Biceps tendinopathy is a condition characterized by pain and impaired function of the tendon in the front, upper portion of the biceps muscle.
Patients often confuse this condition with biceps tendinitis. However, tendinitis specifically refers to inflammation in the tendon, which is not a component of tendinopathy. Biceps tendon pain typically co-occurs with other orthopedic injuries, including underlying bursitis or rotator cuff (shoulder) problems.
Causes of Biceps Tendinopathy
Tendinopathy typically develops from overuse or as the result of wear and tear over time. It is also common in athletes and those who perform repetitive lifting or overhead movement in their work or other daily activities. The risk of this condition increases with age.
Although people of any age can develop this condition, tendinopathy in the biceps is most common in older patients, swimmers, baseball players, and those who use a computer mouse for many hours each day. Tendinopathy can also develop as the result of rheumatic disease.
Symptoms and Diagnosis of Biceps Tendinopathy
The most common symptoms of biceps tendinopathy are tenderness or pain in the shoulder that increases at night or with lifting, pulling or overhead motion. Patients may experience pain or an ache in the upper arm that radiates downward along the bone. Occasional snapping or popping sensations may be felt or heard inside the shoulder.
To diagnose this condition, the doctor will begin by taking a detailed medical history and manually manipulating the shoulder to evaluate pain levels, strength and range of motion. The doctor may recommend X-rays; however, ultrasound imaging may be more beneficial for diagnosis. Dr. Engelen specializes in performing in-office diagnostic and sports ultrasound.
Although an MRI may provide additional insight, this procedure is not typically necessary for diagnosing tendinopathy in the biceps.
Biceps Tendinopathy Treatment
A conservative approach is typically recommended for the initial treatment of biceps tendon pain. This includes limiting lifting, reaching and overhead motion, including throwing or serving tennis balls. Ice may be applied to reduce swelling, and the doctor may prescribe a course of nonsteroidal anti-inflammatory drugs (NSAIDs).
Physical therapy may also be recommended to increase strength, mobility and flexibility. Ultrasound treatments can support this approach. Physical therapy may also be helpful for correcting biomechanical deficits.
For those patients who do not respond well to physical therapy alone, anesthetic, corticosteroid can be effective. Additionally, Dr. Engelen may alternatively recommend regenerative medicine injections, such as Platelet-Rich Plasma (PRP).
However, if a less invasive approach to treatment is not effective, surgical intervention may be necessary if pain persists or returns. Arthroscopic or an open surgery may be used, depending on the degree and type of damage present.
After treatment, therapeutic rehabilitation and occupational therapy can build strength, restore functionality and help prevent recurrence of biceps tendinopathy.