Last Updated on November 4, 2025 by mcelik

Nearly 20% of adults deal with shoulder pain at some point. Many cases are due to bursitis or tendonitis. These two issues share similar symptoms, making it hard to tell them apart. Shoulder Bursitis vs. Tendonitis: The Simple way to tell the Crucial difference for Accurate diagnosis.

It’s important to know the difference between shoulder bursitis vs. tendonitis for the right treatment. Bursitis is when the fluid-filled bursae around joints get inflamed. This can cause pain because it cushions joints and reduces friction. Tendonitis, on the other hand, is when the tendons, which connect muscles to bones, get inflamed.

Getting a correct diagnosis is key to easing shoulder inflammation and improving movement. In this article, we’ll look at the causes, symptoms, and treatments for both conditions. This will help you figure out what’s causing your shoulder pain.

Key Takeaways

• Understanding the difference between bursitis and tendonitis is key for the right treatment.
• Both conditions can lead to a lot of shoulder pain and shoulder inflammation.
• Getting a correct diagnosis means knowing the specific symptoms and causes of each condition.
• Treatment options depend on whether you have bursitis or tendonitis.
• Early diagnosis can lead to better management of shoulder injuries.

Understanding Shoulder Pain: The Basics

It’s important to know the basics of shoulder pain to find the cause and get the right treatment. Shoulder pain can make simple tasks hard.

Common Causes of Shoulder Pain

Shoulder pain can come from injuries, long-term conditions, or doing the same thing over and over. Some common reasons include:

• Rotator cuff injuries
• Dislocation or separation of the shoulder
• Arthritis
• Bursitis and tendonitis
• Poor posture

These issues can cause inflammation, pain, and less movement in the shoulder.

Anatomy of the Shoulder Joint

The shoulder joint, or glenohumeral joint, is a complex part that lets us move our arms in many ways. It has:

• The humerus (upper arm bone)
• The scapula (shoulder blade)
• The clavicle (collarbone)
• Ligaments and tendons that help it move and stay stable

Knowing how the shoulder works is key to fixing pain.

Why Proper Diagnosis Matters

Getting a correct diagnosis is vital for a good treatment plan. Doctors will check your shoulder, look at your medical history, and might use tests to find the pain’s cause.

Diagnostic Method	Description
Physical Examination	Checking how well your shoulder moves, its strength, and what hurts
Imaging Tests	X-rays, MRI, or ultrasound to see the shoulder and nearby tissues
Medical History Review	Looking at past injuries, conditions, and symptoms

Right diagnosis means treatment can target the real problem. This leads to better pain relief and recovery.

What is Shoulder Bursitis?

Shoulder bursitis is when the bursae, fluid-filled sacs, get inflamed. These sacs cushion the joints. They help bones, tendons, and ligaments move smoothly by reducing friction.

Definition and Function of Bursae

Bursae are small, fluid-filled sacs found in the body, including the shoulder. They reduce friction and cushion between bones, tendons, and ligaments. In the shoulder, they help with smooth movement and absorb shock during activities.

Types of Shoulder Bursitis

There are several types of shoulder bursitis, including:

• Subacromial bursitis: Inflammation of the bursa beneath the acromion.
• Subdeltoid bursitis: Inflammation of the bursa between the deltoid muscle and the rotator cuff.

Type of Bursitis	Location	Common Causes
Subacromial	Beneath the acromion	Repetitive motion, direct blow
Subdeltoid	Between deltoid muscle and rotator cuff	Overuse, inflammation

How Bursitis Develops

Bursitis happens when the bursae get inflamed. This can be due to repetitive motion, direct trauma, or infection. Activities like throwing or lifting can irritate the bursae. Knowing the causes helps in preventing and treating it.

What is Shoulder Tendonitis?

Shoulder tendonitis happens when tendons in the shoulder get inflamed. Tendons are strong, flexible cords that connect muscles to bones. They help muscles move bones by transmitting force.

Understanding Tendons and Their Function

Tendons are key in the musculoskeletal system. They help joints move smoothly and perform actions. In the shoulder, they connect muscles to the upper arm bone, enabling lifting and rotating.

The tendons in the shoulder can wear out and get injured. This can cause inflammation and tendonitis.

Common Types of Shoulder Tendonitis

There are several types of tendonitis in the shoulder, including:

• Rotator cuff tendonitis: Inflammation of the tendons in the rotator cuff.
• Bicipital tendonitis: Inflammation of the tendon that surrounds the biceps muscle.
• Supraspinatus tendonitis: Inflammation of the supraspinatus tendon, one of the rotator cuff tendons.

