What is biceps tendinopathy? — Biceps tendinopathy is a condition that can cause pain in the front of the shoulder. Doctors use the term "biceps tendinopathy" when people have a problem with their biceps tendon. The biceps is the muscle in the front of the upper arm (figure 1). Tendons are strong bands of tissue that connect muscles to bones. In people with biceps tendinopathy, a tendon in the shoulder called the "long head biceps tendon" is most often affected.
In most people with biceps tendinopathy, the tendons are not inflamed or swollen. If they do get inflamed or swollen, doctors call it "tendinitis."
What causes biceps tendinopathy? — This condition can happen as people get older, especially if they do a lot of work or activity with their arms overhead. Tendinitis can happen if people hurt their upper arm or shoulder, or do the same movements over and over.
What are the symptoms of biceps tendinopathy? — The most common symptoms are:
Pain in the front of the shoulder – The pain is usually worse at night and with lifting, pulling, or reaching overhead.
Trouble moving the upper arm and shoulder
People with tendinitis can also have swelling.
Sometimes, an injured tendon tears. This can cause a sudden "pop," pain, bruising, or swelling.
Will I need tests? — You might. Your doctor or nurse will talk with you and do an exam. They might also do an imaging test, such as an ultrasound or MRI scan. Imaging tests create pictures of the inside of the body.
How is biceps tendinopathy treated? — Most of the time, this condition will get better on its own, but it can take weeks to months to heal completely. For the first few days or weeks of your symptoms, you can try the following steps to see if you feel better:
Rest your arm and shoulder – Avoid lifting or reaching overhead. Try to keep your arm down, close to, and in front of your body. If you find you need to keep your arm still and close to your body for a while, do some pendulum swings (described below) from time to time. This will help keep you from getting too stiff.
Ice the painful area – Put a cold gel pack, bag of ice, or bag of frozen vegetables on the injured area every 1 to 2 hours, for 15 minutes each time. This is especially helpful after you do a lot of activity involving your shoulder. Put a thin towel between the ice (or other cold object) and your skin.
Take medicine to reduce the swelling and pain – To treat pain, you can take acetaminophen (sample brand name: Tylenol). Your doctor might also recommend that you take a "nonsteroidal antiinflammatory drug" or "NSAID." NSAIDs are a group of medicines that includes ibuprofen (sample brand names: Advil, Motrin) and naproxen (sample brand names: Aleve, Naprosyn).
If your symptoms don't improve with these treatments, your doctor or nurse might recommend that you have physical therapy (work with an exercise expert). They might also recommend that you do exercises at home. The following shoulder exercises can help stretch your shoulder and keep it from getting too stiff:
Pendulum swing – Let your arm relax and hang down, while you sit or stand. Move your arm back and forth, then side to side, and then around in small circles (figure 2). Try to do this exercise for 5 minutes, 1 or 2 times a day. Your doctor might suggest that you hold a weight in your hand when doing the exercise to make it harder.
Wall walk – Face a wall, and stand close enough so that you can touch the wall with your fingertips. Stretch out your arm, parallel to the floor, and put your fingertips on the wall. Then walk your fingers up the wall until you feel mild soreness or aching. Keep your shoulders level (do not shrug them). Try to do this exercise for 5 minutes, 2 or 3 times a day (picture 1).
When you do these exercises, it's important to:
Warm up your shoulder first by taking a hot shower or bath, or putting a heating pad on it.
Start slowly and make the exercises harder over time.
Know that some soreness is normal. If you have sharp or tearing pain, stop what you're doing and let your doctor or nurse know.
What if my symptoms don't get better? — If your symptoms don't get better, talk with your doctor or nurse about other possible treatments, such as:
Getting a shot of medicine into the painful area
When will I be able to do my usual activities again? — You can return to your usual activities when you are able to move your arm in all directions without pain. To avoid hurting yourself, restart your activities or sports slowly.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 16297 Version 7.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.