BICEPS TENDON PAIN
Biceps
Tendonitis
Biceps tendonitis is a common cause of pain in the front of the shoulder. The biceps tendon can become inflamed, irritated, unstable, or damaged, often causing pain with lifting, reaching, curls, overhead activity, or rotation of the arm.
Front Shoulder Pain
Inflamed Or Damaged Tendon
Often Starts Conservatively
Tenodesis When Needed
What Is Biceps Tendonitis?
The long head of the biceps tendon travels from the upper arm into the shoulder joint. It can become inflamed or painful where it passes through the front of the shoulder or where it attaches near the labrum.
Biceps pain often overlaps with other shoulder problems, including rotator cuff tears, labral tears, arthritis, and shoulder instability.
Dr. Streit's Clinical Perspective
The biceps tendon is a common pain generator, but it is rarely evaluated in isolation. When patients have pain in the front of the shoulder, I look carefully for associated rotator cuff, labral, instability, or arthritis problems before recommending treatment.
Common Symptoms
Front Shoulder Pain
Pain is often located in the front of the shoulder near the biceps groove.
Pain With Lifting
Lifting objects away from the body may reproduce symptoms.
Pain With Curls
Biceps curls or resisted elbow flexion may become painful.
Pain With Rotation
Turning a doorknob, reaching, or rotating the arm may cause discomfort.
Clicking Or Catching
Mechanical symptoms may occur when labral pathology is present.
Night Pain
Inflammation can make sleep uncomfortable.
Treatment Options
Activity Modification
Reducing painful lifting or repetitive activity can calm symptoms.
Physical Therapy
Therapy can improve shoulder mechanics and reduce stress on the tendon.
Anti-inflammatory Treatment
Medication or selected injections may reduce inflammation when appropriate.
Address Associated Problems
Rotator cuff, labral, or arthritis problems may need to be treated as part of the plan.
Biceps Tenodesis
When symptoms persist, the tendon can be moved out of the joint and secured to the arm bone.
Individualized Decision
Treatment depends on symptoms, exam, imaging, activity goals, and associated pathology.
When Is Biceps Tenodesis Considered?
Biceps tenodesis is considered when the biceps tendon remains a persistent source of pain despite appropriate nonsurgical treatment, or when biceps pathology is found during surgery for another shoulder condition.
What I Tell My Patients
"The biceps tendon can be a major source of front shoulder pain. If it is clearly causing symptoms and conservative treatment has failed, biceps tenodesis can be a very reliable way to remove that pain generator while preserving arm function."
Related Resources
Front Shoulder Pain With Lifting?
A focused shoulder evaluation can determine whether your pain is coming from the biceps tendon, rotator cuff, labrum, arthritis, or another shoulder condition.
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