Bicep tendonitis is inflammation or irritation of the tendon connecting your bicep muscle to the shoulder or, less commonly, the elbow. It often results from repetitive motion or overuse, particularly overhead arm movements. This condition can cause pain and weakness, making daily tasks difficult. Recognizing symptoms and understanding diagnostic methods can help guide appropriate care.
Recognizing Symptoms of Bicep Tendonitis
Bicep tendonitis often causes pain or tenderness in the front of the shoulder, which may extend down the upper arm. This discomfort worsens with overhead activities, lifting, or reaching backward. The pain can be a dull ache or a sharp sensation.
Other indicators include weakness in the affected arm or shoulder, and sometimes a snapping or clicking sensation within the shoulder joint. The area directly over the bicep tendon may also feel tender to the touch. Pain may worsen at night, especially if sleeping on the affected side.
Simple Home Tests for Bicep Tendonitis
While not definitive, certain simple actions can provide an initial indication of bicep tendonitis. One test involves extending your arm straight out in front with your palm facing upwards, as if holding a cup of soup. While maintaining this position, try to resist someone gently pushing your arm downwards. Increased pain or tenderness in the front of your shoulder, particularly in the bicep groove, suggests bicep tendonitis.
Another self-assessment involves resisted bicep flexion. Bend your elbow to about a 90-degree angle, keeping your upper arm close to your side, and try to curl your forearm upwards while applying gentle resistance with your other hand. Pain or weakness during this motion, especially in the front of your shoulder or upper arm, suggests bicep tendonitis. Additionally, gently pressing along the bicep groove, the indentation on the front of your upper arm, can reveal localized tenderness.
Professional Diagnostic Methods
When seeking professional evaluation, a healthcare provider will conduct a thorough physical examination. This involves assessing the shoulder’s range of motion, strength, and stability. The doctor may also palpate, or gently press on, the front of the shoulder directly over the bicep tendon to identify areas of tenderness. Specific orthopedic tests are performed to help isolate the source of pain.
Two commonly used tests are Speed’s Test and Yergason’s Test. For Speed’s Test, the patient extends their arm forward with the palm up, and the examiner applies downward pressure while the patient resists; pain in the bicipital groove indicates a positive result. Yergason’s Test assesses the long head of the biceps tendon by having the patient flex their elbow to 90 degrees and then externally rotate their forearm against resistance, with pain in the bicipital groove indicating bicep tendonitis. Imaging studies are also used; while X-rays primarily visualize bones and can rule out other issues, magnetic resonance imaging (MRI) or ultrasound can provide detailed views of soft tissues like tendons, revealing inflammation, fraying, or tears.
Differentiating Bicep Tendonitis from Other Conditions
Distinguishing bicep tendonitis from other shoulder or arm conditions is important for accurate treatment. For example, rotator cuff tears can present with similar shoulder pain, but involve sharp, piercing pain, particularly with overhead lifting or rotation, and may lead to significant weakness. Shoulder impingement, another common cause of shoulder pain, occurs when tendons or bursa are pinched within the shoulder joint, exacerbated by repetitive overhead movements. The pain from impingement is more diffuse compared to the localized pain of bicep tendonitis.
Pain originating from the cervical spine, or neck, can also radiate into the shoulder and arm, sometimes mimicking bicep tendonitis. However, cervical radiculopathy, a pinched nerve in the neck, presents with burning or electric-like pain, and arm abduction may relieve symptoms, unlike shoulder pain. A healthcare professional utilizes physical examination findings, specific orthopedic tests, and sometimes imaging to differentiate these conditions, as accurate diagnosis guides the most effective treatment plan.
When to Seek Professional Medical Help
While mild cases of bicep tendonitis may improve with rest, ice, and over-the-counter pain relievers within a few weeks, professional medical attention is advisable in certain situations. If pain persists, worsens, or significantly interferes with daily activities such as lifting or overhead motions, consulting a healthcare provider is recommended. Persistent symptoms that do not respond to self-care within six weeks warrant an evaluation.
It is also important to seek immediate medical attention if you experience sudden, sharp pain, hear a distinct popping or snapping sound, or notice a visible bulge in your upper arm or shoulder. These signs indicate a more severe injury, such as a bicep tendon tear, which may require different management. A medical professional can accurately diagnose the condition and develop a tailored treatment plan.