Biceps Tendinopathy

What is biceps tendinopathy?

Biceps tendinopathy is a condition that causes pain at the front of the shoulder in the biceps tendon.

The biceps tendon is sensitive to overdoing things especially in those doing repetitive lifting, reaching, or throwing.  This can lead to biceps tendinopathy or in severe cases tears of the upper biceps tendon. The condition can be confused with other tendinopathies around the shoulder such as rotator cuff tendinopathy, and to add further confusion, it can occur at the same time as other conditions affecting the shoulder and can also itself be caused by other conditions such as impingement, instability or arthritis.

How is biceps tendinopathy diagnosed?

As with many tendinopathies the diagnosis can usually be made after an assessment of the patient including an examination.  The pain is located exactly over the tendon and is aggravated by lifting and turning movements of the forearm.  The pain often occurs at the start of a movement and some people describe the shoulder becoming weak with continuing activity.  Tenderness over the biceps tendon is typical on examination and there are a number of special tests that can be done in the clinic to confirm the diagnosis.

Ultrasound or MRI scanning can be used to confirm the diagnosis, or more usually to exclude other conditions.

How is biceps tendinopathy treated?

The starting point is an appropriate exercise programme together with icing and avoidance of activities that aggravate the problem.

What if these treatments don’t work?

Further treatments are then considered.  We prefer to use a diagnostic local anaesthetic in these cases to confirm that this temporarily eliminates the pain before using shock wave therapy.  In the very few cases that this is not effective, key-hole surgery to decompress the tendon is needed.

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