Bursitis vs tendonitis: Key differences and how to get relief

Pain around areas like your shoulder or knee can make a lot of daily activities feel more challenging — whether it’s a nagging ache when you lift something off the ground, or a twinge in your knee when you climb the stairs. Bursitis and tendonitis are two common conditions affecting the tissues around a joint. They’re often confused for one another because they feel similar and sound alike. (Both end in "itis," which is just medical-speak for inflammation.)

But they are not the same thing: 

• Bursitis is irritation of the small fluid-filled sacs (called bursae) that cushion your joints.

• Tendonitis affects the tendons: connective tissues that connect your muscles to your bones.

While bursitis and tendonitis are two different issues, treatment for pain relief for each can be similar. Simple at-home treatments like targeted strengthening exercises and modifying your activity levels can help alleviate symptoms of both.

Here, learn the key differences of bursitis vs. tendonitis, how to spot the symptoms of each, and how to manage both types of issues — especially with treatments recommended by Hinge Health physical therapists.

Tendonitis vs. bursitis: main differences 

A major reason bursitis and tendonitis are often confused is because they happen in the same neighborhoods of the body. “Tendons and bursae live closely together,” says Elle Carlson, PT, DPT, a physical therapist at Hinge Health. “Bursae often sit between tissues like tendons and bones near joints.”

Since these structures are close to one another, it can be hard to tell which one is irritated. Sometimes, bursitis can trigger tendonitis and vice versa. It’s even possible to develop or both simultaneously.

That said, there are some key differences between the two, including:

Different structures 

• Tendonitis is inflammation of a tendon, the strong, cord-like tissue that connects your muscle to your bone. “Tendons help your muscles move your bones — when a muscle contracts, the tendon pulls on the bone to create movement at a joint,” says Dr. Carlson.

• Bursitis is inflammation of a bursa. This is a small, fluid-filled sac that acts as a gliding surface or cushion to reduce friction between tissues, usually around a joint.

Pain with motion 

• Tendonitis usually hurts more when you move the joint yourself — like lifting your arm up overhead with shoulder tendonitis — because your muscles are working and pulling on the tendon.

• Bursitis can cause discomfort whether you’re working hard or taking it easy. “If you relax your arm and use your other hand to lift it, you likely won't feel tendonitis pain because the muscle isn’t doing the work,” says Dr. Carlson. “But with bursitis, you might still feel discomfort simply because whenever a joint is in motion, it can affect irritated bursae.”

Symptoms 

Both conditions can cause pain, swelling, and stiffness, especially around joints.

• Tendonitis usually produces sharper pain during movement.

• Bursitis tends to be more sensitive to direct pressure (like kneeling on your knee). It also often causes more visible swelling, warmth, and redness than tendonitis. Bursitis pain can feel like a dull ache even when you’re resting.

Where it hurts 

• Bursitis and tendonitis often occur in similar joints, including the knees, elbows, shoulders, and hips. 

• Tendonitis also frequently affects the Achilles tendon in the back of the lower leg near the ankle.

Causes of tendonitis and bursitis

The causes of these inflammatory conditions overlap. Both are often related to doing more activity than your body is ready for. Bursitis, however, can also occur due to pressure, a bump or fall, or infection. Common shared causes of tendonitis and bursitis include:

• Overdoing it. When you ramp up an activity too quickly or do too much, too often, you can irritate tendons and bursae. For example, too much running without any easy runs or rest days could lead to hip or knee tendonitis or bursitis. Similarly, logging hours of pickleball or tennis when you’re new to the game could lead to shoulder tendonitis or bursitis. You don’t have to stop these activities to avoid problems — you just need to let your body adapt by building up intensity and duration gradually.

• Repetitive motions. Repeating the same movement over and over can sometimes irritate the bursa or tendons,” says Dr. Carlson. This is why many types of tendonitis are named after activities that involve repetitive movements, such as tennis elbow, golfer’s elbow, and jumper’s knee. You can also develop irritation from tasks like overhead painting, chores, or typing. However, the activity itself isn’t the problem. Usually, it’s just a sign that your body needs a little more preparation — like strengthening or stretching moves — to handle that specific activity more comfortably.

• Muscle imbalances. Think of your muscles as a team that works together to move and support your joints. If some team members are stronger or more flexible than others, it changes the way they share the workload. Sometimes, this means one muscle group ends up doing a bit more than its fair share, which can irritate the nearby tendon or bursa. Similarly, if a muscle group isn’t strong enough to handle the demands of an activity, it can become sensitive or place extra stress on these structures. Strengthening the surrounding muscles helps distribute that work more evenly so everything moves smoothly.

• Age. It’s natural for your tissues to change as you get older. You may notice your tendons and bursae aren’t as resilient as they used to be. This doesn't mean you’re fragile; it just means your body might appreciate a little extra time to warm up or recover to feel its best.

Here are other causes that are often more specific to bursitis:

• Sustained pressure. This is a common trigger for bursitis, but usually not tendonitis. “Kneeling for a long time can irritate the bursa around the knee,” says Dr. Carlson. “Similarly, desk workers who lean on their elbows might notice swelling there.” It happens when a bursa is squeezed between your body weight and a hard surface for too long without a break.

• A bump or fall. A hard impact — like falling on your hip or hitting your ankle against a wall — can irritate a bursa and cause it to swell. 

• Infection. Occasionally, a bursa can become swollen if bacteria enter the area through a cut or scrape.

