Tendinitis vs. Arthritis: How to Tell the Difference

Key Takeaways

• Tendinitis affects tendons (connecting muscle to bone); arthritis affects joints
• Tendinitis pain is often sharp and worsens with specific movements; arthritis pain is deeper and more constant
• Tendinitis usually results from overuse and heals with rest; arthritis is chronic and progressive
• Both can occur together, especially in older adults
• Accurate diagnosis determines effective treatment
• Recovery timelines differ significantly: weeks for tendinitis vs. ongoing management for arthritis

When your joint hurts, knowing whether you’re dealing with tendinitis or arthritis can be confusing. Both cause pain around joints, both can limit your activities, and both are common. But they’re fundamentally different conditions with different causes and treatments.

This guide helps you understand the distinctions so you can have informed conversations with your healthcare provider and get appropriate treatment.

Understanding the Anatomy

What Are Tendons?

Tendons are strong, fibrous cords that attach muscles to bones. When a muscle contracts, the tendon pulls on the bone to create movement. You can often feel tendons as firm bands just under the skin—the Achilles tendon at your ankle is a familiar example.

What Are Joints?

Joints are where two bones meet. They’re made up of:

• Cartilage (cushioning the bone ends)
• Synovium (lining that produces lubricating fluid)
• Ligaments (connecting bone to bone for stability)
• Joint capsule (enclosing the joint)

The Difference

Tendinitis: Inflammation of the tendon itself—a structure that crosses over or near a joint but isn’t part of the joint.

Arthritis: Problems within the joint—damage to cartilage (osteoarthritis) or inflammation of the joint lining (inflammatory arthritis).

Comparing Symptoms

Pain Location

Tendinitis:

• Pain is localized along the tendon
• Often felt just outside the joint
• Point tenderness when you press on the tendon
• Pain follows the path of the tendon

Arthritis:

• Pain feels deeper, within the joint itself
• Harder to pinpoint exactly where it hurts
• Tenderness around the entire joint
• May feel like the bones are “grinding”

Pain Character

Tendinitis:

• Often sharp or burning
• Worst during specific movements that load the tendon
• May be intense during activity, then subside
• Might feel better with gentle movement (improved blood flow)

Arthritis:

• Usually aching or throbbing
• More constant (though may worsen with activity)
• Often worse after periods of inactivity
• May have sharp moments when the joint “catches”

When Pain Occurs

Tendinitis:

• Triggered by specific activities
• Often sudden onset after overuse
• Better with complete rest of that activity
• May have morning stiffness but loosens quickly

Arthritis:

• Present even without specific activity
• Gradual onset over months to years (OA) or may fluctuate (inflammatory)
• Never completely goes away
• Morning stiffness may last 30+ minutes (especially inflammatory arthritis)

Physical Signs

Tendinitis:

• Swelling along the tendon (not always visible)
• Warmth over the tendon
• Possible crepitus (creaking sensation) when moving
• The tendon may feel thickened

Arthritis:

• Swelling within the joint
• Joint may appear enlarged (bony enlargement in OA, soft swelling in inflammatory)
• Warmth over the joint (especially inflammatory arthritis)
• Reduced range of motion
• Possible deformity over time

Common Types and Locations

Common Tendinitis Types

Shoulder:

• Rotator cuff tendinitis
• Biceps tendinitis
• Pain with reaching, especially overhead

Elbow:

• Tennis elbow (lateral epicondylitis)—outer elbow
• Golfer’s elbow (medial epicondylitis)—inner elbow
• Pain with gripping and wrist movements

Wrist:

• De Quervain’s tenosynovitis (thumb side)
• Pain with thumb and wrist movement

Hip:

• Gluteal tendinopathy
• Pain on outer hip, worse with walking or lying on that side

Knee:

• Patellar tendinitis (“jumper’s knee”)
• Pain just below the kneecap

Ankle:

• Achilles tendinitis
• Pain at the back of the heel

Common Arthritis Locations

Osteoarthritis commonly affects:

• Knees
• Hips
• Base of thumb
• End joints of fingers
• Big toe
• Spine (neck and lower back)

Rheumatoid arthritis commonly affects:

• Small joints of hands and feet
• Wrists
• Multiple joints symmetrically

Causes and Risk Factors

What Causes Tendinitis?

Primary cause: Overuse

• Repetitive motions
• Sudden increase in activity
• Improper technique
• Inadequate rest between activities

Risk factors:

• Age (tendons become less flexible)
• Occupation (repetitive movements)
• Sports (especially without proper conditioning)
• Poor posture or biomechanics
• Tight or weak muscles
• Some medications (certain antibiotics)

What Causes Arthritis?