Each type has its causes and symptoms. They all involve inflammation and irritation of the tendons.

The Inflammation Process in Tendons

Tendonitis happens when tendons get irritated or damaged. This can be from overuse, repetitive strain, or injury. The inflammatory response is the body’s natural reaction to injury, aiming to repair the damaged tissue. But, this can sometimes cause chronic inflammation, pain, and reduced function.

Knowing the causes and mechanisms of tendonitis is key for effective treatment. Treatment for shoulder tendonitis often includes rest, physical therapy, and anti-inflammatory measures to reduce pain and promote healing.

Shoulder Bursitis vs. Tendonitis: Key Differences

Shoulder bursitis and tendonitis both cause pain, but they have different causes and effects. Knowing these differences is important for the right diagnosis and treatment.

Anatomical Differences

The main difference is where they affect the body. Bursitis is about inflammation in bursae, which are fluid-filled sacs that cushion bones and muscles. Tendonitis, on the other hand, affects the tendons, which connect muscles to bones.

Functional Impact Comparison

Bursitis and tendonitis have different effects on how we move. Bursitis causes pain and stiffness, mainly when moving the joint. Tendonitis leads to pain and weakness, often during specific activities.

For example, tendonitis in the rotator cuff can make lifting the arm hard and painful.

Recovery Timeline Differences

The time it takes to recover from bursitis and tendonitis varies. Mild bursitis might get better in a few weeks with rest and anti-inflammatory treatments. Tendonitis, being more chronic, might need longer, including physical therapy to strengthen the tendons.

Coexisting Conditions

Bursitis and tendonitis often happen together, triggered by similar causes like repetitive motion or trauma. When they do, diagnosing and treating both conditions at once is necessary.

In summary, while bursitis and tendonitis share some traits, their differences in anatomy, function, recovery time, and tendency to occur together are significant. Accurate diagnosis is essential for effective management.

Pain Patterns and Location: Where Does It Hurt?

The spot and type of shoulder pain can tell you a lot. It can help figure out if you have bursitis or tendonitis. Knowing these patterns is key to finding out what’s causing your pain.

Typical Pain Locations in Bursitis

Bursitis pain usually happens around the bursa. For shoulder bursitis, this means pain on the outside or top. The pain can be sharp and intense, getting worse when you move your arm or shoulder.

Characteristic Pain Areas in Tendonitis

Tendonitis pain is different. It’s usually in the front or side of the shoulder, and can go down the arm. The pain is often a dull ache or sharp when you use your shoulder.

Pain Radiation Patterns

Both bursitis and tendonitis can spread pain to other spots. Bursitis pain might go down the arm or to the upper back. Tendonitis pain can also go down the arm, sometimes to the elbow or wrist.

Tenderness to Touch Differences

Bursitis and tendonitis have different touch tenderness. Bursitis causes swelling and tenderness over the bursa. Tendonitis makes areas along the tendon tender.

By looking at pain location, pain patterns, and tenderness to touch, you can guess if your pain is from bursitis or tendonitis.

Symptoms Beyond Pain: What Else You Might Notice

Shoulder bursitis and tendonitis can cause more than just pain. They can affect how well your shoulder works. Knowing these symptoms helps doctors diagnose and treat you better.

Swelling and Visual Changes

Swelling is a common sign of shoulder bursitis. It can also be red and warm to the touch because of inflammation. Tendonitis might not show swelling, but it can make the tendon tender.

Range of Motion Limitations

Both bursitis and tendonitis can make it harder to move your shoulder. Bursitis can make your shoulder stiff suddenly because of inflammation. Tendonitis might make your shoulder stiff over time as the tendon gets irritated.

Weakness and Functional Impairment

Feeling weak in your shoulder or arm is another symptom. Tendonitis can make you very weak because it hurts the tendon’s ability to move forces. This weakness can make everyday tasks like lifting or reaching hard.

Joint Stiffness Patterns

Stiffness in the joint is common in both conditions. But, the stiffness pattern is different. Bursitis makes your shoulder stiffer after resting. Tendonitis makes it stiffer after you’ve been active.

Symptom	Bursitis	Tendonitis
Swelling	Often present, with redness and warmth	May not be significant
Range of Motion	Sudden onset of stiffness	Gradual decrease in mobility
Weakness	Can be present, with severe inflammation	Significant weakness due to tendon irritation
Joint Stiffness	More pronounced after rest	Develops after activity

Pain Triggers: When Does It Hurt Most?

