Shoulder Biceps Tendinitis

Shoulder biceps tendinitis generally occurs due to repetitive overhead movements, such as lifting, throwing, or reaching. These activities can cause wear and tear on the biceps tendon, leading to inflammation and pain. It can also occur from sudden injury or as part of the aging process.

People with shoulder biceps tendinitis may experience:

• Pain in the front of the shoulder, often worsening with overhead activities
• Tenderness to touch in the front of the shoulder
• A sensation of catching or clicking in the shoulder
• Weakness in the shoulder and arm

Many cases of biceps tendinitis can improve with rest and non-surgical treatments such as anti-inflammatories, physical therapy, or injections. However, severe or chronic tendinitis may require more advanced treatment options such as a surgery to relieve the pain.

Diagnosis of shoulder biceps tendinitis usually involves a physical examination and review of your symptoms and medical history by Dr. Mayo. Imaging tests, such as X-ray or MRI, can provide detailed pictures of the shoulder to confirm the diagnosis.

Treatment for shoulder biceps tendinitis typically starts with non-surgical options:

• Rest and activity modification: Avoid activities that cause pain and allow the inflammation to settle.
• Physical therapy: Specific exercises can help strengthen the muscles around the shoulder and improve flexibility.
• Non-steroidal anti-inflammatory drugs (NSAIDs): These medications can help reduce pain and inflammation.
• Corticosteroid injections: These can provide temporary relief for severe pain, but also can be a definitive treatment in some patients. This is usually performed under ultrasound guidance to get the medication right around the inflamed biceps tendon

When non-surgical treatments fail to provide relief, surgical options may be considered. For biceps tendinitis, the most common two treatments are either a biceps tenotomy, where the biceps is released from its attachment inside the shoulder which helps relieve pain, and a biceps tenodesis, where the tendon is then reattached to a spot on the upper arm or humerus bone.

Surgery for shoulder biceps tendinitis is usually reserved for patients who have severe symptoms that have not improved with non-surgical treatments. The timing of surgery depends on the individual’s symptoms, overall health, and personal preferences. There is no urgency to perform the surgery, as delaying the timing will not alter the surgery performed or the expected outcome.

If surgery is needed, the most common procedure is an arthroscopic biceps tenodesis. During this procedure, the surgeon detaches the inflamed part of the biceps tendon from its original attachment in the shoulder and reattaches it to a different area. This relieves the stress on the damaged tendon and allows it to heal.

Recovery from surgery for biceps tendinitis depends on the extent of the injury and the individual’s health. Typically, a period of immobilization is followed by a gradual program of physical therapy to restore strength and range of motion. Most patients can expect to return to their regular activities within 3 to 4 months after surgery.