Tendinitis and bursitis are similar inflammatory conditions, but tendinitis affects tendons and bursitis affects bursae. Tendons are the strong white cords of connective tissue that attach muscle to bone.

Some are covered by a sheath which produces lubricating synovial fluid for the tendon's easy gliding movement. Tendinitis often involves inflammation of both tendon and the surrounding sheath. (If the sheath alone is inflamed the condition is known as tenosynovitis.)

Bursae are sacs filled with synovial fluid and are located where friction is likely to occur, for example, where the tendons or muscles pass over bony bits. Bursitis commonly occurs in the shoulder, but also in the knee, toes and even bottom. Formerly, bursitis and tendinitis had sensible names such as housemaid's knee, tailor's bottom and miner's elbow, but are now given more formal titles such as 'bursitis of the first metatarsal head', which my Mum calls a bunion. Tennis elbow and golfer's elbow are similar conditions, except that muscle strain is often involved as well as an inflamed tendon.

Why Me?

• Bursitis and tendinitis are often caused by repetitive movements, which may be work-related or sports-related.
• A bacterial or viral infection may trigger a bout of either condition.
• Rheumatoid arthritis or other inflammatory conditions may have tendinitis or bursitis as a symptom.

What To Do

Diet

• Avoid foods which increase inflammation including sugar, coffee, alcohol, white flour and red meat.
• A diet similar to that recommended for osteoarthritis will help the chronic sufferer. (See Arthritis, Osteoarthritis.)
• Mucopolysaccharides are an integral component of synovial fluid, the lubricating substance in bursae and surrounding tendons. Foods containing mucopolysaccharides include oysters, tripe, shellfish, oatmeal, aloe vera, slippery elm, pig's trotters, wheatgerm, okra, cactus, comfrey and shark cartilage. Drink an anti-inflammatory juice daily made from fresh carrot, celery and a few sprigs of parsley.

Herbs and Supplements

• See Indispensable
• Vitamin C speeds the repair of tissue, particularly collagen, which is important in tendons. Take up to 6 g daily.
• Gotu kola is a herb that helps regenerate connective tissue.
• Quercetin is a wonderful anti-inflammatory bioflavonoid. In the initial stages take plenty: 6-8 tablets daily, for three or four days. Then bring the dose down to 1-2 daily.
• Take the homoeopathic Ruta grav 30C: four doses daily for seven days.
• Evening primrose oil (3 g a day for several months) together with a spoonful of cold pressed linseed oil will ease a longstanding problem.
• If there is swelling present, take bromelain or digestive enzymes three times daily between meals.
• Coenzyme Q10 will improve circulation to this avascular (without many blood vessels) tissue.
• For the long-term problem, two or three times a week, massage cod liver oil over the affected part, wrap with plastic wrap, then a towel, then a hot pack. Rest for 20 minutes.

Other Steps

• During acute pain practise the RICE recommendations. (See Sprain.)
• It is important to exercise the affected area, unless extremely inflamed, in which case movement will only make things worse. Seek guidance from a physiotherapist or osteopath about which movements will improve things, and about which movements to avoid.
• Acupuncture is often helpful for these conditions.
• TENS (transcutaneous electrical nerve stimulation) is a technique used by some physical therapists. Some people respond marvellously to this.
• Ultrasound, a form of high frequency sound vibration, is used to heat an area, increase blood supply and improve drainage. It is often used a day or two after the initial injury.
• Musicians and sports people who suffer tendinitis benefit from the Feldenkrais system and Alexander Technique, methods that encourage better posture. Drink an anti-inflammatory juice daily made from fresh carrot, celery and a few sprigs of parsley.

At a glance

Good food

Mucopolysaccharide foods, fruits and vegetables, carrot/celery/parsley juice.

Food to avoid

Sugar, alcohol, white flour, coffee, red meat.

Remedies to begin

EPO, vitamin C, acupuncture, quercetin, bromelain, Co Q10, Alexander Technique, RICE.

Lifestyle

Avoid doing what gave it to you in the first place. Or learn how to do that movement without causing strain.

MindBody

What is irritating you? Who or what is causing friction in your life?