Shoulder pain timing and triggers help diagnose bursitis versus tendonitis. Knowing these clues helps people understand their condition better. It also guides them to the right treatment.

Activity-Related Pain Differences

Bursitis and tendonitis pain differ in activity. Bursitis pain gets worse with certain movements that bother the inflamed bursa. For example, lifting the arm overhead can hurt more if you have bursitis.

Tendonitis pain is linked to activities that stress the tendon. Rotator cuff tendonitis might hurt when you rotate your arm or throw. This is because the tendon is strained.

Resting Pain Characteristics

Resting pain varies between bursitis and tendonitis. Bursitis often causes a dull ache or stiffness, even when you’re not moving. This is because the bursa is inflamed.

Tendonitis might also hurt at rest, but pain is more noticeable during movement. This is because the tendon is stretched or contracted.

Night Pain and Sleep Disruption

Night pain is common in both conditions. But, it can be different. Bursitis might hurt when lying on the shoulder or in certain arm positions at night.

Tendonitis, like rotator cuff, can cause pain when rolling onto the shoulder. This is because the tendon is under tension, even when you’re not moving. This pain can really mess up your sleep.

Pain Duration and Progression

Pain duration and progression are key. Bursitis pain can start quickly, often after repetitive motion or shoulder trauma. Tendonitis pain can also be sudden, but it can also be long-term due to tendon strain.

Understanding when pain starts and how it changes can help figure out the cause.

Risk Factors and Common Causes

It’s important to know what causes shoulder bursitis and tendonitis. This knowledge helps in preventing and treating these conditions. Many factors can increase the risk of getting these problems.

Age-Related Factors

Age is a big factor in getting shoulder bursitis and tendonitis. As we get older, our tendons and bursae wear out. This makes them more likely to get inflamed and irritated. People over 40 are at a higher risk because their tendons lose flexibility and build up damage over time.

Occupational and Activity Risks

Some jobs and activities raise the risk of shoulder bursitis and tendonitis. Jobs that involve repetitive overhead movements, like construction or painting, can strain the shoulder. Sports like tennis and swimming also increase the risk.

Previous Injuries and Their Impact

Having had a shoulder injury before can make you more likely to get bursitis or tendonitis. Shoulder trauma can cause long-term inflammation and damage to tendons and bursae. It’s key to heal any shoulder injury well to avoid long-term problems.

Anatomical Predispositions

How your body is built can also affect your risk. For example, differences in shoulder shape or abnormalities in the rotator cuff can make tendons and bursae work differently. This can increase your risk of getting these conditions.

Risk Factor	Description	Impact
Age	Wear and tear over time	Increased risk over 40
Occupation/Activity	Repetitive overhead movements	Strain on tendons and bursae
Previous Injuries	Trauma to the shoulder	Chronic inflammation
Anatomical Variations	Abnormalities in shoulder structure	Increased risk due to functional impact

How Doctors Diagnose Shoulder Conditions

Doctors use a mix of methods to figure out shoulder problems like bursitis or tendonitis. They look at how the body works and use special tools to help.

Physical Examination Techniques

A physical examination is the first step. Doctors check how well the shoulder moves, its strength, and where it hurts. They use tests like the Neer test to find out what’s wrong.

They also look for tenderness, swelling, or any odd shapes. This helps them understand what’s causing the pain.

Imaging Studies

Imaging studies are key to making a diagnosis. X-rays check for bone problems. Ultrasound and MRI (Magnetic Resonance Imaging) show soft tissues like tendons and bursae in detail.

Ultrasound lets doctors see how tendons and joints move. MRI gives a full view of the shoulder, spotting inflammation or tears.

Differential Diagnosis Considerations

Differential diagnosis means figuring out which condition is causing the symptoms. For shoulder pain, doctors look at many possibilities, like bursitis or tendonitis.

They study the patient’s history, what they find during the exam, and imaging results. This careful process helps find the right diagnosis and treatment.

Treatment Approaches for Shoulder Bursitis

Managing shoulder bursitis well needs a treatment plan that covers all angles.

Conservative Management Options

First, we try conservative management for shoulder bursitis. This includes:

• Rest and changing activities to not make it worse
• Ice to lessen swelling and pain
• Compression bandages for support
• Keeping the arm up to cut down swelling

Medication and Injection Therapies

Medicines and injections are key in managing shoulder bursitis symptoms.

• NSAIDs to cut down pain and swelling
• Corticosteroid shots for big relief from swelling

Physical Therapy Protocols

Physical therapy is vital for getting the shoulder back to normal.

