Tendonitis:
is the term applied to inflammation of a tendon. Tendons can become inflamed after being damaged in an acute injury or by an episode over-use. Persistent use after the initial injury leads to chronic tendon inflammation

Tendonitis tends to occur in sites where muscles are used repeatedly in day-to-day activities. Common sites are the shoulder ( tendonitis of the long head of the biceps; supraspinitus tendonitis), the elbow (biceps tendon) the fingers and thumbs (flexor and extensor tendons). In flexor tendons in the hands, the synovial covering ( sheath) of the tendon is also inflamed and the condition is then termed “tenosynovitis”.

Involvement of the flexor tendons of the fingers and the thumb may result in thickening of the tendon and the formation of a localised nodule in the tendon. This may lead to a triggering or snapping action as the nodule passes under the fibrous tendon “sling” with movement; hence the term“trigger finger/thumb”. Tendons may also be inflamed where it is inserted to bone. The condition is termed “enthesopathy”. A common example is in the heel at the insertion of the archilles tendon; it is termed “tendo-archilles enthesopathy”. Variants of this condition occur in the elbow (tennis and golfer’s elbow) and in the heel (plantar fasciitis).


Tendinous inflammation responds well to acupuncture therapy. The rate of recovery will depend on avoidance of over-use, appropriate exercise and graded activities.

Bursitis:
bursal sac has a lining like an overstretched balloon which has been deflated, with the inside filled with a light lubricant.

This “collapsed” sac is closed, with walls in direct contact with each other, providing friction-free movement between these walls. Apart form a thin film of lubricating fluid, there is no space between the walls of the sac. This sac is found interposed between moving parts of the anatomy where it facilitates movement. It is commonly interposed between tendons and bone, between tendon and skin, between tendons and tendons or between skin and bone.

This potential cavity can become inflamed from acute of chronic injury. The cavity then fills up with fluid and becomes swollen and painful. Common sites for bursitis are the hip (trochanteric bursitis), shoulder (subacromial bursitis), knee (prepatella bursitis), and elbow (olecranon bursitis).

It is interesting to note that lubricating surfaces are not unique to the musculo-skeletal system as they are also present in other parts of the body where movement occurs, e.g. the heart (pericardium) the lungs (pleura) and the abdomen (peritoneum). These structures can also be subject to inflammation, often with more serious consequences.

Bursitis responds well to acupuncture therapy which facilitates resolution of inflammation and promotes healing. It needs to be combined with a graded self-exercise program and modulation of activities to enhance the rate of recovery.
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