Pain with movement, not at rest
Tendonitis tends to hurt most when the tendon is loaded: lifting the arm, climbing stairs, pushing off the foot. Bursitis can ache even sitting still if the bursa is compressed.
Bursitis & tendonitis · North Waterfront & Telegraph Hill
Bursitis and Tendonitis Treatment in San Francisco
Shoulder, elbow, hip, knee and heel pain from an overloaded tendon or an irritated bursa. Our chiropractors treat the tissue and the mechanics that caused it, without medication or surgery.
5.0 from 273 Google reviews · Mon to Fri, 8am to 6pm · No referral needed
Symptoms
Signs of bursitis or tendonitis
Both show up as pain near a joint that gets worse with repeated use, but the pattern is a little different for each. Most people have a mix of these.
A specific tender spot
Pressing directly over the tendon or the bursa reproduces the pain, which is one of the more reliable ways we tell the two apart.
Swelling or warmth over a joint
Bursitis in the elbow, knee or shoulder can visibly puff up. A tendon rarely swells this way unless it has partially torn.
Stiffness after rest
Getting up after sitting, or the first few minutes after waking, often feel worse before they loosen up.
Weakness or a catching sensation
A tendon that has been overloaded for a while can feel like it is giving way, especially in the shoulder or the knee.
Pain that built up gradually
Unlike a sprain, most tendonitis and bursitis has no single injury moment. It builds over weeks of repetitive load.
The basics
What is the difference between bursitis and tendonitis?
A bursa is a small fluid-filled sac that cushions a joint. Tendonitis is irritation of a tendon, the cord that connects muscle to bone. Both are usually caused by the same thing, repeated friction or load on a joint, and both respond to a similar approach: find out what is overloading the area and correct it, not just quiet the pain.
Common causes we see
- A repetitive motion at work or in a sport (throwing, typing, lifting overhead)
- A sudden jump in training volume or intensity
- Poor joint mechanics elsewhere in the chain shifting load onto one spot
- Prior injury that never fully resolved
- Age-related changes in tendon elasticity
Choosing a provider
Who treats bursitis and tendonitis?
Chiropractor
Looks at the joint mechanics and movement pattern feeding the irritation, and combines hands-on treatment with a loading plan so the tendon or bursa can settle and stay settled.
Physical therapist
Builds supervised strengthening and mobility programs, often used alongside chiropractic care for a more complete recovery.
Orthopedist
A good next step for severe or persistent cases, especially if imaging or a steroid injection is being considered.
Primary care doctor
Can rule out other causes, order imaging, and prescribe anti-inflammatory medication if appropriate.
Sports medicine physician
Specializes in overuse injuries in active people and can coordinate between other specialists.
The question we get most
Should I rest it, or keep moving?
Neither extreme works well on its own. Total rest lets the tendon or bursa calm down, but a tendon that never gets loaded again actually gets weaker and more prone to flaring the next time you use it. Pushing straight through sharp pain just keeps re-irritating the area.
What works is a measured middle path: reduce the specific motion that is provoking it, keep everything else moving normally, and reintroduce load to the tendon in small controlled doses as it improves. That is where a specific plan matters more than general advice.
What to expect
Your first visit
1
History and movement screen
We ask how and when it started, then watch how the joint moves to find the pattern that is loading the tendon or bursa.
2
Hands-on exam
Palpation and a few provocative tests pinpoint the exact structure involved and rule out a tear or fracture.
3
A working diagnosis
You leave the first visit knowing what is actually irritated and why, not just that something hurts.
4
First treatment
Usually a combination of manual therapy, soft tissue work, and guidance on what to avoid for the next few days.
5
A plan with a timeline
Most mild cases improve over two to six weeks with consistent care. We tell you what to expect and when to check back in.
Seek urgent care if you notice
- Fever or chills along with joint swelling (possible infected bursa)
- A joint that is hot, red, and significantly swollen
- Inability to move the joint at all, or a visible deformity
- Numbness or loss of circulation in the limb
Weighing your options
Bursitis and tendonitis treatment options, compared
There is no single right answer. Here is how the common paths actually compare.