• Stretching to boost flexibility
• Strengthening to support the shoulder
• Manual therapy for better recovery

Comparison of Treatment Approaches:

Treatment Approach	Benefits	Potential Risks
Conservative Management	Avoids invasive procedures, reduces inflammation	May not work for severe cases, needs patience
Medication and Injections	Quick relief, cuts down swelling	Possible side effects, might need ongoing use
Physical Therapy	Improves function, strengthens muscles	Needs dedication, might be uncomfortable at first
Surgery	Works for chronic or severe cases	Is invasive, needs time to heal, risks involved

When Surgery Might Be Necessary

Surgery is an option when other treatments don’t help or if bursitis is long-lasting.

• Bursectomy to take out the inflamed bursa
• Fixing any underlying issues that cause bursitis

Treatment Approaches for Shoulder Tendonitis

Dealing with shoulder tendonitis requires a mix of rest, rehab, and sometimes advanced treatments. The aim is to cut down inflammation, ease pain, and get the shoulder working right again.

Rest and Activity Modification

The first step in treating shoulder tendonitis is to cut down or stop activities that make it worse. Giving the tendon a break lets the swelling go down and starts the healing. This might mean changing your daily routine or taking breaks to rest your shoulder.

Anti-inflammatory Strategies

Using anti-inflammatory methods is key in managing shoulder tendonitis symptoms. Nonsteroidal anti-inflammatory drugs (NSAIDs) can help lessen pain and swelling. Sometimes, corticosteroid shots are suggested for stronger anti-inflammatory effects.

Rehabilitation Exercises

Rehab exercises are vital for getting the shoulder strong and flexible again. A physical therapist will create a custom exercise plan. This plan will include stretches and strength-building exercises that fit your specific needs.

Advanced Treatment Options

If shoulder tendonitis doesn’t get better with basic treatments, more advanced options might be looked at. These could include PRP therapy, ultrasound, or sometimes surgery to fix damaged tendons.

Treatment Approach	Description	Benefits
Rest and Activity Modification	Avoiding activities that aggravate the condition	Reduces inflammation, allows tendon healing
Anti-inflammatory Strategies	Use of NSAIDs or corticosteroid injections	Reduces pain and inflammation
Rehabilitation Exercises	Personalized exercise program for strengthening and flexibility	Restores shoulder function, improves strength
Advanced Treatment Options	PRP therapy, ultrasound therapy, or surgical intervention	Effective for cases not responding to conservative management

When to Consult a Specialist

If you’re dealing with ongoing shoulder pain, knowing when to see a specialist is key. At first, symptoms might seem minor. But, some signs mean it’s time to get expert help.

Red Flag Symptoms

Some symptoms need quick attention from a specialist. These include:

• Severe pain that makes daily tasks hard or keeps you awake
• Pain that starts suddenly after an injury
• Big swelling or bruises around the shoulder
• Arm or hand weakness or numbness
• Can’t move your shoulder or has lost range of motion

Spotting these red flags early can stop more harm and help your treatment.

Failed Conservative Treatment

If rest, ice, and pain meds don’t help much, it’s time to see a specialist. They have better tools and treatments for your specific problem.

Choosing the Right Specialist

For shoulder issues like bursitis and tendonitis, you might see an orthopedic doctor, sports medicine specialist, or PM&R doctor. The best one for you depends on your condition’s severity and what you need.

What to Expect at Your Appointment

At your visit, the specialist will ask about your health and do a physical check. They might also do X-rays or an MRI to confirm what’s wrong. Then, they’ll create a treatment plan just for you, which could include new therapies or surgery if needed.

Knowing what to expect can reduce stress and help you get the most from your visit.

Conclusion

Knowing the difference between shoulder bursitis and tendonitis is key for managing shoulder pain well. Recognizing symptoms and causes helps find the right treatment. This way, people can ease their pain.

Getting a proper diagnosis is the first step to feeling better. Self-checks can spot problems, but a doctor’s diagnosis is needed to know for sure. Then, treatments like rest, physical therapy, and medicine can be chosen to fit the issue.

Rehabilitation is important to avoid pain coming back and to heal fully. Strengthening muscles and improving joint movement helps. Places like Om Physio Plus Nutrition have the tools and advice for good shoulder care.

Being proactive about shoulder health and getting help when needed helps manage pain. This way, people can keep their shoulders working well.

FAQ

References

1. Varacallo, M., et al. (2023). Rotator cuff tendonitis – StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK532270
2. Rees, J. L., & Lewis, J. S. (2021). Shoulder pain diagnosis, treatment and referral. BMJ Open Sport & Exercise Medicine, 7(1), e001012. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7905504