Bicep tendonitis is a condition caused by inflammation or irritation of the tendon situated in the upper arm, just beneath the shoulder bone. This tendon connects the biceps muscle to the shoulder bones. This type of tendonitis often indicates its presence by pain and weakness at the front of the shoulder. The primary method of treatment is rest (as with most overuse injuries). However, in extreme cases that do not respond to rest, the patient may have to consider surgery to correct the problem by repairing the tendon.
Bicep tendonitis is a fairly rare overuse condition that is more likely to develop as the patient ages. It occurs mainly following vigorous or unaccustomed exercise of the shoulder. If the patient has a job that requires repetitive overhead movements, the risk of developing the condition increases.
The bicep is a large muscle situated at the front of the upper arm between the shoulder and elbow. Its main anatomical function is the flexing and supination of the forearm Supination is the movement whereby the forearm is rotated so that the palm of the hand is facing upwards (when the person is standing up with the elbow flexed to 90 degrees).The biceps tendon connects this muscle to the shoulder. It is this tendon that becomes irritated or inflamed when bicep tendonits develops.
In general, a tendon is a piece of tissue that connects a muscle to its adjacent bone. Tendonitis refers to any condition in which a tendon may become inflamed or irritated. Tendonitis (including of the bicep) is primarily an overuse condition. It is commonly accompanied by rotator cuff tears.
The classical presentation is a dull ache in the anterior shoulder. This is often accompanied by tenderness and weakness at the front of the shoulder. The patient may find that these symptoms worsen when he or she performs overhead lifting or other activity.
The pain of bicep tendonitis may also move down along the upper arm bone to the elbow over time. In severe cases, the patient may also experience an occasional snapping sound or feeling in the shoulder.
Bicep tendonitis is usually diagnosed based on the clinical symptoms. However, ultrasound and/or magnetic resonance imaging (MRI) are occasionally indicated where there is diagnostic uncertainty or as a guide to a therapeutic intervention.
As treatment, your doctor will likely suggest that you abstain from any overhead work for a while to give your bicep tendonitis a chance to recover spontaneously. Ice and/or heat treatment can be recommended as well. These conservative measures are usually sufficient to bring about resolution of the condition. NSAIDs may also be suggested to ease the pain while the tendon heals. Examples for NSAIDs include ibuprofen (advil, motrin) and naproxen (aleve). Physical therapy to strengthen the shoulder and bicep muscles will help to reduce the risk of recurrence of the condition.
A corticosteroid injection into the affected shoulder joint sometimes alleviates symptoms if the above-mentioned measures are ineffective. It needs to be mentioned that the use of steroid injections is associated with a certain risk of post-injection tendon rupture.
If these conservative treatment options do not work, your doctor may suggest surgery to correct your bicep tendonitis. Only a small minority of cases of biceps tendonitis require surgical intervention. The specialist may perform this surgery either arthroscopically or via an open incision. In arthroscopic surgery, a specialist will insert a small camera into your shoulder joint. He or she will then use the images from the camera to repair the tendon using miniature surgical instruments.
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