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Biceps Tendinitis at the Elbow

What is biceps tendinitis (at the elbow)?

Biceps tendinitis is a condition that causes pain and degeneration in the biceps tendon, which attaches the biceps muscle to the radius bone at the elbow. The biceps muscle is responsible for bending the elbow and rotating the forearm.

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Who is affected by biceps tendinitis?

Biceps tendinitis can affect people of all ages, but it is most common in adults between the ages of 30 and 50. It is also more common in people who participate in activities that require repetitive overhead movements, such as tennis, baseball, gym weights and swimming. It is also seen with activities such as using a screw-driver.

Other risk factors for biceps tendinitis include:

  • A history of elbow injuries

  • Diabetes

  • Obesity

  • Age-related changes in the tendons

What are the main symptoms of biceps tendinitis at the elbow?

 

The main symptom of biceps tendinitis at the elbow is pain at the front of the elbow. The pain may be worse with activity, especially activities that involve overhead lifting or reaching, bending of the elbow and rotation. Other symptoms of biceps tendinitis at the elbow may include:

Tenderness at the front of the elbow

Weakness in the elbow

How is biceps tendinitis diagnosed?

Biceps tendinitis is usually diagnosed based on a physical exam and the patient's medical history. The doctor will ask about the patient's symptoms and activities. The doctor will also examine the elbow for pain, tenderness, and range of motion limitations. Imaging tests, such as X-rays, ultrasound or MRI scans, may be required to rule out other causes of elbow pain. Under ultrasound assessment it is possible to see thickening and structural change within the tendon, as well as fluid seen surrounding the tendon towards its insertion at the radius bone.

How is biceps tendinitis treated?

 

Treatment for biceps tendinitis typically focuses on relieving pain and progressively strengthening the muscle and tendon. Non-surgical treatments are often effective. Non-surgical treatments may include:

  • Rest:

    Avoiding activities that aggravate the pain
  • Ice

    : Applying ice to the elbow for 10-15 minutes
  • Over-the-counter pain relievers:

    Over-the-counter pain relievers, such as ibuprofen, paracetamol or naproxen, can help to relieve mild to moderate pain.
  • Physiotherapy:

    Physiotherapy can help to improve range of motion and strengthen the muscles around the elbow to compensate for the weakened tendon.
  • Corticosteroid injections:

    Corticosteroid injections can be used to reduce inflammation and pain in the biceps tendon.

At The Joint Injection Clinic, these injections are performed after a thorough consent process, whereby the risk and benefits of the procedure are discussed in detail with your doctor.  The experienced medical doctor will then place you in a seated position.  The front of the elbow is cleaned using a cleaning solution to ensure that the procedure is performed under sterile conditions.  The tendon sheath injection is performed with a small dose of steroid and local anaesthetic.

The injection itself is normally completed within 30-60 seconds, after which a plaster is applied and post-injection advice is given.  The patient is advised to look out for any signs of infection, specifically to check whether the local area becomes red, hot, tender, swollen or if they develop a fever.  If this occurs then the patient is asked to contact the clinic immediately at which time a formal reassessment will occur and if needed oral antibiotics can be prescribed.  The patient is also warned that following any injection they may notice a short-term worsening or flare in their symptoms after the local anaesthetic has worn off (4-5 hours).  This may last for 3-5 days and the patient is advised to consider icing of the area using an ice pack for 10-15 minutes every hour as required.

If non-surgical treatments are not effective, surgery may be an option. Surgery for biceps tendinitis at the elbow may involve:

  • Arthroscopic debridement:

    This minimally invasive surgery involves removing damaged tendon tissue.
  • Biceps tenotomy:

    This surgery involves cutting the biceps tendon from the radius bone. This surgery is usually only performed if the tendon is severely damaged or cannot be repaired.

Additional tips for managing biceps tendinitis at the elbow pain:

  • Use a brace or sling to support the elbow and limit movement, particularly during periods when the pain is bad.
  • Avoid activities that aggravate the pain, such as overhead lifting and reaching.
  • Gradually increase range-of-motion exercises as pain allows.

If you are experiencing pain and stiffness in your elbow, it is important to see a doctor to get a diagnosis and discuss treatment options. With early diagnosis and treatment, most people with biceps tendinitis at the elbow can recover fully and return to their normal activities.