Tendinopa­thy or Bur­si­tis?

How to spot—and treat—these trou­ble­some con­di­tions

Reader's Digest (Canada) - - Contents - BY SA­MAN­THA RIDEOUT

SA­MAN­THA RIDEOUT

IF THE HU­MAN BODY were a mar­i­onette, the ten­dons would be its strings. These cord-like struc­tures con­nect your mus­cles to your bones, let­ting you move your body when your mus­cles con­tract. In pop­u­lar par­lance, painful ten­dons are called ten­dini­tis (which is de­fined as the in­flam­ma­tion of a ten­don). How­ever, the most com­mon ten­don prob­lem isn’t just caused by in­flam­ma­tion. It’s an overuse in­jury that in­volves tis­sue de­gen­er­a­tion and swelling re­lated to wa­ter re­ten­tion, so the pre­ferred clin­i­cal term for it is “tendinopa­thy.”

Near the ten­dons are your bur­sae, cush­iony, fluid-filled sacs that al­low for smooth glid­ing in the spots where your ten­dons and other mov­ing parts would oth­er­wise rub against your bones. When a bursa gets in­flamed, a con­di­tion known as “bur­si­tis,” it can feel sim­i­lar to tendinopa­thy, with lo­cal­ized pain and swelling. Ten­don troubles usu­ally cause pain only dur­ing move­ment, where bur­si­tis might hurt even at rest.

Any­one can suffer from these con­di­tions, but the risk in­creases with age. The main cause for both bur­si­tis and tendinopa­thy is repet­i­tive stress. They could be trig­gered by poor pos­tural habits, shov­el­ling for hours or clench­ing your hands around the steer­ing wheel while driv­ing. Peo­ple who re­peat the same move­ments con­stantly—mu­si­cians, gar­den­ers, golfers—are more at risk. If a job or hobby is con­tribut­ing to the prob­lem, an oc­cu­pa­tional ther­a­pist could sug­gest ad­just­ments to your tools, workspace or body po­si­tion­ing.

Com­monly af­fected ar­eas in­clude the shoul­ders, wrists, an­kles and knees. Un­like arthri­tis, tendinopa­thy and bur­si­tis can usu­ally im­prove.

To speed up the heal­ing process, you should “re­duce ac­tiv­ity in the af­fected area to a level that does not overly ir­ri­tate the ten­don,” says Dr. Seth O’Neill, a phys­io­ther­a­pist af­fil­i­ated with the Char­tered So­ci­ety of Phys­io­ther­apy in the U.K. “How­ever, to­tal rest isn’t ideal be­cause ten­dons, like mus­cles, waste when you rest them too much.”

A good rule of thumb: if a par­tic­u­lar move­ment pro­vokes pro­longed pain and swelling, cut back on it un­til the flare-up is tol­er­a­ble. You can also ice the area reg­u­larly for the first few days and take an­ti­in­flam­ma­to­ries such as As­pirin or ibupro­fen. If your pain doesn’t sub­side af­ter a month or so, see a doc­tor. Longer-last­ing tendinopa­thy or bur­si­tis may call for phys­i­cal ther­apy, phys­i­cal sup­ports (a cane, brace or splint) or, in se­vere cases, surgery.

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