Key Takeaways
- Knee pain causes can be surprisingly similar, but knee bursitis and knee tendonitis (tendinitis) affect different tissues and often feel different day to day.
- Bursitis is inflammation of a small fluid-filled cushion (bursa), often causing visible swelling and tenderness, especially when kneeling.
- Tendonitis symptoms typically center around tendon pain and stiffness, often worsening with activity and improving with rest (at least early on).
- Overuse, repetitive motion, sudden increases in activity, and biomechanical strain can trigger both conditions, making accurate diagnosis of knee pain essential for proper recovery.
- Persistent swelling, difficulty bearing weight, or pain that disrupts work, exercise, or sleep is a sign to consult a specialist rather than guessing “tendonitis or bursitis.”
- Interventional Pain & Spine Center in Wexford, PA, provides comprehensive knee pain evaluation and personalized treatment, led by Dr. Mohammad Ali (triple board-certified in clinical neurophysiology, pain management, and neurology).
Why These Two Conditions Get Confused
If you’ve ever Googled “tendonitis or bursitis,” you’ve probably noticed the symptom overlap: pain with movement, tenderness around the knee, stiffness, and trouble exercising. The difference is where the inflammation is happening.
- A bursa is a small sac filled with fluid that reduces friction between skin, bone, tendons, and other tissues. When it’s irritated, it can swell and feel warm or “puffy.”
- A tendon is a tough band that connects muscle to bone. When irritated, it can become painful with motion, loaded activity (stairs, squats, running), or repetitive strain
Because both structures live close together around the knee, the discomfort can feel like it’s coming from the same spot—especially without a hands-on exam.
Knee Bursitis Symptoms vs. Tendonitis Symptoms
Here’s a practical way to compare what many patients notice.
Signs that lean toward knee bursitis
You may be dealing with bursitis if you notice:
- A localized “bubble” of swelling (often at the front of the kneecap or inner knee)
- Warmth and tenderness over a specific spot
- Pain that spikes when you kneel, lean on the knee, or apply direct pressure
- Stiffness that feels worse after prolonged kneeling, crawling, or floorwork
Common scenario: “My knee looks swollen and feels sore when I kneel, but walking isn’t always the worst part.”
Signs that lean toward knee tendonitis
You may be dealing with tendonitis if you notice:
- Pain that feels deeper, tighter, or more ‘pulling’ with movement
- Activity-related pain (worse during/after stairs, squats, jumping, running, or long walks)
- Morning stiffness or stiffness after sitting, improving as you warm up
- Tenderness along a tendon path (often below the kneecap with patellar tendon irritation)
Common scenario: “It hurts during workouts or stairs, and it flares afterward. I don’t always see swelling.”
Common Types Around the Knee
Understanding the usual locations helps narrow down the problem.
Common knee bursitis locations
- Prepatellar bursitis (front of the kneecap): often linked to frequent kneeling
- Pes anserine bursitis (inner knee): sometimes related to overuse or alignment issues
- Infrapatellar bursitis (below kneecap): can overlap with tendon pain pattern
Common knee tendonitis locations
- Patellar tendonitis (“jumper’s knee”): pain below the kneecap, often tied to jumping, squats, stairs
- Quadriceps tendon irritation: pain above the kneecap where the quad tendon attaches
- Tendon overload can also appear alongside hip/ankle mechanics that shift stress into the knee.
Causes and Risk Factors for Each Condition
What causes knee bursitis?
Knee bursitis often develops when the bursa is repeatedly irritated. Common triggers include:
- Repetitive kneeling (flooring, construction, gardening, cleaning)
- Direct impact (a fall or bump onto the kneecap)
- Overuse and friction from repetitive movement
- Underlying inflammatory conditions (like certain forms of arthritis)
- In some cases, infection can irritate a bursa, especially if there’s a nearby cut or skin brea
Risk factors: frequent kneeling, jobs with pressure on the knees, prior knee irritation, and activities with repeated contact or stress.
What causes tendonitis?
Tendonitis is usually driven by overload—either too much volume or the wrong kind of load. Common causes include:
- Sudden increase in activity (new workouts, longer runs, more stairs)
- Repetitive motion without enough recovery
- Strength imbalances (quad/hamstring weakness, hip stability issues)
- Poor mechanics (form issues, alignment, footwear changes)
- Aging-related tendon changes + repeated stress
Risk factors: repetitive training, high-impact sports, inconsistent conditioning, and movement patterns that overload the tendon.
Diagnostic Methods to Differentiate the Two
Because symptoms overlap, diagnosing knee pain properly saves time—and prevents a cycle of “rest it, flare it, repeat.”
