Tendinitis, Bursitis & Soft-Tissue Pain: A Head-to-Toe Guide

If your diagnosis ends in "-itis," you have plenty of company. In medicine, "-itis" means inflammation — so tendinitis is inflammation of a tendon, bursitis of a bursa. These soft-tissue rheumatic syndromes affect the structures around joints — tendons, ligaments, bursae, and muscles — rather than the joint itself. That distinction matters: because these structures sit so close to joints, their pain is easily mistaken for arthritis, but arthritis is inflammation inside the joint, and the treatment differs.

The reassuring news: most of these conditions come on suddenly, last days to weeks, and resolve — often without any lasting damage when treated properly. They can recur in the same spot or appear elsewhere.

The three main types

Tendinitis — inflammation or irritation of a tendon, the thick cord anchoring muscle to bone. Bursitis — inflammation of a bursa, the small fluid-filled sac that lets tendons, muscles, and skin glide smoothly over bone. Myofascial pain — muscle pain, commonly in the neck, shoulder, and back, marked by tender "trigger points" that hurt when pressed and can refer pain elsewhere.

What follows is a head-to-toe tour of the common ones. This is a map, not a diagnosis — the value of naming these precisely is that each responds to targeted treatment, and most respond very well to the right local injection, activity change, and rehabilitation.

Shoulder

The shoulder is the champion producer of soft-tissue pain. Rotator cuff tendinitis (impingement) occurs when the cuff tendons get pinched during shoulder motion — pain with reaching and overhead work. A rotator cuff tear can follow a severe injury or chronic impingement. Subacromial bursitis sits just above the cuff and mimics cuff tendinitis. Bicipital tendinitis inflames the biceps tendon at the front of the shoulder. And myofascial pain in the broad muscle over the shoulder or between shoulder blade and spine can be severe on its own.

Elbow

Tennis elbow (lateral epicondylitis) — pain on the outer elbow from overusing the wrist-extending muscles (not just from tennis: tools, gardening, and hauling suitcases all qualify). Golfer's elbow (medial epicondylitis) — the inner-elbow counterpart, less common. Olecranon bursitis — swelling at the very tip of the elbow, from injury, gout, arthritis, or simply leaning on it. Ulnar nerve entrapment — pressure on the "funny bone" nerve, affecting the ring and little fingers. (Our dedicated elbow, wrist, and hand page covers these in depth.)

Wrist and hand

De Quervain's tenosynovitis — irritation of the thumb-side tendons from pinching-plus-wrist-motion; classically appears during and after pregnancy. Carpal tunnel syndrome — the median nerve compressed at the wrist, causing numbness and tingling in the thumb and first fingers; linked to repetitive use, pregnancy, thyroid disease, diabetes, and arthritis. Ganglion — a jelly-filled sac near a joint or tendon, often painless and often needing no treatment. Trigger finger (stenosing tenosynovitis) — a thickened tendon sheath that catches the finger in a bent position. Dupuytren's contracture — thickening of the tissue under the palm that gradually draws fingers into a bend.

Chest wall

Chest-wall pain is frightening because it mimics the heart — but a common cause is harmless inflammation. Costochondritis — tenderness where ribs meet the breastbone, often worse on the left. Tietze's syndrome — a rarer cousin with visible swelling. (These are diagnoses of exclusion: never assume chest pain is muscular. Cardiac causes must be ruled out first — when in doubt, call 911.)

Hip

Trochanteric bursitis — pain over the bony prominence on the side of the hip, tender to lie on; more common in women and middle-to-older age, and often provoked by an abnormal gait from arthritis elsewhere or a leg-length difference. Ischial bursitis ("weaver's bottom") — over the sit-bone, from injury or long sitting on hard surfaces.

Lower back

Myofascial back pain — dull, aching pain in the muscles and fascia of the low back and buttocks from minor strain, without a herniated disc or fracture, sometimes alongside degenerative arthritis. (Our low back pain and sciatica page covers the full picture.)

Knee

Prepatellar bursitis ("housemaid's knee") — in front of the kneecap, from kneeling, injury, or gout. Infrapatellar bursitis ("clergyman's knee") — just below the kneecap. Anserine bursitis — on the inner leg below the knee, common with jogging, knock-knees, knee arthritis, or excess weight. Iliotibial band syndrome — irritation of the fibrous band on the outer thigh and knee, frequent in runners.

Ankle and foot

Achilles tendinitis — of the tendon connecting calf to heel, usually from sports or ill-fitting shoes; a sudden calf contraction can rupture it. Retrocalcaneal bursitis ("pump bump") — at the back of the heel, often linked to shoe fit or inflammatory arthritis. Plantar fasciitis — sharp heel pain (worst with the first morning steps) from stress on the sole's fibrous band; aggravated by running, prolonged standing, flat feet, and excess weight. Tarsal tunnel syndrome — the foot's version of carpal tunnel, from compression of the tibial nerve at the inner ankle.

The common thread

Nearly all of these share a treatment logic: identify the exact structure, stop the aggravating activity, calm the inflammation (ice, anti-inflammatories, and often a precisely placed corticosteroid injection), then rehabilitate with stretching and strengthening so it doesn't return. The precision is the point — "shoulder pain" has half a dozen causes on this page alone, and the right injection in the right spot is the difference between weeks of relief and none.

If an "-itis" has outlasted rest and over-the-counter measures, a targeted evaluation is worth it. Call Newport Pain Management at (949) 759-8400.

This article is for general education and is not a substitute for individual medical advice. Chest pain should always be evaluated urgently to rule out cardiac causes.