Biceps Tendinitis

Biceps tendinitis is inflammation or irritation of the upper biceps tendon, which is a cord-like structure that connects the biceps muscle to the bone in the shoulder socket. These tendons attach the biceps muscle, which is in the front of the upper arm, to the shoulder blade bone.

What is Tendinitis in the Biceps?

When the long head of the biceps tendon becomes inflamed it is called biceps tendinitis. In its early stages, the tendon is swollen and inflamed which, as it develops, causes the tendon sheath to thicken and, later, create a dark red color. The damage the tendon takes from the inflammation can cause a partial or complete tear and may result in a deformity in the upper arm.

Tendinitis in the biceps usually develops alongside other shoulder problems, specifically damage to the rotator cuff tendons, and sometimes also:

  • Shoulder impingement
  • Tears in the glenoid labrum
  • Chronic shoulder instability (shoulder dislocation)
  • Arthritis of the shoulder joint

Biceps Tendinitis Symptoms & Causes

Symptoms of biceps tendinitis include:

  • Tenderness or pain in the front of the shoulder, worsening with overhead lifting or activity
  • Hearing an occasional snapping sound or sensation in the shoulder
  • Ache or pain felt moving down the upper arm bone

Damage to the biceps tendon is usually due to everyday wear and tear that has built up over time, weakening the tendons and causing them to degenerate. This normal wear and tear can be made worse by overuse such as from sports like swimming, tennis, and baseball, or jobs with repetitive overhead motions. Other biceps tendinitis causes include:

  • Rotator cuff tears
  • Osteoarthritis
  • Dislocated shoulder (chronic shoulder instability)

Biceps Tendinitis Treatment & Diagnosis

To diagnose tendinitis in the biceps, a healthcare provider will assess the shoulder for range of motion, strength, and signs of shoulder instability, and discuss symptoms. They may also order imaging tests, such as:

  • X-ray to see problems with the shoulder joint
  • MRI or Ultrasound: to see any issues with the biceps tendon in greater detail

There are several treatment options for a patient with biceps tendinitis:

  • Resting the affected arm and avoiding activities that cause pain
  • Applying cold packs for twenty minutes, several times a day, to help with swelling
  • NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen, aspirin, and naproxen to reduce pain and swelling
  • Steroid injects, like cortisone, to relieve pain and calm inflammation
  • Physical therapy to strengthen and stretch the biceps to restore range of motion and improve strength in the shoulder
If nonsurgical and conservative approaches fail to improve the tendinitis or other shoulder problems have developed, a healthcare provider may recommend surgery. Procedures for biceps tendinitis are usually arthroscopically performed, using a small instrument called an arthroscope and miniature surgical instruments. The surgery can be performed to repair biceps tendons, which is rare, or remove sections of the biceps that are damaged before the remaining tendon is reattached to the upper arm bone. This operation is called biceps tenodesis and it often resolves the symptoms and restores normal function.

Another surgery, called tenotomy, is used when the biceps tendon is so damaged that it cannot be repaired. When this is the case, the surgeon may release the damaged biceps tendon from its attachment.

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