Osteoarthritis:

• Wear and tear over time
• Previous joint injury
• Excess body weight
• Genetics
• Joint abnormalities
• Age

Inflammatory arthritis (RA, etc.):

• Autoimmune dysfunction
• Genetics
• Environmental triggers
• Smoking (for RA)

Getting the Right Diagnosis

When to See a Doctor

See a healthcare provider if:

• Pain persists for more than 2 weeks despite rest
• Severe pain or significant swelling
• Inability to use the joint normally
• Symptoms are getting worse
• You’re unsure what’s causing your pain

What to Expect at Your Appointment

Medical history:

• When pain started
• What makes it better or worse
• Activity level and changes
• Previous injuries
• Family history of arthritis

Physical examination:

• Range of motion testing
• Palpation of specific structures
• Strength testing
• Special tests to stress specific tendons

Imaging:

• X-rays: Show bone changes (arthritis), may be normal in tendinitis
• Ultrasound: Excellent for visualizing tendons
• MRI: Shows soft tissue detail including tendons and cartilage

Blood tests:

• Not useful for tendinitis or osteoarthritis
• Important for inflammatory arthritis (RF, anti-CCP, inflammatory markers)

Treatment Approaches

Treating Tendinitis

Rest and activity modification:

• Avoid the aggravating activity
• Don’t immobilize completely—gentle movement helps healing
• Gradual return to activity

Ice:

• 15-20 minutes several times daily
• Reduces inflammation

Anti-inflammatory medications:

• NSAIDs (ibuprofen, naproxen) for 1-2 weeks
• Topical NSAIDs may help with fewer side effects

Physical therapy:

• Stretching the affected tendon
• Eccentric strengthening exercises (very effective)
• Addressing underlying biomechanical issues

Other treatments:

• Bracing or splinting (temporarily)
• Corticosteroid injection (for persistent cases)
• PRP injections (emerging treatment)
• Shock wave therapy

Treating Arthritis

Osteoarthritis:

• Exercise (crucial—strengthens supporting muscles)
• Weight management
• Physical therapy
• Pain medications (acetaminophen, NSAIDs)
• Hyaluronic acid injections
• Corticosteroid injections
• Joint replacement (if severe)

Inflammatory arthritis:

• Disease-modifying drugs (DMARDs)
• Biologic therapies
• Exercise
• Physical therapy
• Joint protection strategies

Key Differences in Treatment

Aspect	Tendinitis	Arthritis (OA)
Rest	Critical initially	Complete rest not recommended
Timeline	Weeks to months	Ongoing management
Cure	Usually heals completely	Managed, not cured
Injections	Limited (1-2)	Can be repeated periodically
Surgery	Rarely needed	Joint replacement option

Can You Have Both?

Yes, and it’s common. Several scenarios:

Osteoarthritis plus tendinitis:

• Altered joint mechanics from arthritis stress nearby tendons
• Common in hips (arthritis plus gluteal tendinopathy)
• Common in knees (arthritis plus patellar tendinopathy)

Inflammatory arthritis with tendinitis:

• Some inflammatory conditions (like psoriatic arthritis) directly affect tendons (enthesitis)
• Inflammation can spread from joints to tendons

Age-related changes:

• Both tendons and joints become more vulnerable with age
• Someone over 50 may have mild OA plus tendinitis

If you have features of both, treatment needs to address each component.

Recovery and Prognosis

Tendinitis Recovery

Typical timeline:

• Mild cases: 2-4 weeks
• Moderate cases: 6-12 weeks
• Chronic tendinitis: Several months

Full recovery is typical with proper treatment and gradual return to activity.

Recurrence is common if:

• Return to activity too quickly
• Don’t address underlying causes
• Don’t maintain flexibility and strength

Arthritis Progression

Osteoarthritis:

• Chronic and typically progressive
• Rate varies widely between individuals
• Many people manage well with conservative treatment
• Some eventually need joint replacement

Inflammatory arthritis:

• Variable course depending on type and treatment
• Modern treatments can achieve remission
• Early aggressive treatment prevents joint damage

Frequently Asked Questions

Can tendinitis become arthritis?

Not directly. Tendinitis doesn’t turn into arthritis. However, severe, untreated tendinitis can alter how you use a joint, potentially contributing to abnormal wear over time. The conditions are different but can coexist.

Why does my doctor call it tendinopathy instead of tendinitis?

“Tendinitis” implies acute inflammation, while “tendinopathy” is a broader term that includes chronic degenerative changes without active inflammation. Many “chronic tendinitis” cases are actually tendinopathy—the tendon is damaged but not actively inflamed.

I’ve had tendinitis for months—is that normal?

Tendinitis that persists for months may actually be tendinopathy requiring different treatment (more emphasis on strengthening, less on anti-inflammatories). It’s also worth confirming you don’t have underlying arthritis or another condition.

Can I prevent tendinitis?

Yes, often:

• Warm up before activities
• Progress exercise gradually
• Maintain flexibility and strength
• Use proper technique
• Take breaks during repetitive tasks
• Address biomechanical issues

If I have arthritis, am I more likely to get tendinitis?

Possibly. Arthritis can alter joint mechanics, putting extra stress on tendons. People with arthritis may also modify their movement patterns to avoid pain, inadvertently stressing tendons abnormally.

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Learning about joint conditions? Explore our guides on bursitis, osteoarthritis vs. rheumatoid arthritis, or visit our conditions hub.

Last medically reviewed: February 2025

Medical Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. If you’re unsure whether you have tendinitis or arthritis, please consult a healthcare provider for proper evaluation.