Rest and ice alone
- Low cost, no appointment needed
- Often eases mild, early-stage pain
- Does nothing to fix the underlying mechanical cause
- Pain frequently returns once activity resumes
Chiropractic care
- Addresses the joint mechanics driving the overload
- Combines manual therapy with a loading plan
- Non-invasive, no medication involved
- Usually needs a series of visits, not a single fix
Physical therapy
- Strong evidence base for guided strengthening
- Good for building long-term resilience
- Can be slower to relieve acute pain on its own
- Often works best paired with manual therapy
Anti-inflammatory medication
- Fast, accessible pain relief
- Useful short-term alongside other care
- Does not address the mechanical cause
- Not meant for long-term, repeated use
Common sites
Where it tends to show up
Shoulder
Rotator cuff tendonitis and subacromial bursitis from overhead work or swimming.
Elbow
Tennis and golfer’s elbow, among the most common tendon overuse injuries.
Hip
Trochanteric bursitis on the outside of the hip, common in runners.
Knee
Patellar tendonitis, often called jumper’s knee.
Heel and ankle
Achilles tendonitis and related heel pain from running or sudden activity increases.
Wrist and hand
Overuse tendonitis from repetitive gripping or typing.
Why it lingers
Why rest alone often does not fix tendon pain
Tendons heal slowly because they have a limited blood supply compared to muscle. Resting stops the irritation from getting worse, but it does not correct whatever mechanical imbalance put the extra load on that tendon in the first place, a stiff joint nearby, a weak muscle group, or a movement habit.
That is why the same injury so often comes back once a person returns to their normal activity. Lasting relief usually means correcting the mechanics and gradually rebuilding the tendon or bursa's tolerance to load, not just waiting for a flare to pass.
Related conditions
You might also be dealing with
Where to find us
Two San Francisco locations
North Waterfront
50 Francisco Street, Suite 257, San Francisco, CA 94133
(415) 421-1115
Telegraph Hill
150 Lombard Street, San Francisco, CA 94111
(415) 421-1115
FAQ
Common questions
What is the difference between bursitis and tendonitis?
A bursa is a fluid-filled cushion near a joint, while a tendon connects muscle to bone. Bursitis is inflammation of the bursa, and tendonitis is irritation of a tendon. Both are usually caused by repetitive friction or overload near a joint.
How long does bursitis or tendonitis take to heal?
Mild cases often improve within two to six weeks with consistent care. More chronic or severe cases can take several months, especially if the underlying mechanical cause is not addressed.
Can a chiropractor help with tendonitis?
Yes. Chiropractic care addresses the joint mechanics and movement patterns that are overloading the tendon, often combined with soft tissue work and a graded loading program.
Should I rest completely or keep moving?
Neither extreme is ideal. Reduce the specific motion that provokes pain while keeping everything else moving, and reintroduce load gradually as the tissue improves.
What causes bursitis and tendonitis?
Common causes include repetitive motion at work or in sport, a sudden increase in training load, poor joint mechanics elsewhere in the body, prior injury, and age-related changes in tendon elasticity.
When should I see a doctor instead of waiting it out?
See a doctor urgently if you have fever or chills with joint swelling, a hot red significantly swollen joint, inability to move the joint, or numbness and loss of circulation.
Does Truspine treat shoulder, elbow, knee, and heel tendonitis?
Yes. We regularly treat rotator cuff tendonitis, tennis and golfer’s elbow, patellar tendonitis, Achilles tendonitis, and trochanteric bursitis at both San Francisco locations.
What treatments does Truspine use for bursitis and tendonitis?
Depending on the case, we use chiropractic adjustment, active release technique, Graston technique, shockwave therapy, dry needling, laser therapy, custom orthotics, and a home loading program.
Get the actual cause looked at.
Not another round of rest and hoping it goes away.