Biceps Tendonitis

synonyms: biceps tenosynovitis, biceps tendinosis, long head of biceps tendonitis

Biceps tendinitis is an inflammation or irritation of the biceps tendon. Biceps tendinitis may occur from inflammatory arthritis, osteoarthritis, osteochondromatosis, osteophytes (bone spurs) in bicipital groove, rotator cuff pathology, or biceps instability. The biceps tendon contains a large network of sensory and sympathetic nerve fibers which can lead to significant pain in the shoulder. Patients with biceps tendonitis generally have pain in the front of the their shoulder which can radiate towards the elbow and can even reach the hand.

    Treatment options for Biceps tendonitis include both operative and nonoperative treatments. Nonoperative treatment includes NSAIDs, activity limitations, physiotherapy, and corticosteriod injections. Operative treatment options include biceps tenotomy or biceps tenodesis. Biceps tenotomy is a release of the biceps tendon insertion inside the shoulder. This has very good outcomes in terms of pain relief with little to no functional limitations. Patients who have a biceps tenotomy can develope asymmetry in the biceps muscles with a buldge biceps muscle near the elbow. Biceps tenodesis moves the insertion of the biceps tendon outside of the shoulder. This decreases the risk of a buldge in the arm, but requires a longer rehab program after surgery. Most biceps lesions are associated with other inciting pathology which must be corrected at surgery as well. Surgery is generally done arthroscopically.

    Potential complications of surgery include but are not limited to: Cosmetic deformity (buldge in distal arm) if rupture occurs, Pain, Weakness, Infection, Shoulder stiffness, CRPS, Nerve or vascular injury, Hematoma, DVT/PE, Risks of anesthesia including heart attack, stroke and death. Complications from surgery are infrequent and the majority of patients are satisfied with the outcomes of surgery for biceps tendonitis.

    Further information about Biceps tendonitis can be found at the following sites:

    Every person and their particular circumstances are different so the treatment for your shoulder may be different than those discussed. Please read this information carefully. Write down any questions that you have about your shoulder and its treatment and discuss them with Dr. Grutter. Working together you and Dr. Grutter will determine the best treatment for you.
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