A specialist evaluation often includes:
- History and pattern review
When did it start? What makes it worse? Is swelling visible? Does pressure matter more than movement? - Physical exam
Pinpointing tenderness location, checking range of motion, strength, stability, and how the pain behaves during specific movements. - Imaging when appropriate
- Ultrasound can sometimes help visualize soft-tissue irritation and swelling.
- MRI may be used for persistent symptoms or when other injuries are suspected.
- Rule-outs for infection or other conditions
Significant redness, warmth, fever, or rapidly increasing swelling needs urgent attention
Treatment Options for Bursitis and Tendonitis
First-line home and conservative care (often helpful for both)
- Relative rest and activity modification (reduce aggravating movements)
- Ice for short-term symptom control
- Gentle mobility and progressive strengthening (often guided by PT)
- Short-term anti-inflammatory strategies when appropriate and safe for you
The key difference is what you strengthen and how you progress load.
Bursitis-focused treatment strategies
- Offloading pressure (knee pads, avoiding kneeling)
- Treating swelling and inflammation
- In stubborn cases, a clinician may consider targeted interventions based on exam findings
- If infection is suspected, urgent medical treatment is required
Tendonitis-focused treatment strategies
- Progressive tendon loading (often eccentric or heavy-slow resistance protocols)
- Fixing training errors (volume, intensity, recovery)
- Addressing contributing mechanics (hip strength, ankle mobility, gait form)
- Bracing or taping in select cases
When Interventional Pain & Spine Center May Be a Fit
If your pain isn’t improving—or you’re stuck guessing between tendonitis or bursitis—a targeted evaluation can provide clarity.
At Interventional Pain & Spine Center in Wexford, PA, your plan may include:
- A thorough evaluation of knee pain causes, including bursitis and tendinitis
- Personalized treatment planning that may include conservative care guidance, physical therapy coordination, and interventional options when appropriate
- A philosophy that aims to address pain at the source rather than relying on medication as the only tool
- Access to advanced diagnostics and a neurology-informed approach when symptoms suggest nerve involvement
Treatment Comparison Table
| Treatment Option | Primary Goal | When It’s Used |
|---|---|---|
| Activity Modification + Rehab Guidance | Reduce aggravation and rebuild strength | Early and mid-stage bursitis/tendonitis |
| Targeted Injections (when appropriate) | Reduce localized inflammation/pain | Persistent symptoms limiting rehab progress |
| Nerve Blocks (select cases) | Interrupt pain signaling / clarify pain source | When pain patterns suggest nerve contribution |
| Medication Management (supportive) | Short-term relief while treating the source | When clinically appropriate as part of a broader plan |
When to Consult a Specialist for Persistent Knee Pain
Consider scheduling an evaluation if you have:
- Pain that lasts longer than a week or two without improvement
- Visible swelling that persists or keeps returning
- Trouble walking, bearing weight, or doing stairs
- A knee that “gives way” or feels unstable
- Redness, fever, or rapidly worsening warmth/swelling
Searching “knee specialist near me” is common—but the best next step is choosing a clinic that can evaluate the full picture and build a plan that fits your goals and lifestyle.
Evidence-Based Knee Pain Treatment in Wexford, PA
Whether your symptoms match tendonitis symptoms, classic bursitis swelling, or something in between, you don’t have to self-diagnose. The right evaluation can confirm what’s driving your pain and outline the most efficient path forward, so you can return to activity with confidence.
Ready to stop guessing and start treating the real cause? Schedule an appointment with Interventional Pain & Spine Center in Wexford, PA.
Frequently Asked Questions
How can I tell if I have tendonitis or bursitis?
Bursitis is more likely if you see localized swelling and pain with direct pressure (like kneeling). Tendonitis is more likely if pain flares with activity and feels tight or sharp along a tendon pathway.
What are common tendonitis symptoms in the knee?
Knee tendonitis symptoms often include pain below or above the kneecap during stairs, squats, running, jumping, and stiffness after rest that eases as you warm up.
Do knee pain causes like bursitis and tendonitis require imaging?
Not always. Many cases can be identified with a focused exam. Imaging may be recommended if symptoms persist, worsen, or if other injuries are suspected.
What should I avoid if I think I have knee bursitis?
Avoid kneeling and direct pressure on the swollen area. If your job requires kneeling, consider protective pads and schedule an evaluation if swelling persists.
When should I see a knee specialist near me?
If pain, swelling, or stiffness doesn’t improve with rest and basic measures—or if walking/weight-bearing becomes difficult—it’s time to see a specialist for a clear diagnosis and plan.