Treatments for bursitis and tendonitis

Most cases of bursitis and tendonitis respond well to simple, at-home treatments, with the best remedies being daily movement and targeted exercises to strengthen surrounding areas and improve blood flow to the area. Other strategies, such as heat and cold therapy and taping, can provide temporary pain relief and support, allowing you to remain active and do targeted exercises that help restore strength and mobility. These treatments include:

• Try physical therapy and targeted exercises. Targeted exercises can help improve strength and range of motion in the affected joint or tendon. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Stay active. It can be tempting to stop moving completely when you have pain, but movement is medicine. Targeted exercises are designed to help with recovery, but any type of movement — like walking, stretching, or even household chores — can improve blood flow and healing. “General activity helps reduce inflammation, decrease pain, and get blood flowing throughout the body, which can enhance healing,” says Dr. Carlson.

• Pace your activities. Modify activities that trigger pain. For example, if standing or walking for long periods aggravates symptoms, break up activity into shorter sessions. “You want to be respectful of your symptoms and find your movement sweet spot,” says Dr. Carlson. “A little bit of discomfort is actually good — it signals your body to adapt and heal — but you don’t want to overdo it.” The key is to nudge into that discomfort slightly without pushing into sharp pain.

• Start strength training. “Strength training builds resilience in your muscles and tendons, helping you handle activities like running or jumping with more ease,” says Dr. Carlson. “It also helps support your joints and improves your body’s overall ability to handle stress.”

• Try over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can help ease pain so you can do your targeted exercises and stay active when you have pain from tendonitis or bursitis. Other options are topical NSAIDs or pain relief creams. If you have a medical condition or take other medications, check in with your provider to make sure these OTC options are ‌safe to take.

• Apply ice or heat. “Ice can be helpful for both inflammatory conditions,” says Dr. Carlson. “It decreases swelling from bursitis and can calm tendonitis pain, especially after activity.” Heat is often better for reducing stiffness and relaxing muscles. Experiment with both to find which one gives you the most relief.

• Use kinesiology tape. Taping acts as a second skin, providing sensory feedback that helps your body feel supported and secure while you move. KT tape is an elastic, therapeutic tool that can support soft tissues and provide relief as you move. A physical therapist can show you proper taping techniques.

• Make ergonomic adjustments. Whether you’re at a desk or on the couch, how you position yourself matters. Small changes, like keeping your mouse close to avoid reaching or ensuring your monitor is at eye level, can reduce the repetitive strain or pressure that flares up tendonitis or bursitis. Remember, though, that the "best" posture is a moving one, so try to shift positions frequently throughout the day.

• Consider complementary treatments. Talk to your provider if you’re interested in trying alternative treatments for bursitis and tendonitis relief, such as massage, acupuncture, or chiropractic care.

• Ask about TENS therapy. TENS, or transcutaneous electrical nerve stimulation, uses gentle pulses to quiet your pain response and help reduce pain from inflammatory conditions like tendonitis and bursitis. One option is the wearable device Enso, available through Hinge Health. It’s small, wireless, and portable.

• Talk to your doctor about injections. Also known as corticosteroid or cortisone shots, these deliver a strong anti-inflammatory medication directly to the area around an irritated tendon or bursa. While they don't fix the underlying cause of the irritation, they can provide a “window of opportunity” by reducing pain enough to help you tolerate physical therapy exercises comfortably.

How physical therapy can help

Physical therapy is one of the most effective ways to manage bursitis or tendonitis. In addition to skilled intervention, it focuses on exercise therapy, including stretching and strengthening movements to help improve mobility and reduce pain sensitivity. The goal is to calm irritation and build resilience in the affected joint. Targeted exercises help strengthen the surrounding muscles and improve blood flow to the area to support healing.

A physical therapist (PT) can look at how you move and design a program just for you. They can also show you how to tweak everyday activities to make them more comfortable while you heal. “The goal is to calm down the symptoms first, and then rebuild your strength so you are more resilient,” says Dr. Carlson. “We help you build a solid foundation so your muscles and joints can handle more activity without getting irritated.”

You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

When to see a doctor

Bursitis and tendonitis often improve with conservative treatments, like exercise, training modifications, and physical therapy. However, if your pain is severe, worsening, or causing difficulty with daily activities, consult a healthcare provider. You should also get checked out if your injury is due to a fall or accident. It’s also important to get care if you’re experiencing:

• Significant swelling that doesn’t improve

• Inability to bear weight on affected joint

• Feeling generally unwell or fatigued

PT tip: Avoid the boom-and-bust cycle

“The boom-and-bust cycle is when you have an issue like tennis elbow, and it feels really good today, so you play tennis for two hours tomorrow,” says Dr. Carlson. “This often leads to a spike in pain that forces you to rest for several days.” Instead, try to ease back into activity gradually. Start by hitting the ball against a wall or playing for just 20 minutes at a time. This steady approach allows your body to adapt without the rollercoaster of pain, whether you’re managing with tendonitis or bursitis.

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

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3. Tendonitis (Bursitis). (n.d.). Rheumatology.org. https://rheumatology.org/patients/tendinitis-bursitis

4. Andres, B. M., & Murrell, G. A. C. (2008). Treatment of Tendinopathy: What Works, What Does Not, and What Is on the Horizon. Clinical Orthopaedics and Related Research, 466(7), 1539–1554. doi:10.1007/s11999-008-0260-1

5. R Purdam, C. (2026). Tendinopathy: Overview of management. Uptodate.com. https://www.uptodate.com/contents/tendinopathy-overview-of-management

6. Kane, S. F., Olewinski, L. H., & Tamminga, K. S. (2019). Management of Chronic Tendon Injuries. American Family Physician, 100(3), 147–157. https://www.aafp.org/pubs/afp/issues/2019/0801/p147.html