
Shoulder Pain: Differences Between Tendinitis and Bursitis
Shoulder pain is a common complaint, affecting individuals of all ages and lifestyles. The shoulder is a complex joint with a wide range of motion, making it susceptible to injury. Two of the most common causes of shoulder pain are tendinitis and bursitis. While these conditions may share similar symptoms and both involve inflammation, they are distinct issues with different causes, treatments, and recovery timelines. Understanding the differences between tendinitis and bursitis is key to proper diagnosis and treatment, allowing for a more effective path to recovery.

What is Tendinitis?
Tendinitis is an inflammation of a tendon, the thick fibrous tissue that connects muscle to bone. Tendinitis in the shoulder most commonly affects the tendons of the rotator cuff, a group of muscles and tendons that stabilize the shoulder. These tendons are essential for overhead movements, such as lifting, reaching, or throwing.
When a tendon becomes overused, injured, or subjected to repetitive motion, it can become inflamed, leading to tendinitis. Tendinitis can also occur due to age-related wear and tear as tendons lose flexibility and elasticity over time. This condition is often the result of repetitive motions, poor posture, or improper techniques during physical activities, especially sports or jobs that require heavy lifting.
Common causes of shoulder tendinitis include:
- Repetitive overhead movements or activities (e.g., throwing, lifting, swimming)
- Poor posture that puts strain on the shoulder
- Direct trauma or injury to the shoulder
- Aging, which causes wear and tear on tendons
What is Bursitis?
Bursitis refers to the inflammation of a bursa, a small, fluid-filled sac that provides cushioning and reduces friction between bones, tendons, and muscles around a joint. In the shoulder, the bursa that is most commonly affected is the subacromial bursa, which lies between the rotator cuff tendons and the acromion (a part of the scapula). The subacromial bursa helps the tendons glide smoothly as the shoulder moves.

Bursitis is also often caused by overuse, repetitive motion, or trauma. However, it can also be triggered by infection, gout, or certain systemic conditions such as rheumatoid arthritis. When the bursa becomes inflamed, it can lead to pain, stiffness, and difficulty moving the shoulder.
Common causes of shoulder bursitis include:
- Repetitive overhead movements or activities: (e.g., throwing, lifting, swimming)
- Direct injury to the shoulder area
- Conditions like rheumatoid arthritis or gout can affect bursa sacs
- Prolonged pressure on the shoulder, such as resting on the elbow for extended periods
How Do Tendinitis and Bursitis Affect the Shoulder?
Both tendinitis and bursitis can lead to significant shoulder pain, but they affect the shoulder in different ways.
- Tendinitis: This condition primarily affects the tendons of the rotator cuff, leading to pain, swelling, and difficulty moving the arm. The pain is often worse with overhead motions or when reaching behind the back. In some cases, the pain may also worsen at night, especially if the shoulder is placed in a position that puts pressure on the affected tendon. Over time, tendinitis can lead to tendon degeneration and tears if not treated properly.
- Bursitis: This condition affects the bursa, causing pain and swelling in the area around the shoulder joint. This pain is often sharp and can radiate along the upper arm. Bursitis may cause discomfort even with minimal movement, and you may experience pain when lying on the affected side. Unlike tendinitis, bursitis is more likely to cause pain with direct pressure on the shoulder, such as when resting on the elbow or sleeping on that side.
Prevention techniques for these conditions are very similar. Make sure you practice proper posture, warm up before workouts/activities, avoid repetitive movement, and practice shoulder strengthening exercises.
Key Differences Between Tendinitis and Bursitis
While these conditions share some similarities in their symptoms, there are distinct differences between the two. Here are the key ways in which tendinitis and bursitis differ:
- Location of Pain:
- Tendinitis: The pain is often localized to the tendon itself, typically around the shoulder joint, and can radiate down the arm. It tends to get worse with specific movements, such as lifting the arm overhead.
- Bursitis: The pain is often located around the outer shoulder, especially near the point of the shoulder, and can radiate along the upper arm. It may worsen with pressure or when the shoulder is at rest.

- Cause of Inflammation
- Tendinitis: Inflammation occurs within the tendon, which can become irritated due to repetitive motion, overuse, or injury. Tendinitis may also result from aging or biomechanical issues that strain the tendons.
- Bursitis: Inflammation affects the bursa, which is a fluid-filled sac that cushions the tendons and bones in the shoulder. Bursitis is often caused by overuse, injury, or systemic conditions like arthritis.
- Range of Motion
- Tendinitis: This condition can lead to a limited range of motion, particularly with movements involving lifting or reaching overhead. The pain may restrict arm movements due to the tenderness of the inflamed tendon.
- Bursitis: This condition can also lead to a decreased range of motion, especially with arm movement or when pressure is applied to the shoulder. The pain may be more constant, even with minor movements.
- Treatment
- Tendinitis: Treatment typically involves rest, ice, anti-inflammatory medications, and physical therapy to strengthen the muscles around the shoulder and improve flexibility. In severe cases, corticosteroid injections or surgery may be necessary.
- Bursitis: This condition is often treated with rest, ice, and anti-inflammatory medications. Physical therapy can also be helpful in addressing any underlying muscle imbalances. If bursitis is caused by an infection, antibiotics may be required. In some cases, fluid may be aspirated from the bursa to relieve pressure and reduce inflammation.
Diagnosing These Conditions: Jacksonville Orthopaedic Institute
Both conditions are diagnosed based on a combination of medical history, physical examination, and imaging tests. During the physical exam, the doctor will assess the range of motion and test for tenderness or swelling around the shoulder. JOI has several physicians who specialize in shoulder injuries and conditions. Contact JOI today to set up an appointment with a shoulder specialist.