diclofenac or ketoprofen/ can be prescribed by your doctor.
Using NSAIDs over a long period of time can increase the risk of heart disease and internal bleeding.
Cortisone Steroid Injections
For more severe or persistent symptoms, your doctor may inject steroids into the affected area. Cortisone is a powerful steroid, blocking body chemicals causing inflammation. The injection usually brings rapid pain relief and one injection is all you need.
However, this comes at a price of numerous potential side effects, especially if cortisone is used in a long-term: increase of blood pressure, risk of getting an infection, cartilage damage, tendons weakened, bones depleted of minerals to name a few. Hence, this treatment is (and should be) used sparingly.
Surgery
Depending on the severity of your tendon injury, surgical repair may be needed.
Sometimes an inflamed bursa must be drained using a needle, but only rarely is the actual surgical removal of the affected bursa necessary.
How long?
Bursitis and tendonitis are likely to improve in a few days or weeks if you rest and treat the affected area. However, unless you strengthen the muscles around the problematic joints or change the way you do the activities that caused the condition in the first place, it might not be long until the pain comes back to hunt you. Keep doing things the same way and you can end up with chronic bursitis and/or tendonitis for life.