How is biceps tendonitis treated?
When chronic symptoms develop or when there is an acute rupture of the long head biceps tendon, medical attention should be sought.
Depending on the severity of the symptoms and results shown by physical examination and imaging tests such as an MRI, Dr. Millett will initiate a treatment plan. In most instances, doctors try to treat biceps tendonitis non-surgically. Even complete ruptures can sometimes do well without surgical treatment. The first step is to rest the shoulder and eliminate all overhead activity. A sling may be required to keep the arm stable and in a resting state. Applying ice, several times a day for about 20 minutes per session, will help reduce swelling and pain; non-steroidal, anti-inflammatory medicines (such as ibuprofen) can also be helpful. After a period of rest, physical therapy may be prescribed with strengthening movements and stretching exercises so that range of motion can be restored in the shoulder.
In many cases surgery is needed to alleviate the chronic pain of biceps tendonitis. Oftentimes, the surgery to treat the biceps will accompany another treatment procedure that is taking place to treat another shoulder problem, most commonly rotator cuff problems. Surgical intervention for the treatment of biceps tendonitis is usually done arthroscopically. During arthroscopic shoulder surgery, Dr. Millett will make small incisions around the shoulder and insert a camera and tiny instruments through the incisions to assess the biceps tendon and to complete the repair. If during the surgery Dr. Millett determines that the damaged section of the biceps tendon is too inflamed, he may disconnect the tendon and reattached the remaining healthy tendon to the humerus (upper arm bone). This procedure, known as a biceps tenodesis, is extremely successful in removing the painful symptoms and restores function for the patient. Dr. Millett has performed over 1000 of these procedures and has had a very high success rate and a very, very low (<1%) severe complication rate.
Surgical Treatment of Chronic Long Head Biceps Ruptures
Most ruptures of the long head biceps tendon can be treated without surgery, although some patients will have persistent cramping and pain associated with the rupture. This can also occur after a surgical procedure called a biceps tenotomy. Some patients are bothered by the slight muscle disfigurement, called a pop-eye deformity. In these cases, there is a surgical option to treat this type of condition. This is called an open biceps tendodesis. Through a small incision, the torn and retracted tendon or muscle is retrieved and pulled up and reattached the humerus. This restores the biceps muscle so it can work properly and eliminates the deformity of the ‘pop-eye’ muscle. Dr. Millett has performed the repair of many chronic ruptures, some of which occurred as many as 25 years earlier.
Results and Rehab
Patients who undergo arthroscopic shoulder surgery for the treatment of biceps tendonitis typically have excellent and predictable results. Dr. Millett believes that the treatment of biceps tendon disorders is among the most satisfying of all the surgical treatments because it is so predictable. Most will regain full range of motion in a few short weeks. Following the rehab protocol and physical therapy regime as set by Dr. Millett will be necessary in order to ensure a successful recovery.
Will Shoulder Tendonitis Go Away On Its Own?
For additional resources on biceps tendonitis, please contact the orthopedic office of Dr. Peter Millett, serving patients in Vail, Aspen and the surrounding Denver, Colorado communities.