"Itis" vs. "Osis"

You have most likely heard of an “itis” condition, such as Rheumatoid arthritis, tendonitis or plantar fasciitis. However, what you probably haven’t heard of are “osis” conditions, which are actually much more common. Hopefully this will help shed some light onto why you should know the difference between the two. To start, let’s define what they are:

  • “Itis”: Signifies an inflammatory process, with the cardinal signs of inflammation being present (pain, heat, redness, swelling, and loss of function). This is usually the result of some type of trauma, and a biopsy of the tissue would show inflammatory mediators present.
  • “Osis”: Signifies a degenerative process. This is usually caused by age or overuse, and a biopsy of the tissue would show degenerative changes with NO inflammatory mediators.






Now the tricky thing is that most “itis” conditions are actually “osis” conditions – creating a misnomer. “Osis” conditions are MUCH more common than an “itis” condition – meaning that the majority of tendinitis cases are actually tendinosis ones. This can be deceiving for someone trying to treat it on their own, since treatments between the two conditions differ. The goal for treating an “itis” is to decrease the inflammation – think ice (like an Ice Wrap) and anti-inflammatories (such as Circumin Phytosome), whereas the goal for an “osis” is to stimulate collagen deposition and orientation – think scraping tools (like this one), collagen supplementation, and rehab exercises.

So, when trying to treat a condition that falls into one of these categories, it’s important to first figure out whether you’re dealing with an “itis” or an “osis”. From there, you can tailor the treatment accordingly and maximize the healing!

Below is a general game plan for treating both types of conditions at home. Remember that they are notoriously chronic, so giving them their due diligence is important. Stay consistent on treating it for a bit to get on top of it! Once you do, it will be much easier to maintain.


“ITIS” CONDITIONS: (Inflammatory)

  1. Avoid Aggravating Factors:
    1. Anything that brings your pain level above a 4 out of 10, or causes the area to swell up.
  2. Maintain A Daily Anti-Inflammatory Routine:
    1. Ice for 5-10min (Wrap)
    2. Supplements (like Circumin Phytosome)
  3. Work Range-of-Motion:
    1. Move the area around in circles, staying in the pain-free range


“OSIS” CONDITIONS: (Microtears/Degeneration)

  1. Avoid Aggravating Factors:
    1. Anything that brings your pain level above a 4 out of 10
  2. Maintain A Daily Collagen Deposition / Joint-Support Routine:
    1. Lightly scrape the area (with a tool like THIS)
    2. Supplements (like Glucosamine, Chondroitin Sulfate, Collagen)
  3. Work Range-of-Motion:
    1. Move the area around in circles, staying in the pain-free range
  4. Work Stability
    1. For Hands/Wrists/Elbows/Shoulders: Movements like Waiter’s Carries and Farmer’s Walks
    2. For Hips/Knees/Ankles: Movements like Standing Leg Marches and Single-Leg Hinges



Do you want to learn about how tendons heal and what you can do to maximize it? Click HERE!


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Written by Dr. Brandon Buchla, DC, CSCS

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